Psychotherapy Supervision for Psychiatry Residents

Abstract

Objective To review specificities of and difficulties in psychodynamic psychotherapy training for psychiatry residents. The Royal College of Physicians and Surgeons of Canada requires a minimum of 32 weeks of the PGY2-PGY5 psychotherapy experience. Most of Canadian universities organize training in supportive psychotherapy, cognitive-behavioral therapy and long-term psychodynamic psychotherapy for psychiatry residents. At the beginning of the PGY3 year, residents will begin supervised practice in psychodynamic psychotherapy for a minimum of one year. Residents may perceive psychodynamic psychotherapy as too complicated and they may require a more directive approach in supervision and guidance regarding psychotherapy technique and psychotherapy process. This is understandable because they lack personal/didactic analysis. Supervisor trained in psychoanalysis needs to take into account differences in supervision as a part of psychoanalytic training and psychiatry resident supervision in psychodynamic psychotherapy. Unlike the psychoanalytic training organized by psychoanalytic institutes, training in psychotherapy as a part of residency training is much less defined in terms of standards and expectations from both residents and supervisors. The profile of psychodynamic psychotherapists who serve as supervisors for residents may vary significantly with regards to their training, experience and personal style in supervision. Criteria for assessment of resident performance and his/her progress in training are not well established. Residency training committees and psychotherapy training committees should work on developing training standards of psychotherapy supervisions for residents. In conclusion, psychodynamic psychotherapy supervision for psychiatry residents is a specific and modified type of psychotherapy supervision. There is a need for standardization of the long-term psychodynamic psychotherapy supervision.