Postgraduate psychotherapy training : incorporating findings from the empirical literature into curriculum development

The Y model: an integrated, evidence-based approach to teaching psychotherapy competencies

OBJECTIVE

The authors' goal was to develop an integrated model for teaching psychotherapy competencies across schools of therapy.

METHOD

The authors surveyed the comparative psychotherapy process literature to identify core features of psychotherapy shared across schools and differentiate those features from the defining features of psychodynamic therapy and cognitive-behavioral therapy.

RESULTS

The resulting Y Model for teaching psychotherapy competencies locates core processes of therapy that are shared across schools on the stem of the Y, differentiates psychodynamic therapy and cognitive-behavioral therapy on the branches of the Y, and locates supportive therapy largely on the stem of the Y.

CONCLUSIONS

The Y Model offers an efficient, integrated, evidence-based system for teaching psychotherapy competencies across schools in a conceptually clear way that is free of competition and bias between schools.

Integrative dimensions of psychotherapy training

This paper investigates the influence of integrative factors on psychotherapy education. The broad relevance of integrative psychotherapy to residency training and continuing mental health education is discussed. Following a review of the existing literature on the education of integrative psychotherapists, the article systematically examines the integrative and pedagogic issues to be considered in planning psychotherapy training informed by integrative principles. The integrative issues are organized into 5 categories: attitudinal set, knowledge base, clinical techniques and skills, developmental tasks and challenges, and systemic institutional factors. The educational issues can be divided into 4 categories: content, format and process, sequence, and faculty development. Brief descriptions of actual educational interventions illustrate the implementation of such ideas. Specific recommendations are made regarding the development of integrative educational initiatives and future study of unresolved questions.

Advances in psychotherapy education

Acquiring expertise in psychotherapy is central to the professional development of psychiatrists able to employ a broad therapeutic repertoire in their clinical practice. This article reviews how postgraduate psychiatry programs address this important aspect of training. We present the results of a national survey of psychotherapy education in Canadian psychiatry residency programs. The results highlight significant advances over the past decade in curriculum, in teaching methods, and in evaluation. These include training in evidence-based, manualized, time-limited therapies such as cognitive-behavioural and interpersonal therapy, greater attention to evaluating competence, and integrating electronic technology. Trends and advances in postgraduate and continuing medical psychotherapy education programs are considered in association with principles of adult learning. Health education research endorses the provision of longitudinal training programs that integrate learning and practice. We discuss issues related to the development of expertise, the importance of educational communities of practitioners, and the importance of attending to both educational process and outcomes, with a view to more effectively translating psychotherapy practice guidelines into sustained improvements in practice behaviours.

Residency training: challenges and opportunities in preparing trainees for the 21st century

The future will see increased medicalization of psychiatry and will demand changes in training that better prepare residents for the realities of practice in a sustained period of physician shortage. Residency programs will need to move from the current apprenticeship model of training to competency-based programs built on the CanMEDS 2000 articulation of physician roles. Training will need to focus on evidence-based treatments, more efficient models of health care delivery, more attentive tracking of resident clinical work, and more reliable and standardized methods of evaluating resident competencies.