Psychotherapy and Psychoanalysts in Psychiatric Residency Training

Abstract

There is a renewed interest in teaching psychotherapy in psychiatry training programs in the context of the current accreditation standards for developing competency in psychotherapy. However, meeting the standards requires adequate faculty, expertise, motivation, and patient population to support a substantive didactic and experiential base for residents to develop phase-appropriate competence. Psychoanalysts are in a position to provide capable instruction and supervision in psychodynamic as well as supportive psychotherapy, but they are not evenly distributed in the United States. The psychoanalyst authors investigated the experience of psychiatry residency training programs in eastern Massachusetts and northeast Ohio with regard to their current practice in psychotherapy training in general and psychodynamic psychotherapy in particular. They asked about the time given to formal teaching, therapy experience and supervision, the composition of the faculty, and the presence of psychoanalysts as teachers or supervisors. Personal interviews to clarify aims, attitudes, and needs supplemented responses to the questionnaire. This article describes these findings and the opportunities and challenges that are evident in the current environment of psychiatric training. We found that most programs made substantial efforts to teach psychodynamic and cognitive-behavioral therapies, but that supportive therapy received less focused attention. The involvement of psychoanalysts in teaching was generally welcomed in this sample, but was dependent on their availability in the community.