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Psychiatrists, psychoanalysts, other mental health workers, behavioral scientists, and university medical and neuroscience professionals will benefit from this articulate insider's view of post-World War II psychiatry in Changing American Psychiatry: A Personal Perspective by Melvin Sabshin, M.D. Dr. Sabshin served as Medical Director of the American Psychiatric Association (APA) for 23 years, from 1974 to 1997, during a period of perhaps the greatest change in psychiatry since the World War II produced a dramatic modification of practice.
The author describes in detail two extraordinary periods of change, the first stimulated by laudatory efforts to understand the high rate of psychiatric casualties among World War II veterans and to provide treatment for them. Psychiatry grew quickly during the postwar years, considerably influenced by the immigration of many Central European psychoanalysts. Gradually, however, psychiatry began to weaken its ties to medicine and lost much of its public respect. By the 1970s, postwar optimism had been replaced by widespread concern that psychiatric practice was being dominated by unsubstantiated formulations rather than reliable evidence. Psychiatry was dramatically impacted by enormous pressure for therapeutic accountability exerted by a managed care reimbursement system. The profession recognized the need for a new direction and resolved to change.
In the foreword to the book, current APA Medical Director James H. Scully Jr., M.D., notes that Dr. Sabshin has woven a personal journey of the history of the intellectual conflicts and changes in the field of psychiatry in the post-war era, culminating in the remedicalization of psychiatry and the development of the DSM-III.
Dr. Sabshin encourages psychiatric professionals to change
the field so it can employ an empirically based "bio-psycho-social" model
that has the potential to revitalize the next phase of American psychiatry.
He details how the potential for the future of psychiatry can be enhanced by
today's practicing professionals, stressing the:
• Need to incorporate the rapid developments of neuroscience into a
professional practice that is increasingly integrated with empirically
demonstrated psychological and social influences upon mental illness.
•
Importance on continued research that is fed back into practice and keeps
the professional evidence-based.
• Need of psychoanalysis to make its
beliefs explicit, formulating hypotheses that can be tested scientifically
in order to be employed reliably in evidence-based practice.
This well-crafted historical account describes how the profession has become a more respected and accountable part of medicine and how it scientific credentials have risen as a result. Dr. Sabshin concludes that the use of psychological understanding and psychotherapies must play a major role combined with psychopharmacology in the treatment of psychiatric patients.
In this book, the author takes readers on a journey through psychiatry from the mid to late 1900s by using personal accounts, humor, and historical facts. In doing so, he has created a unique historical perspective on psychiatry.
Changing American Psychiatry is a well-documented insider's view of the changing face of psychiatry during the past half century. It will interest anyone concerned with the history of psychiatry or who wants to understand the past as a guide to dealing with current challenges in mental health care. Consequently it will be of value to both mental health practitioners and public policy makers.
Melvin Sabshin, M.D., was Medical Director of the American Psychiatric Association from 1974 to 1997. Dr. Sabshin studied medicine at Tulane University. After postgraduate training and a research post at Tulane's Department of Psychiatry, he received an appointment at the Michael Reese Hospital in Chicago, a center of psychiatric research and psychodynamically oriented practice, where he completed psychoanalytic training. In 1961 he was appointed Professor and Head of the Department of Psychiatry at the University of Illinois College of Medicine. Dr. Sabshin is an Honorary Fellow of the Royal College of Psychiatrists.
List of Plates
About the
Author
Foreword
Introduction
Acknowledgments
Chapter 1.
Post–World War II Scene in American Psychiatry
Chapter 2. A Pathway to
Psychiatry
Chapter 3. Implicit Preparations for a Leadership Role in
Psychiatry
Chapter 4. Reflections During the Search
Chapter 5.
Clarifying the Mission
Chapter 6. En Route to Equity
Chapter 7.
International Affairs
Chapter 8. Psychoanalysis
Chapter 9. Forensic
Psychiatry
Chapter 10. Evidence-Based Diagnosis and
Treatment
Chapter 11. Psychiatric Research
Chapter 12. Psychiatric
Education
Chapter 13. A Changing Membership
Chapter 14. Annual
Meetings
Chapter 15. Publications
Chapter 16. Governance and
Leadership
Chapter 17. Management of External Relationships
Chapter
18. Social and Community Psychiatry
Chapter 19.
Conclusions
Appendixes:
Appendix 1: Selected Papers
Appendix 1A:
Turning Points in Twentieth-Century American Psychiatry
Appendix 1B: The
Future of Psychiatry
Appendix 2: American Psychiatric Association
Speakers of Assembly of District Branches
Appendix 3: Presidential
Themes for American Psychiatric Association Annual Meetings,
1984–2008
Appendix 4: Officers of the American Psychiatric
Association
Appendix 5: American Psychiatric Association Membership
Figures, 1873–2007
Appendix 6: Presidents of the American Psychiatric
Association
Appendix 7: American Psychiatric Association Organizational
Chart, 2008 and 1986
Appendix 8: American Psychiatric Association Joint
Commission on Government Relations
Appendix 9: Psychiatry Organizations
of Interest
Appendix 10: American Psychiatric Association Assembly Area
Councils by Region
Appendix 11: Comparison of American
Psychiatric
Association Area and District Branch Membership,
2002–2007
Appendix 12: DSM Task Forces and Working Groups
Appendix
13: American Psychiatric Association Medical Directors
Appendix 14:
American Psychiatric Association Governance System
Index