Psychotherapy Overview
Speaker: Dr. Phil Hall
CoreTraining Programme Director
Author: Dr Jane Blunden
Psychotherapy Tutor, Sussex
Royal College Requirements
• The Royal College has made it an absolute
requirement for core trainees in psychiatry to
complete basic psychotherapy training
• Trainees will need to have attained
satisfactory psychotherapy competencies in
order to pass their ARCPs, and crucially to
have completed them by the end of CT3 to be
eligible for higher training
Why?
• It’s better for patients
• It’s better for psychiatrists
Advantages for patients
• Psychiatrists who have a good understanding
of psychotherapy and of therapeutic
relationships listen better, understand better
and react better
• “Better” includes with knowledge (of human
psychological development and of the
complexities of emotional life) and with
emotional attunement
Advantages for psychiatrists
• Completing the competencies won’t make you
into a psychotherapist; but it will make you
more likely to be able to refer appropriately
• A therapeutic relationship, like any
relationship, has two people in it. Becoming
aware of what you bring to it is important, and
includes learning to look after your own
emotional needs and sensitivities within that
Advantages for psychiatrists
• Discovering whether or not you’d like to take it
further. Some trainees go on to do a training
in one or other type of psychotherapy and
hence do become therapists as well as
psychiatrists
• Some trainees decide to have a personal
therapy at some point in their training,
whether or not they train as therapists
themselves
The core training requirements
1. Balint groups (30 sessions minimum)
And to undertake a minimum of two
psychotherapy cases under expert supervision,
of different modalities and different lengths
2. One short case (duration up to 6 months, or
12 to 20 sessions)
3. One long case (duration 9-12 months, or 3040 sessions)
Balint groups
• These are groups in which one trainee volunteers
to present either a case they have seen, or an
incident in which they have been involved.
• The group conductor helps the group members
think about the psychological content of the
material, including the group members’ own
emotional reactions
• They are a good way to introduce trainees to
‘thinking psychologically’, and to continue to
develop their skills as time goes on
Supervised cases
• All supervisors have to be a trained therapist
in the type of therapy (modality) being used,
and to continue to be a practitioner of that
therapy themselves.
• Choosing appropriate cases for therapy for
psychiatry trainees is a complex task in itself;
try and let your supervisor or psychotherapy
tutor do this for you
Supervised cases
• Long cases: a psychodynamic case is usually done
as a long case (because the longer the
therapeutic relationship is, the more issues of
transference and counter-transference come to
the fore)
• Short cases: often either cognitive behavioural
therapy (CBT); cognitive analytic therapy (CAT);
interpersonal therapy (IPT); or any other type of
therapy available locally
• Other combinations are possible eg a long CBT
case and a short psychodynamic case
Assessments
• Your Balint Group Conductor will need to do a
psychotherapy CBD (case based discussion)
assessment for you after each 6 month block
• The supervisor of each of your cases should be
asked to do a SAPE (structured assessment of
psychotherapy expertise) twice: one mid-way and
one after completion
• Finally, you should do a PACE (psychotherapy
assessment of clinical expertise) with a suitable
person (often the psychotherapy tutor)
How to do all this?
• Contact your psychotherapy tutor and let
them know who you are and where you are.
Kent: currently vacant, contact DME
Surrey: Sean Fernandez
Sussex: Jane Blunden
• Find out where your local Balint group is, and
attend regularly
• When ready, seek a supervisor to do a case
Finally: Enjoy!