Where Do You Get Your News?

By Shawn Kennedy, MA, RN, AJN editor-in-chief

I’ve watched the recent political conventions and have been listening to the sound bites one hears on the radio and television news shows. The speakers and newscasters all sound intelligent and righteous and in command of “facts.” However, as we’ve learned from the widespread public misunderstanding of many aspects of the Affordable Care Act, it takes some deeper digging to know what’s “spin” versus what’s fact. (Indeed, fact-checking has become its own political issue, as it seems both parties have been playing a bit loose when it suits their messaging.)

I wonder how many people actually take the time to validate what they hear on the radio or television. Do most people take what they hear at face value? Will many people vote based only on what they heard from the convention coverage or in 30-second news clips (or worse, in the barrage of advertising paid for by the PACs, many of which are quietly funded by industries or wealthy individuals with a stake in who gets elected)?

It occurred to me that I’ve never seen my youngest son or nieces and nephews read a newspaper, yet they seem well-informed about the political issues. I asked my son where he gets his information. He said, “Well, there’s something called RSS feeds . . . .” (He was surprised that I not only knew what they were, but that I use them!) (RSS stands for really […]

If the Patient Doesn’t Understand the Treatment: New Essay by Theresa Brown

Ben’s inability to understand even the basics of his situation, combined with his lack of family support, made it seem that we were in effect imprisoning him and torturing him.

That’s an excerpt from the Reflections essay in the June issue of AJN. By Theresa Brown, a nurse who regularly writes for the New York Times “Well” blog, “Right Treatment, Right Patient?” explores the ethics and emotions involved in providing an unpleasant but potentially life-saving treatment to a patient who can’t understand what’s being done to him (click through to the PDF for the best version).

We hope you’ll read it through and let us know if you’ve ever faced a similar ethical quandary as a health care professional (or, for that matter, as a family member or patient).—JM, senior editor

Psychiatrists as Therapists: A Vanishing Breed

By Maureen Shawn Kennedy, AJN editor-in-chief

In an article in the New York Times on Sunday, writer Gardiner Harris described how many psychiatrists have abandoned psychotherapy in favor of short consultations and pharmacotherapy; if patients want to discuss their problems, they are referred to a therapist. The main driver of this trend is money—with other, cheaper professionals available to provide therapy with comparable results, insurance companies won’t pay the higher fees most psychiatrists charge. So, instead of seeing 50 to 60 patients a week for the traditional 45-minute session on the psychiatrist’s couch, the psychiatrist can see 1,000 or more patients in a 15-minute, “what’s happening? do you need a medication adjustment? see you next week” check-up. As the wife and business manager of the psychiatrist profiled in the article says, “It’s all about volume.” One only hopes that most of the patients take his advice to see a therapist.

In fact, there is a growing body of evidence favoring psychotherapy over medications in mental health, notably in depression. In a recent meta-analysis in the Journal of Nervous and Mental Disease comparing psychotherapy with second-generation antidepressants (SGAs), researchers found that “ [b]ona fide psychotherapy appears as effective as SGAs in the short-term treatment of depression, and likely somewhat more effective than SGAs in the longer-term management of depressive symptoms.” 

And in the March issue of AJN, we report on a study published in the Archives of General Psychiatry, which found that “cognitive therapy combined with […]

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