P s s y c h o t t h e r a p y C u r r i i c u l l u m
The Psychotherapy Curriculum in the Psychiatry Residency Training Program,
Department of Neuropsychiatry at Texas Tech University has been carefully designed to integrate the art and science of teaching, learning and practicing of the different areas of psychotherapeutic intervention in a “spiral” progression. Each consecutive year, the residents assimilate new material and experience starting from basic skills to a more advanced level while continuing to apply the previously learned principles in: supportive, dynamic, cognitive- behavior, brief, group, couples, family and integrated psychotherapy with psychopharmacology. The gradual immersion of residents in the world of learning and practicing psychotherapy makes the implementation of the
RRC/ACGME requirements on the specific (psychotherapy forms of treatment) competencies, i.e. Brief, Cognitive-Behavior, Psychodynamic, Combined
Psychotherapy and Psychopharmacology, and Supportive Therapy a smoothly evolving experience for both, trainees and faculty.
There are several main educational components that in concert build and reinforce the residents’ cognitive and intellectual growth in psychotherapies: 1. didactic teaching, 2. on-going supervision, and the 3. Oral Board simulated Examination (MOCK exam).
1. The following comprehensive didactic courses are taught to the respective level of psychiatry residents:
Introduction to Psychotherapies/Cultural Issues in Psychiatric Cases PGY-1
Supportive Therapy: PGY-1
Psychodynamic Therapy:
Cognitive-Behavior Therapy:
PGY-2
PGY-2
Combined (Psychotherapy and Psychopharmacology):
Brief Therapy:
Family and Couples Therapy:
Group Therapy:
PGY-3
PGY-3
PGY-3 + 4
PGY-3 + 4
Sex Therapy: PGY-3 + 4
The didactic courses introduce core concepts, historical data, major schools of thoughts and scholars in the specific subtypes of psychotherapies and also teach residents the respective psychotherapeutic formulation (dynamic formulation, cognitive behavior formulation etc.), which would ultimately help residents build and implement the tripartite and contemporary BioPsychoSocial model when diagnosing and treating patients. A written psychotherapy case formulation is one of the End-of-Course requirements for the dynamic, brief, combined, cognitive-behavior and supportive therapies didactic courses.
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Residents are required to treat a minimum of 2 – 3 patients with each specific psychotherapeutic intervention required by the Residency Review Committee and the
ACGME. Their practical experience in other forms of psychotherapy will encompass group therapy that starts at the PGY 2 during the Inpatient Psychiatry Rotation, and continues at the PGY 3 level of training in Addiction Psychiatry setting. During this time the residents will also gain experience with Family and Couples Therapy.
2. While the supervision for PGY 1 (on supportive therapy cases) and PGY 4 (on all types of therapy cases) residents consist of weekly one-hour individual psychotherapy supervision, a Type Specific Therapy Group Supervision (TSTGS) system will augment the weekly psychotherapy supervision for the PGY 2 and 3 residents. The TSTS is based on small group supervision for the specific therapies: brief, dynamic, combined and CBT. Residents benefit from supervisors’ and each other’s feedback on their case presentations (combination of psychotherapy notes, and/or audio- as well as videotapes). Resident’s performance and level of competency is evaluated by the individual psychotherapy supervisor who follows the residents’ progress during the hourly supervision sessions on a weekly basis and also by the group supervisor at the end of the type specific therapy supervision.
3. Another step that our residency program has undertaken to asses residents’ level of competency in interviewing, case presentation, clinical skills, medical knowledge, interpersonal and communication skills, patient care as well as the ethics of doctorpatient relationship in General Psychiatry and Neuropsychiatry is the introduction of the Oral Board simulated examination (MOCK exam) . Shortly after the ABPN evolved the Board Exam Part II toward a new format that includes standardized vignette-cases, our Program introduced in June 2006 a new MOCK exam format that resembles the
ABPN Board format. Two out of four examination stations feature Neuropsychiatric cases: Live-Patient Interview, 2 written-vignette and/or 10-15 minutes video-clip case.
Residents then are asked pre-prepared questions that pertain to the case(s), and the
(examiner) faculty matches the responses with pre-prepared answers.
The required reading for the psychotherapy courses and supervision:
Dynamic Therapy: Gabbard, G: Long-Term Psychodynamic
Psychotherapy
Cognitive Behavior Therapy:
Supportive Therapy:
Brief Therapies:
Combined Therapy:
Wright, J. H. et al.: Learning Cognitive-Behavior
Therapy
Winston, A. et al.: Introduction to Supportive
Psychotherapy
Dewan, M. J. et al.: The Art and Science of Brief
Psychotherapies
Riba, M. et al.: Competency in Combining
Pharmacotherapy & Psychotherapy
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