PSYCHOTHERAPY PRACTICE AMONG CHILD AND ADOLESCENT PSYCHIATRISTS IN THAILAND
Natchanan Charatcharungkiat, Sirichai Hongsanguansri, CÃ©sar A Alfonso, Silvia W Olarte
Objective: To survey patterns of psychotherapy practice of child and adolescent psychiatrists in Thailand, including identifying obstacles to conduct psychotherapy. Methods: This was a cross-sectional descriptive study. A selfreported questionnaire was developed by the authors and sent to all child and adolescent psychiatrists in Thailand by mail. Results: The total number of child and adolescent psychiatrists in Thailand at the time of the survey was 176. There were 95 respondents (54.0 % response rate), with the average age of 39.7 ± 9.8 years old. 67 (70.5%) respondents were female. Respondents endorsed conceptual frameworks used in case formulation and treatment planning as following: learning and cognitive theory (68.8 %), Eriksonian theory (41.3 %) and attachment theory (34.8%). Only 6.4 % of respondents reported that they provided psychotherapy to their patients “frequently” and “very frequently”. Instead, the majority of respondents provided just only counseling and parenting advice & guidance, parent management therapy (PMT). Respondents estimated that 36.3 ± 24.0 % of their patients should be treated with psychotherapy but in real-life practice, they provided psychotherapy for 5.1 ± 8.6 patients/ week in the past year. Psychotherapies that most children and adolescent psychiatrists used were behavioral therapy, supportive psychotherapy and cognitive-behavioral therapy (73.3 %, 71.8 %, and 56.5% of respondents reported to conduct “frequently” and “very frequently," respectively). Main obstacles in performing psychotherapy were heavy workload, lack of readiness of patients and lack of confidence by child and adolescent psychiatrists. Conclusion: Although psychotherapy is considered an essential treatment in child and adolescent psychiatry practice, child and adolescent psychiatrists in Thailand provide psychotherapy to only a small number of patients. Behavioral therapy, supportive psychotherapy and cognitive-behavioral therapy were the most frequently used psychotherapiesby Thai child and adolescent psychiatrists. Lack of time to engage in psychotherapy due to heavy workload was the most common obstacle in providing this treatment.