Contemporary Practice Patterns of Dynamic Psychiatrists—Survey Results

The authors examine the practice characteristics of dynamic psychiatrists, including the combined use of medication and psychotherapy, and adherence by self-report to psychodynamic, supportive, and cognitive behavioral therapy theoretical principles and techniques. Method: Survey of 555 members of the American Academy of Psychoanalysis and Dynamic Psychiatry conducted in 2009. Results: 24.1% response rate; 75% of respondents were between 61 and 80 years old, 61% had over 30 years of experience; 89% have a private practice but work on an average of 1.6 settings; 39% teach. Most respondents treat patients with complex comorbidities; 92.6% prescribe psychotropic medication. The preferred mode of practice is individual psychotherapy and the preferred frequency once a week; 94.5% of sessions are 45-60 minutes. Using Plakun's Y-model framework, psychoanalysts and dynamic psychiatrist subgroups equally support all core psychotherapy and psychodynamic features, with lesser emphasis but substantial endorsement of cognitive-behavioral psychotherapy features. Conclusions: Dynamic psychiatrists are committed to see most patients once a week for 45-60 minute sessions and use a variety of conceptual frameworks to guide their treatment plans. They endorse supportive and psychodynamic practice elements more than cognitive-behavioral principles.