Academic Psychiatry

, Volume 42, Issue 2, pp 228–232 | Cite as

Results from the Field: Development and Evaluation of a Psychiatry Residency Training Rotation in Cognitive-Behavioral Therapies

  • Barbara W. Kamholz
  • Amy E. Lawrence
  • Gabrielle I. Liverant
  • Shimrit K. Black
  • Justin M. Hill
In Brief Report



The goal of this project was to develop and evaluate a new residency training rotation focused on cognitive-behavioral therapies (CBT) and to assess outcomes across multiple domains.


Data are presented from 30 psychiatry residents. Primary learning-related outcomes included content knowledge, self-efficacy, and attitudes and behavioral intentions towards evidence-based psychotherapies (e.g., CBT).


Residents reported significant increases in CBT knowledge, CBT-specific self-efficacy, overall psychotherapy self-efficacy, belief in patient benefit from CBT, and behavioral intention to use CBT. However, there were almost no changes in attitudes towards evidence-based practice more broadly, with one significant finding showing an increase in skepticism towards such practices.


This empirically based example of training program development, implementation, and evaluation appears largely successful and represents one approach for addressing the CBT competency goals outlined by the Accreditation Council for Graduate Medical Education (ACGME) and Milestone Project Guidelines. Despite these initial, positive findings, conclusions should be tempered by limitations of the project design (e.g., the lack of comparison group, absence of objective measures of resident behavioral change, or assessment of the effect of such changes on patient outcomes). Findings highlight the need for continued development and evaluation of training methods in CBT for residency programs.


Residency Training Psychotherapy CBT 


Compliance with Ethical Standards

All procedures performed in this program development project were in compliance with the ethical standards of the VA Boston Healthcare System IRB.

Ethical Considerations

The VA Boston Healthcare System Research and Development IRB is aware of this program development project and has indicated that no official oversight was required. Per VA Boston IRB policy, they have been informed of this manuscript being submitted for publication and have been provided with a copy of it.


On behalf of all authors, the corresponding author states that there is no conflict of interest.

Funding Sources



  1. 1.
    Sackett DL, Rosenberg WM, Gray JM, et al. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312:71. doi: 10.1136/bmj.312.7023.71.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    US Public Health Service, US Department of Health and Human Services, Office of the Surgeon General. (1999). Mental Health: A Report of the Surgeon General. Published 1999. Accessed from September 26, 2016.
  3. 3.
    Nathan PE, Gorman JM, editors. A guide to treatments that work. Fourth ed. New York: Oxford University Press; 2015.Google Scholar
  4. 4.
    Association for Behavioral and Cognitive Therapies – Resources for Professionals and Students – Syllabi – Medical Education. 2015. Accessed from January 12, 2017.
  5. 5.
    Fouad NA, Grus CL, Hatcher RL, et al. Competency benchmarks: a model for understanding and measuring competence in professional psychology across training levels. Train Educ Prof Psychol. 2009;3:S5–S26. doi: 10.1037/a0015832.Google Scholar
  6. 6.
    Klepac RK, Ronan GF, Arnold KD, et al. Guidelines for cognitive behavioral training within doctoral psychology programs in the United States: report of the inter-organizational task force on cognitive and behavioral psychology doctoral education. Behav Ther. 2012;43:687–97. doi: 10.1016/j.beth.2012.05.002.CrossRefPubMedGoogle Scholar
  7. 7.
    Roth AD, Pilling S. Using an evidence-based methodology to identify the competences required to deliver effective cognitive and behavioural therapy for depression and anxiety disorders. Behav Cogn Psychother. 2008;36(02):129–47. doi: 10.1017/S1352465808004141.CrossRefGoogle Scholar
  8. 8.
    Yager J, Bienenfeld D. How competent are we to assess psychotherapeutic competence in psychiatric residents? Acad Psychiatr. 2003;27:174–81. doi: 10.1176/appi.ap.27.3.174.CrossRefGoogle Scholar
  9. 9.
    Sudak DM, Beck JS, Wright J. Cognitive behavioral therapy: a blueprint for attaining and assessing psychiatry resident competency. Acad Psychiatr. 2003;27:154–9. doi: 10.1176/appi.ap.27.3.154.CrossRefGoogle Scholar
  10. 10.
    Sudak DM, Goldberg DA. Trends in psychotherapy training: a national survey of psychiatry residency training. Acad Psychiatr. 2012;36:369–73. doi: 10.1176/appi.ap.11030057.CrossRefGoogle Scholar
  11. 11.
    Muse K, McManus F. A systematic review of methods for assessing competence in cognitive–behavioural therapy. Clin Psych Rev. 2013;33:484–99. doi: 10.1016/j.cpr.2013.01.010.CrossRefGoogle Scholar
  12. 12.
    Aarons GA. Mental health provider attitudes toward adoption of evidence-based practice: The Evidence-Based Practice Attitude Scale (EBPAS). Mentl Hlth Serv Res. 2004;6:61–74. doi: 10.1023/B:MHSR.0000024351.12294.65.CrossRefGoogle Scholar
  13. 13.
    Aarons GA, Glisson C, Hoagwood K, et al. Psychometric properties and US National norms of the Evidence-Based Practice Attitude Scale (EBPAS). Psychol Assessment. 2010;22:356–64. doi: 10.1037/a0021103.CrossRefGoogle Scholar
  14. 14.
    Wright JH, Wright AS, Salmon P, et al. Development and initial testing of a multimedia program for computer-assisted cognitive therapy. Am Journal of Psychother. 2002;56:76–86.Google Scholar
  15. 15.
    Karlin BE, Brown GK, Trockel M, et al. National dissemination of cognitive behavioral therapy for depression in the Department of Veterans Affairs health care system: therapist and patient-level outcomes. J Consult and Clin Psych. 2012;80:707–18. doi: 10.1037/a0029328.CrossRefGoogle Scholar
  16. 16.
    Turkington D, Kingdon D. Cognitive-behavioral techniques for general psychiatrists in the management of psychosis. Brit J Psychiatr. 2000;177:101–6. doi: 10.1192/bjp.177.2.101.CrossRefGoogle Scholar
  17. 17.
    Bennett-Levy J, Padesky CA. Use it or lose it: post-workshop reflection enhances learning and utilization of CBT skills. Cogn Behav Pract. 2014;21:12–9. doi: 10.1016/j.cbpra.2013.05.001.CrossRefGoogle Scholar

Copyright information

© Academic Psychiatry (outside the USA) 2017

Authors and Affiliations

  1. 1.VA Boston Healthcare System and Boston University School of MedicineBostonUSA
  2. 2.Suffolk UniversityBostonUSA

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