Abstract
Administrative data from Cigna for 149 somatoform cases were analyzed to determine the cost, number of sessions, dropout rates, and recidivism rates. Comparisons on these outcomes were made between medical doctors, psychologists, master’s nurses, master’s social workers, marriage and family therapists, and professional counselors. Recidivism rates and number of sessions are higher than for other mental health problems. There were no significant difference in total cost by profession, but did indicate a significant difference in cost per session for MDs. Analyses indicate that masters and doctoral level providers produced the same drop out and recidivism rates.
Similar content being viewed by others
References
Allen, L. A., Woolfolk, R. L., Escobar, J. I., Gara, M. A., & Hamer, R. M. (2006). Cognitive-behavioral therapy for somatization disorder. Archives of Internal Medicine, 166, 1512–1518.
American Medical Association. (2006). Current procedural terminology. Chicago: American Medical Association.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. text revision). Washington, DC: American Psychiatric Association.
Barsky, A. J., Orav, E. J., & Bates, D. W. (2005). Somatization increases medical utilization and costs independent of psychiatric and medical comorbidity. Archives of General Psychiatry, 62, 903–910.
Brown, R. J. (2004). Psychological mechanisms of medically unexplained symptoms: An integrative conceptual model. Pyschological Bulletin, 130(5), 793–812.
Crane, D. R., & Payne, S. H. (2011). Individual and family therapy in managed care: Comparing the costs of treatments by the mental health professions. Journal of Marital and Family Therapy, 37(3), 273–289. doi:10.1111/j.1752-0606.2009.00170.x.
De Waal, W. M., Arnold, I. A., Eekhof, J. A. H., & Van Hemert, A. M. (2004). Somatoform disorders in general practice: Prevalence, functional impairment, and comorbidity with anxiety and depressive disorders. British Journal of Psychiatry, 184, 470–476.
Finno, A. A., Michalski, B. H., Wicherski, M., & Kohout, J. L. (2010). Report of the 2009 APA salary survey. APA Center for Workforce Studies. Washington, DC: American Psychological Association.
Hamilton, S., Moore, A. M., Crane, D. R., & Payne, S. H. (2011). Psychotherapy dropouts: Differences by modality, license, and DSM-IV diagnosis. Journal of Marital and Family Therapy, 37(3), 333–343. doi:10.1111/j.1752-0606.2010.00204.x.
Hansen, N. B., Lambert, M. J., & Forman, E. M. (2002). The psychotherapy dose-response effect and its implications for treatment delivery services. Clinical Psychology: Science and Practice, 9(3), 329–343.
Treating somatoform disorders. (2009). Harvard Mental Health Letter, 26(5), 6–7.
Kraft, S., Puschner, B., Lambert, J. M., & Kordy, H. (2006). Medical utilization and treatment outcome in mid- and long-term outpatient psychotherapy. Psychotherapy Research, 16(2), 241–249.
Kroenke, K. (2007). Efficacy of treatment for somatoform disorders: A review of randomized controlled trials. Psychosomatic Medicine, 69, 881–888.
Kroenke, K., Spitzer, R. L., DeGruy, F. V., Hahn, S. R., Linzer, M., Williams, J. B., et al. (1997). Multisomatoform disorder: An alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. Archives of General Psychiatry, 54(4), 352–358.
Kroenke, K., & Swindle, R. (2000). Cognitive-behavioral therapy for somatization and symptom syndromes: A critical review of controlled clinical trials. Psychotherapy and Psychosomatics, 69(4), 205–215.
Limpert, E., Stahel, W., & Abbt, M. (2001). Log-normal distributions across the sciences: Keys and clues. BioScience, 51(5), 341–352.
Real, P. M., Rodriguez-Arias, P. M. L., Cagigas, V. J., Apariciao Sanz, M. M., & Real Pérez, M. A. (1996). Brief family therapy: An option for the treatment of somatoform disorders in primary care. Atencian Primaria, 17, 241–246.
Roca, M., Gili, M., Garcia-Garcia, M., Salva, J., Vives, M., Garcia, J. C., et al. (2009). Prevalence and comorbidity of common mental disorders in primary care. Journal of Affective Disorders, 119(1–3), 52–58.
Sumathipala, A. (2007). What is the evidence for the efficacy of treatments for somatoform disorders? A critical review of previous intervention studies. Psychosomatic Medicine, 69(9), 889–900.
Tazaki, M., & Landlaw, K. (2006). Behavioural mechanisms and cognitive-behavioural interventions of somatoform disorders. International Review of Psychiatry, 18(1), 67–73.
Wierzbicki, M., & Pekarik, G. (1993). A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice, 24(2), 190–195. doi:10.1037/0735-7028.24.2.190.
Acknowledgments
The authors would like to express appreciation to our collaborators who made this project possible: Jodi Aronson Prohofsky, Ph.D., LMFT Former Senior Vice President of Operations, Cigna, now Head of Operations at Bloom Health, Anthony G. Massey, MD, MBA, Senior Medical Director, Cigna, and David Bergman, J. D., Former Director of Legal and Government Affairs at AAMFT, now VP of Legal & External Affairs & Chief Legal Officer, National Board for Certified Counselors.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Crane, D.R., Morton, L.B., Fawcett, D. et al. Somatoform Disorder: Treatment Utilization and Cost by Mental Health Professions. Contemp Fam Ther 34, 322–333 (2012). https://doi.org/10.1007/s10591-012-9182-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10591-012-9182-x