Brightwell reflects on 50 years in psychiatry

Brightwell’s psychiatry practice in 2021 little resembled the medical environment 50 years ago. Counseling sessions, collaborative care with a multidisciplinary team of experts, and the latest evidence-based tools gave him options for care that didn’t exist when he began practicing medicine.

Brightwell, who recently retired after nine years with Rosecrance McHenry County, estimated that he touched the lives of more than 35,000 different clients over the years. Working in settings ranging from academia to the military, as well as agencies like Rosecrance, he watched the field take leaps forward in its care of individuals struggling with behavioral health disorders.

“We have a much better understanding with the ways people need to change how they interact with the world in order to do better,” Brightwell said. “For most of human history, once somebody had a substance use disorder, they never got better. Now we have large numbers of people who are successfully living in recovery because of medications and therapy interventions available today.”

Brightwell attributes this success to a transition in counseling philosophies underway by the time he entered medical school at the University of Iowa. While Sigmund Freud’s ideas had dominated the field, research moved beyond a focus on the subconscious into studies of biology and behavior. This transition opened the door to evidence-based practices such as cognitive and dialectical behavior therapy. These therapies, which are used by Rosecrance, focus on finding practical solutions to address issues.

Along with that shift, psychiatrists’ roles changed. Where the healthcare model originally was built around longer comprehensive sessions with fewer individual clients, it is now more common for psychiatrists to specialize in medication management for many, though agencies like Rosecrance may offer more opportunities for one-on-one counseling.

As a physician, innovations that help more people find lasting recovery have been welcome. Because of Rosecrance’s collaborative approach, Brightwell has been able to work closely with clients like he did early in his career, this time with the support of a caring team, and that has produced memorable success stories.

“I’ve seen clients go from a near-disaster of a situation to become thriving, happy people doing things they never thought they would be able to do,” he said. “I can’t tell you how many times I’ve heard clients say someone at Rosecrance changed their life. That is very rewarding.”