A New Doctor’s View of the Retreat | The Retreat at Sheppard Pratt

A New Doctor’s View of the Retreat

January 11, 2011 —

When I began working at The Retreat in October 2009 it felt like a homecoming of sorts. I had trained at Sheppard Pratt Hospital as a psychiatric resident in the early 1990’s. This was a time of great turmoil in the financing and delivery of mental health care. Insurance companies had determined that comprehensive treatment and extended stay for hospitalized patients, the type of specialized treatment in which Sheppard Pratt Hospital excelled, was “too expensive”. The tsunami of cost cutting measures by insurance companies washed away many of the essentials of quality psychiatric care leaving only the bare bones of treatment.

For many psychiatric residencies, the sea change in mental health care delivery affected training in psychiatry in a parallel way. Washed away in this case was training in conducting psychotherapy. This left the biological perspective on mental illness as the predominant mode of conceptualizing patients. Biological treatments, especially treatment with medication, became established as the predominant treatment.

I chose psychiatric training at Sheppard Pratt because it was one of only a handful of programs that was committed to training their psychiatric residents in psychotherapy as well biological treatments. My goal had been to receive training that would allow me to treat patients in the most comprehensive and most effective way possible. When an opportunity arose last fall to join the staff at The Retreat I was excited by the prospect. The skills I had developed fit in perfectly with the philosophy of The Retreat in which the psychiatrist, as head of the treatment team, is both primary therapist and medication manager to the patients treated there. The variety of resources that can be successfully brought to bear on a patient’s condition is truly remarkable and inspiring. I feel very grateful to be involved in such a high quality program that has such a high level of integrity. The manner in which even patients with highly refractory emotional conditions have been able to significantly benefit has been very gratifying.
Dan Kakuska, M.D.