Psychotherapy Training for Residents: Reconciling Requirements With Evidence-Based, Competency-Focused Practice
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The Accreditation Council for Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) changed the training requirements in psychotherapy, moving toward evidence-based therapies and emphasizing competence and proficiency as outcomes of training. This article examines whether the therapies selected for training are evidence based and the authors review research concerning methods for training and assessment that effectively lead to competence in these psychotherapies.
The authors searched PsycINFO and PubMed for studies from 2000 to 2009 using the terms meta-analysis, metaanalyses, and psychotherapy combined with specific psychotherapies listed in the ACGME and RCPSC requirements to determine if high-level evidence supported the use of these therapies in patients with psychiatric disorders. A similar systematic search was carried out using the same search engines for all years with the terms psychotherapy, competence, training, evaluation, and therapist rating scales for the specific therapies selected by the ACGME and the RCPSC to determine if empirically validated therapist competency scales and specific teaching methods that enhance competence could be identified.
Meta-analyses support the use of several psychotherapies in the treatment of patients with psychiatric disorders and specifically those selected for training. Empirically validated rating scales assess therapist competence in several therapies, and specific teaching methods enhance therapist skill.
The Accreditation Council for Graduate Medical Education and the Royal College of Physicians and Surgeons of Canada have incorporated evidence-based psychotherapies in their new guidelines. Evidence-based methods for assessing competence and for teaching psychotherapy are available and could be encouraged or required in the future.
KeywordsAcademic Psychiatry Acad Psychiatry Consult Clin Psychol Psychotherapy Training Functional Analytic Psychotherapy
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- 1.Accreditation Council for Graduate Medical Education: Program requirements for graduate medical education in psychiatry, 2007. Available at www.acgme.org/
- 2.Royal College of Physicians and Surgeons of Canada: Specialty Training Requirements in Psychiatry, 2008. Available at www.rcpsc.medical.org/
- 5.Guyatt G, Rennie D, Meade MO, et al: User’s Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice. New York, McGraw-Hill Medical, 2008Google Scholar
- 13.Rogers CC: Client-Centered Therapy: Its Current Practice, Implications, and Theory. Boston, Houghton Mifflin Company, 1965Google Scholar
- 14.Luborsky L: Principles of Psychoanalytic Psychotherapy: A Manual for Supportive-Expressive Treatment. New York, Basic Books, 1984Google Scholar
- 17.Gabbard GO: Textbook of Psychotherapeutic Treatments in Psychiatry. Arlington, Va, American Psychiatric Publishing, 2008Google Scholar
- 18.Nathan PE, Gorman JM: A Guide to Treatments That Work. New York, Oxford University Press, 2007Google Scholar
- 19.Lambert MJ: Handbook of Psychotherapy and Behavior Change. New York, John Wiley & Sons, 2004Google Scholar
- 35.Elliot R, Greenberg LS, Lietaer G: Research on experiential psychotherapies, in Handbook of Psychotherapy and Behavior Change. Edited by Lambert M. New York, John Wiley & Sons, 2004Google Scholar
- 39.Binks CA, Fenton M, McCarthy L, et al: Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev 2006; 1Google Scholar
- 53.Barber K: Canadian Oxford Dictionary. Don Mills, Ontario, Oxford University Press, 2004Google Scholar
- 54.Weerasekera P: Postgraduate psychotherapy training: incorporating findings from the empirical literature into curriculum development. Acad Psychiatry 1997; 21: 122–132Google Scholar
- 57.Truax CB: A scale for the rating of accurate empathy, in The Therapeutic Relationship and Its Impact. Edited by Rogers C. Westport, Ct, Greenwood Press, 1976Google Scholar
- 73.Miller WR, Moyers TB, Ernst D, et al: Manual for the Motivational Interviewing Skill Code (MISC), 2003. Available at www.motivationalinterview.org/
- 77.Kirschenbaum H, Jourdan A: The current status of Carl Rogers and the person-centered approach. Psychother Theor Res Pract Train 2005; 42: 37–51Google Scholar
- 79.Truax CB, Carkhuff RR: Toward Effective Counseling and Psychotherapy: Training and Practice. Hawthorne, NY, Aldine, 1967Google Scholar
- 82.Locke EA, Latham GP: A Theory of Goal Setting and Task Performance. Englewood Cliffs, NJ, Prentice Hall, 1990Google Scholar
- 85.Goldfried MR, Davison GC: Clinical Behavior Therapy. New York, Holt, Rinehart, and Winston, 1976Google Scholar