Psychotherapy for patients with mental health concerns in primary care

To the Editor of Canadian Family Physician:

The article “Psychotherapy for Patients with Mental Health Concerns in Primary Care” in the October issue of CFP really grabbed our attention! As representatives of the Medical Psychotherapy Association Canada (MDPAC), we were pleased to see the argument being made for more access to physician-delivered psychotherapy as well as more psychotherapy training for family medicine residents.

We thought the authors also might like to know about our organization, as we noted that MDPAC was not mentioned in the article.

MDPAC’s mission is to support and advocate for physician-delivered psychotherapy and mental health care—entirely in accord with the authors’ view. Our national association has roughly 200 physician members, most of whom are family physicians and all of whom practise some psychotherapy (some practise psychotherapy exclusively).

To address a key point of the authors, part of MDPAC’s mandate is to connect and support family physicians eager to pursue additional psychotherapy training. We offer educational programs, including a five-weekend Psychotherapy Training Program comprising experiential learning and supervision, as well as one-hour teaching sessions on a wide variety of psychotherapy-related topics, delivered via an online platform.

MDPAC also provides opportunities for physicians to obtain supervision of their psychotherapy practice. In addition, as psychotherapy work often can be a solo venture—and therefore potentially isolating—we advocate and foster collegial contact. Finally, we keep our eyes on political and bureaucratic factors affecting our members.

We agree with the writers that family physicians are the best-placed professionals to provide psychotherapy, given their long-term pre-existing relationships with their patients. We would like to point out that this service is not insured in the province of British Columbia. BC family physicians are able to bill for “counselling” only a few minutes per patient per year—and in fact psychotherapy billings also may soon be restricted in Ontario. Inadequate or absent remuneration limits the ability of physicians to provide this service equitably throughout Canada. Needless to say, financial factors also influence physicians’ motivation to seek supplemental training.

MDPAC has long advocated for the addition of a CFPC Certificate of Added Competency in Psychotherapy, which we believe would raise the level of physician-delivered psychotherapy across the country.

Once again, well done in addressing a much needed facet of family medicine training. Let’s hope this timely article receives the attention it deserves!

Sincerely,

Caroline King Elizabeth Parsons
President, MDPAC Chair, MDPAC

www.mdpac.ca