Psychodynamic Child and Adolescent Psychiatry and the Future of Our Field

Abstract

The Accreditation Council for Graduate Medical Education (ACGME) requirements for child and adolescent psychiatry training require that child and adolescent psychiatry fellows demonstrate competence in psychodynamic psychotherapy.1 Child and adolescent psychiatry educators may turn to JAACAP to find up-to-date advances in psychodynamic psychotherapy to teach. However, the term psychodynamic appears to be hard to find, literally. A search on https://www.jaacap.org/ of past issues for psychodynamic2 resulted in 4 articles published in the past year, but none have the word psychodynamic in the title. Three articles describe newer evidence-based forms of psychotherapy: brief focused parent-infant psychotherapy, adolescent-focused therapy, and mentalization-based treatment. These are are described in their respective articles as "psychodynamic-based," as "psychodynamically informed," and having "historical roots in psychodynamic psychotherapy." As none are specifically titled psychodynamic therapy, it is unclear whether teaching these modalities would satisfy the ACGME requirement of competence in psychodynamic psychotherapy. Comparatively, this linguistic dilution does not seem to affect cognitive-behavioral therapy (CBT), another psychotherapy required by the ACGME1: specialized branches such as trauma-focused CBT, CBT for psychosis, and CBT for insomnia all retain the parent name of CBT. Therefore, it is important to define psychodynamic.