Competence In Psychotherapy Research Articles

Feasibility assessment of using ChatGPT for training case conceptualization skills in psychological counseling

This study investigates the feasibility and effectiveness of using ChatGPT for training case conceptualization skills in psychological counseling. The novelty of this research lies in the application of an AI-based model, ChatGPT, to enhance the professional development of prospective counselors, particularly in the realm of case conceptualization—a core competence in psychotherapy. Traditional training methods are often limited by time and resources, while ChatGPT offers a scalable and interactive alternative. Through a single-blind assessment, this study explores the accuracy, completeness, feasibility, and consistency of OpenAI's ChatGPT for case conceptualization in psychological counseling. Results show that using ChatGPT for generating case conceptualization is acceptable in terms of accuracy, completeness, feasibility, and consistency, as evaluated by experts. Therefore, counseling educators can encourage trainees to use ChatGPT as auxiliary methods for developing case conceptualization skills during supervision processes. The social implications of this research are significant, as the integration of AI in psychological counseling could address the growing need for mental health services and support. By improving the accuracy and efficiency of case conceptualization, ChatGPT can contribute to better counseling outcomes, potentially reducing the societal burden of mental health issues. Moreover, the use of AI in this context prompts important discussions on ethical considerations and the evolving role of technology in human services. Overall, this study highlights the potential of ChatGPT to serve as a valuable tool in counselor training, ultimately aiming to enhance the quality and accessibility of psychological support services.

Psychiatry Trainees’ Perspectives on Psychotherapy Training in Residencies Worldwide

IntroductionIncorporating psychotherapy into the curricula of psychiatry residency programs has been proven difficult, even in countries where psychotherapy training is a requirement for psychiatry residents to become psychiatrists. There is a risk that future psychiatrists lacking psychotherapy skills will be restricted in managing the wide scope of disorders and personalities they will face in clinical practice. It is important to assess what psychiatry trainees around the globe have to say about psychotherapy training as part of their residency curricula.ObjectivesThe primary purpose of the article was to assess psychiatry trainees’ perspectives on psychotherapy training in residency programs worldwide.MethodsThe authors performed a narrative review, resulting 19 original research studies, published between 2001 and 2021, evaluating psychiatry residents’ perspectives by the application of a questionnaire.ResultsNineteen articles were included in this review. Most of the studies were developed across European countries (47.4%) and in the USA (36.8%). Psychiatry residents are interested in and value psychotherapy training, and some consider it should be an obligatory competency for psychiatrists, as it already occurs in some countries worldwide. Even though, most psychiatry trainees feel dissatisfaction with the existing training in residency curricula, pointing out concerns related to the quality of resources such as courses of psychotherapy and supervision of cases, time within the residency period, and financial constraints. In terms of personal psychotherapy, we found contrasting views of its importance in psychotherapy training for psychiatry residents. A crucial finding was that psychiatry residents tend to lose interest in psychotherapy during the years of the residency, and dissatisfaction with the quality of the psychotherapy curricula, lack of support, and low self-perceived competence in psychotherapy by trainees were factors associated with reduced interest in psychotherapy training.ConclusionsAt a time when psychotherapy is increasingly becoming acknowledged to play a central role in the treatment of most psychiatric disorders, current training is failing to provide these competencies to psychiatry trainees. Serious reflection must be given to both the extent of the guidelines and the practical opportunities for psychotherapy training so future psychiatrists can be qualified to provide an accurate biopsychosocial model of psychiatric care. The authors postulate that maintaining residents’ interest in psychotherapy requires improvements in the residency curricula and departmental leadership must support trainees’ goals of becoming comprehensively trained psychiatrists.Disclosure of InterestNone Declared

Cultural adaptation of CBT as a human rights issue: A UK study

Cognitive behaviour therapies have been used widely across the world and have been recommended as the first line of psychotherapeutic treatment for multiple mental health disorders. However, such blanket guidelines for use of Western-generated psychotherapies discount the socio-cultural determinants and aspects of mental health when recommended unadapted across ethnicities, eventually creating disparities in thequalityof care available to different populations. Examining the cultural relevance of these therapies for ethnic minority groups has therefore become an important avenue of inquiry.Recent decades have brought a revolution of cultural competency and adaptation research for such psychotherapies. Despite recent advances in cultural competency and adaptation research, the available body of literature in this domain remains limited and heterogenous. Furthermore, the lack of mandatory cultural competence training and the ineffectiveness of existing programmes increase the obvious discrepancy in the provision of mental healthcare services for certain minority groups, jeopardising equitable access and raising concerns about human rights protection.AimsThis study aimed to explore UK-based CBT therapists’ use of adaptations in their own practice, and understand what elements they tend to adapt, the impact and feasibility of their approaches, and the challenges faced by those who adapt and those who do not. The larger intention was to be able to gather information to recommend basic direction for policy and research to create plans for the benefit of ethnic minority groups for whom access to quality, tailored healthcare is currently largely overlooked.MethodThe study involved developing a survey informed by existing literature and distributing it to UK-based CBT therapists.ResultsThis study found that CBT therapists and their clients value cultural competency. It also found that therapists tend to believe that adapting CBT techniques and implementation and using culturally significant idioms and stories are impactful for their clients and practical to achieve as therapists. It further found that current barriers to adapting CBT for ethnic minority clients involves a lack of resources to study the efficacy of adaptations as well as a lack of well-established evidence-based adaptations in existing literature.ConclusionThe authors recommend that policymakers and service managers prioritise the regulation of cultural competence in psychotherapy and afford resources and incentive to researchers and clinicians that would eventually help to improve the effectiveness of their approaches and enhance mental health outcomes for ethnic minority groups. Future research could build on this study using qualitative methods or creating more robust surveys, using random sampling, and drawing larger sample sizes.

Evaluation of doctors’ experience of psychodynamic psychotherapy training at Leeds and York Partnership NHS Foundation Trust during the COVID‐19 pandemic

Developing psychotherapeutic competencies is an essential part of psychiatric training. All Core Trainees at Leeds and York Partnership NHS Foundation Trust (LYPFT) saw a patient for psychodynamic psychotherapy until 2020. Due to the pandemic, all face‐to‐face appointments at the LYPFT Medical Psychotherapy Service were paused from March 2020. Patients could choose whether to continue therapy remotely or defer therapy. Supervision was also moved to a remote format. Face‐to‐face therapy sessions resumed from August 2020, with new infection control procedures. This project aimed to establish doctors’ experience of training in delivering psychodynamic psychotherapy at LYPFT during the pandemic. A two‐step methodology was used: an online survey including qualitative and quantitative analysis of the impact of the pandemic; and semi‐structured interviews with thematic analysis. The online survey had a response rate of 68%. Four patients deferred therapy; the mean deferral length was two months. Ten respondents had sessions cancelled due to infection/self‐isolation. Thirteen respondents (commencing therapy pre‐pandemic) delivered therapy face‐to‐face (without personal protective equipment [PPE]). During the pandemic five respondents delivered therapy via phone, six face‐to‐face with PPE. Thirteen were concerned about attaining psychotherapy competencies. Thematic analysis of the interviews identified three main themes (with subthemes). Challenges of delivering therapy during the pandemic were identified, as well as areas of good practice and opportunities.

REVISITING COMPETENCE IN CLINICAL SUPERVISION

Competency-based approaches have been advocated in psychology graduate education and clinical training for over two decades, paralleling developments in medicine and other health professions. The competencies movement aimed at bringing greater accountability to the healthcare professions and to provide society with competent health service providers. Competency-based approaches to clinical supervision, including competency-based clinical supervision [1], [2] were developed to ensure the well-being of clients, facilitate the development of clinical competence, and protect the public. Although more than 6000 articles and books were published on clinical supervision from 2003-2021, relatively few explicitly focus on competence or competency-based approaches. And in practice, it appears that broad-based and systematic implementation of competency-based approaches has not been accomplished. The authors suggest that the failure to implement competency-based clinical supervision has significant consequences on mental health services. Effective, evidence-based services are critically needed given the increasing mental health acuity. The provision of evidence-based treatments requires the ’training-up’ of clinicians to establish competence in evidence-informed psychotherapy and psychosocial interventions. Developing competence would be best achieved through the use of competency-based approaches to training and clinical supervision. Barriers to implementation are discussed and a renewed call for implementation, including increased empirical research, is made.

Teaching Psychotherapy to Psychiatric/Mental Health Nurse Practitioner Students in the Virtual Classroom

The aim of this quality improvement project was to evaluate student satisfaction and achievement of select core competencies in psychotherapy by Psychiatric Mental Health Nurse Practitioner (PMHNP) students enrolled in a newly developed, and virtually delivered psychotherapy course. Both qualitative and quantitative data were collected to assess students’ competencies in five domains (i.e. professionalism, cultural diversity, ethical/legal standards of care, reflective practices, and application of knowledge and skills) and satisfaction with content and delivery using simulation and virtual sessions. Using pre- and post-training surveys, we found that competencies in the five domains increased from an average score of 3.1 to 4.5. Integrating a virtual psychotherapy course in advanced nursing education, bringing PMHNP students together to learn about interviewing clients, applying various psychotherapeutic modalities and techniques across diverse cultures, and maintaining ethical and legal standards of care is a challenging but achievable endeavor. We found that using a version of an APA self-assessment tool that was used in psychiatric residency training programs was an effective way to assess PMHNP students’ knowledge, skills, and attitudes on these core competencies. Although this training course proved to be effective in imparting appropriate skills, there is a need to develop sophisticated methods to evaluate how students use complex psychotherapy skills in the clinical setting.

When the Supervisor Needs a Supervisor: A Case-based Guide for Developing Psychotherapy Supervisors.

Supervision of psychotherapy is recognized as fundamental for attaining competency in psychotherapy. However, there is a lack of training in "best practices" of supervisory skills, and some supervisors may lack contemporary knowledge to support supervisees adequately. Training program leadership challenged by limited time and resources to provide supervisors with the necessary education and support can benefit from additional resources for developing psychotherapy supervisors. The authors present 3 core elements of navigating supervisory challenges: training, open dialogue in supervision, and a formal program-level process. Common issues in psychotherapy supervision are then presented in a case-based format. Reflection questions are included to provide an opportunity to consider a personal approach to the case, while specific guidance based on the literature addresses critical aspects of the case examples. Complex supervisory conflicts can challenge programs, but they are normative to the learning process and promote growth in our supervisors.

Afterword to "When the Supervisor Needs a Supervisor: A Case-based Guide for Developing Psychotherapy Supervisors".

Supervision of psychotherapy is recognized as fundamental for attaining competency in psychotherapy. However, there is a lack of training in "best practices" of supervisory skills, and some supervisors may lack contemporary knowledge to support supervisees adequately. Training program leadership challenged by limited time and resources to provide supervisors with the necessary education and support can benefit from additional resources for developing psychotherapy supervisors. The authors present 3 core elements of navigating supervisory challenges: training, open dialogue in supervision, and a formal program-level process. Common issues in psychotherapy supervision are then presented in a case-based format. Reflection questions are included to provide an opportunity to consider a personal approach to the case, while specific guidance based on the literature addresses critical aspects of the case examples. Complex supervisory conflicts can challenge programs, but they are normative to the learning process and promote growth in our supervisors.

Teaching dialectical thinking to enhance graduate trainees’ competence in outpatient psychotherapy for adolescents experiencing suicidal thoughts and behaviors.

Teaching dialectical thinking to enhance graduate trainees’ competence in outpatient psychotherapy for adolescents experiencing suicidal thoughts and behaviors.

Psychodynamic Child and Adolescent Psychiatry and the Future of Our Field

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.

Finding Psychodynamic Psychiatry's Lost Generation.

This paper describes forces that have adversely affected the place of the psychodynamic perspective within psychiatric practice and training over the last generation. One effect of these forces has been to create a lost generation of psychiatrists with little knowledge or experience with psychodynamic treatment. The article addresses opportunities to reverse some of the detrimental effects of recent changes. The Residency Review Committee's introduction of a requirement that residents achieve a measurable level of competence in five schools of psychotherapy represents a major opportunity to influence psychiatric training and practice. The past and present work of the Committee on Psychotherapy by Psychiatrists (COPP) is summarized, including efforts to integrate and revise the five existing core competencies in psychotherapy into a "Y"-shaped model in a way that secures the future of psychodynamic therapy training in residencies. One existing unusual training opportunity with a central psychodynamic focus is described.

Audit on Availability, Quality and Frequency of Clinical Supervision

AimsWe have completed a cycle of audit on the availability and quality of clinical supervision in Somerset NHS Foundation Trust. Last year we had highlighted the results of our first survey (run in 2020) in local teaching and audit meetings. We have now completed the cycle following the intervention. Both Severn deanery and Somerset NHS Foundation Trust both recommend psychiatry trainees have one hour of supervision per week, involving exploration of trainee clinical and educational needs. This audit is now part of a quality improvement project being run across Severn Deanery. This particular audit focuses on the results from Somerset NHS Foundation Trust.MethodsTrainees working in Somerset NHS Foundation Trust were invited to participate in this survey. We used the original survey from last year but added further white spaces to invite feedback and to explore what was particularly good about the clinical supervision currently offered. Questions on accomplishing workplace based assessments (WPBA), managing e-portfolio requirements were asked, with Likert scale responses available. The survey was sent out in the form of Microsoft Forms disseminated via email to all junior doctors (n = 27).Survey was run from May till June 2021 (nearing the end of placement). We sent out 3 reminders before closing the survey. The authors of the audit then reviewed the data.Results9 out of 27 doctors responded, response rate of 33%. Our last survey had a response rate of 63%. Supervision appears to be more regular now with only 11% stating that they were meeting their supervisor sometimes in comparison to 17% the last survey. Similar percentage of respondents were able to complete WBPAs as in the last survey (88% Vs 89%).QI project/audits were being discussed at a similar rate (60% Vs 66%). 75% of psychiatry trainee respondents were discussing their psychotherapy competencies (42% were having some discussion in the last survey). There was a better response from GP and FY doctors for this survey.ConclusionResponse rate appears to have fallen, however supervision appears to be more regular with more focus on competencies.White space answers showed that most trainees were satisfied with supervision. However, supervision could be more consistent and serious attempts must be made to protect it from clinical work overshadowing it.We will be comparing the results of our audit in Somerset NHS Foundation Trust to the results from other parts of the deanery.

Evaluation of Junior Doctors’ Experience of Psychodynamic Psychotherapy Training in LYPFT During the COVID-19 Pandemic

AimsDeveloping psychotherapeutic competencies is an essential part of psychiatric training. All core trainees in LYPFT until 2021 saw a patient for Psychodynamic Psychotherapy. The pandemic led to unprecedented changes to clinical practice and medical education. In LYPFT all face-to-face appointments in the Medical Psychotherapy Service were paused in March 2020. Patients were offered the choice to continue therapy remotely or postpone therapy. Supervision was also moved to a remote format. Face-to-face psychotherapy sessions resumed from August 2020, with new departmental procedures around infection control and the use of PPE. This project aimed to establish the junior doctors’ experience of delivering psychodynamic psychotherapy in LYPFT during the COVID-19 pandemic.MethodsThe project was carried out via a two-step methodology: Firstly with an online survey which included a quantitative analysis of the impact of the pandemic; and secondly via semi-structured interviews with a resultant thematic analysis.Results22 junior doctors who were invited to participate, 15 completing the survey (68%). Four patients had deferred therapy; the mean length of deferral was 2 months. Ten respondents had sessions cancelled due to infection or self-isolation. Face-to-face delivery was experienced by 13 respondents, 5 respondents had delivered therapy via phone and 6 had delivered therapy with PPE. Thirteen were concerned about attaining their psychotherapy competencies. Seven preferred face-to-face supervision, and 4 preferred remote working.Thematic Analysis of the semi-structured interviews identified three themes regarding the impact of the COVID-19 pandemic on Junior Doctors experience of Psychodynamic Psychotherapy, with sub-themes detailed below. Throughout the themes, the challenges and difficulties with delivering therapy in the COVID-19 pandemic, as well as areas of good practice and opportunities were identified.The Work of Therapy (Remote Therapy, PPE and Therapy, COVID-19-related) 1.The Structure of Therapy (COVID-19 Guidance, Setting/Frame of Therapy, Boundaries of Therapy)2.The Therapist's Training (Supervision, Attaining Competencies, Loss of Training Experience)ConclusionRecommendations: 1.To create a short guide for junior doctors delivering Psychodynamic Psychotherapy during a pandemic.2.To consider the types of supervision delivery within the Medical Psychotherapy Service3.To ensure there is space for junior doctors within the Medical Psychotherapy department or a private space within their base placement, should remote therapy be required.4.To ensure future plans related to possible pandemic restrictions address the need for good quality and strong internet connections/WIFI

Assessing therapist and clinician competency in parent-infant psychotherapy: The REARING coding system (RCS) for the group attachment based intervention (GABI).

The development of fidelity and quality measures for the dissemination of evidence-based practices is an often-neglected, vital step in the implementation of psychological interventions, especially within parent-infant mental health. The current study aims to address this gap by developing a competency-based measure for clinicians delivering the Group Attachment Based Intervention (GABI). GABI is an intervention aimed at supporting family preservation in parents who have experienced disparities across multiple systems of care. After observing over 100 hours of clinical video, the research team, comprised of clinicians and academic researchers, developed a competency coding system to measure clinician efficacy titled the REARING coding system (RCS). This paper outlines the development and structure of the measure, including a detailed discussion of the model of therapeutic action (i.e., REARING: reflective functioning, emotional attunement, affect regulation, reticence, intergenerational transmission of attachment, nurturance, and group therapy context), as well as provides a clinical case study to illustrate the utility, flexibility, and depth of the measure. The case study details a family session consisting of a mother, father, and two children (one infant, one toddler), and how RCS can be used in supervision to foster clinical competency and effectiveness in the GABI model. RCS seeks to address the dissemination gap in Evidence Based Practices (EBPs) by contributing to the limited number of existing fidelity and competency measures in infant mental health and psychodynamic dyadic psychotherapy. RCS is an important tool for monitoring clinical competency in the dissemination of GABI and gives supervisors the ability to provide fidelity-focused supervisions.

Evaluating psychotherapist competence: Testing the generalizability of clinical competence assessments of graduate trainees.

Health service psychology (HSP) graduate programs are shifting from knowledge- to competency-based assessments of trainees' psychotherapy skills. This study used Generalizability Theory to test the dependability of psychotherapy competence assessments based on video observation of trainees. A 10-item rating form was developed from a collection of forms used by graduate programs (n = 102) in counseling and clinical psychology, and a review of the common factors research literature. This form was then used by 11 licensed psychologists to rate eight graduate trainees while viewing 129, approximately 5-min video clips from their psychotherapy sessions with clients (n = 22) at a graduate program's training clinic. Generalizability analyses were used to forecast how the number of raters and clients, and length of observation time impact the dependability of ratings in various rating designs. Raters were the primary source of error variance in ratings, with rater main effects (leniency bias) and dyadic effects (rater-target interactions) contributing 24% and 7% of variance, respectively. Variance due to segments (video clips) was also substantial, suggesting that therapist performance varies within the same counseling session. Generalizability coefficients (G) were highest for crossed rating designs and reached maximum levels (G > .50) after four raters watched each therapist working with three clients and observed 15 min per dyad. These findings suggest that expert raters show consensus in ratings even without rater training and only limited direct observation. Future research should investigate the validity of competence ratings as predictors of outcome. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Use of Synchronous Videoconference in Bipolar Patients

Background: A considerable literature has developed around demonstrating the clinical relevance of mentalizing as a construct. However, much of the emphasis has been on patients’ deficits rather than therapist’s abilities. Although it may be the case that therapist’s mentalization capacity can facilitate better outcomes in psychotherapy, there is a dearth of empirical evidence concerning the impact mentalization has on therapist competencies in psychotherapy and the implications of this in clinical practice dyads.
 Methods/Design: A pilot study will use an integrated design. A longitudinal case series alongside a qualitative grounded theory approach will be utilized to develop a context-specific, grounded micro theory model of therapeutic alliance rupture and resolution during online psychotherapy with patients with bipolar disorder. 10 dyads of therapists and patients will be assessed by pre-and post-session outcome ratings, as well as baseline and post-therapy performance ratings during the four-month intervention period. In addition, semi-structured grounded theory interviews will be conducted with participants to gain a deeper understanding of their experiences during the therapeutic process.
 Discussion: New research findings on videoconferencing-enabled clinical interventions have been needed since the COVID-19 pandemic began. According to an assessment of the available evidence, little is known about psychotherapy, and significant gaps remain. This paper describes a protocol of a pilot aimed to capture the explicit and implicit knowledge that emerge from therapists and patients during the therapeutic process in order to investigate the complex process of therapeutic interaction beyond “outcome effects”.

Dissoanalysis as a Modern Psychotraumatology Theory: Denial Trauma and Mass Dissociation versus Dissociative Revolution and Psychocommunal Therapy

The "theory of dissoanalysis", structured on an axis that has the closest interactional dynamic with each individual and social element of the "multiple consciousness system" and "multiple memory phenomenon" conjugated with traumatic experiences, has its scientific roots in modern psychotraumatology studies conducted by Öztürk, a trauma therapist and a psychohistorian. Dissoanalysis makes significant scientific contributions to the development of both effective psychotherapy methods and innovative psychotraumatology and psychohistory movements in the field of "trauma and dissociation". “Dissoanalysts” are defined as “trauma therapists” who have professional competence in psychotraumatology, psychotherapy and suicidology, undertake and conduct the treatment of trauma-related psychiatric diseases, especially dissociative disorders, and complete them with a high average of success. As a modern theory of psychotraumatology, the psychosocial mission of dissoanalysis is to ensure that a society of psychologically integrated individuals prevails in the intergenerational process. The main purpose of dissoanalysis is, on the other hand, to create a development-oriented, normal and functional society composed of compassionate, fair, peaceful, empathetic, innovative and prudent individuals. Unless individually and socially originated "trauma denials" and "denial traumas" are neutralized by the psychosocial dissoanalysis method, chronic wars, colonial policies, dissociogenic oppressive systems, violent negative child-rearing styles, dysfunctional families and dysfunctional generations will continue to prevail at maximal rates and in all nations of the world! Öztürk, who developed the theory of dissoanalysis, emphasizes that an era of "mass dissociation", which spreads from individual to society, has begun on behalf of today's oppressive systems and the directed people controlled and managed by dominant leaders. Every moment when intergenerational development submits or evolves to intergenerational fossilization is a milestone and starting point for wars and genocides. Individuals and societies that are controlled and managed by traumatizing can be freed from captivity, oppression and abuse through "dissociative revolutions" that they will initiate by reactivating the healthy parts of themselves. Dissociative revolutions are all actions taken by individuals and societies, which have been ruled by oppression and traumatization for many years, in order to cut their hypnotic bonds with their fascist leaders and to liberate them, with these actions a psychosocial consciousness alliance is achieved and a new development-oriented human and society profile is created. As long as the dissoanalysis of “traumatized individuals whose smiles have been stolen” and “communities with shattered memories” cannot be carried out, no nation or any psychogenic mass can get rid of its borderline components, which are encompassing and focused on chronic violence; let alone gaining a direction towards an integrative life organization and in this context, the “theory of dissoanalysis” is the “psychocommunal therapy” itself!...

Pilot Study of the MAP Curriculum for Psychotherapy Competencies in Child and Adolescent Psychiatry.

This pilot study aimed to evaluate the relevance, feasibility, acceptability, and instructional efficacy of the Managing and Adapting Practice (MAP) curriculum for enhancing the teaching of psychotherapy to child and adolescent psychiatry (CAP) fellows. MAP is a system of resources and decision models that supports practitioners in selecting and implementing psychotherapeutic interventions for children and adolescents. The MAP curriculum includes modules to guide education about psychotherapeutic procedures (e.g., behavioral activation) common in evidence-based treatments for an array of childhood problems and to support development of competencies in assessment, treatment planning, and reflective practice. Curriculum coding was used to examine the relevance of MAP's core components to the skills articulated in the Accreditation Council for Graduate Medical Education (ACGME) CAP milestones. Feasibility, acceptability, and learning outcomes were examined after delivery of the MAP curriculum to 12 CAP fellows at two sites, with instructional features tailored according to faculty preferences and training program structure. Coding suggested that the MAP curriculum was relevant to 95% of the 21 ACGME CAP training subcompetencies. Feasibility was indicated by the successful delivery of 100% of the planned MAP curriculum across the two sites. Acceptability was supported by positive feedback from the CAP fellows, and psychotherapy knowledge increased significantly. Finally, case review scores (mean±SD=2.21±0.15) showed positive posttraining application of MAP to two patients and exceeded scores achieved by other samples of mental health professionals. This pilot study demonstrated the potential for the MAP curriculum to support CAP education. MAP's versatility as a curriculum supports broader adoption, with continuing rigorous empirical evaluation.

Development of a Scale for Assessing Basic Psychotherapeutic Skills

Abstract. Background: Well-established scales for the observation-based assessment of psychotherapy competence encompass multiple domains, require extensive rater training, and are rather cost-intensive. Objective: To develop a comprehensive but easy-to-administer instrument for the observation-based assessment of basic communication and counseling skills in both real and simulated patient encounters, the Clinical Communication Skills Scale (CCSS). Methods: We investigated the content validity and applicability of this scale. We then presented videos of simulated therapy sessions conducted by a competent vs. noncompetent therapist online to N = 209 laypersons and psychology students. Results: Results suggested a one-factorial solution. Internal consistency was excellent ( α = .94). For most aspects, convergent validity with established scales was moderate to high. The CCSS effectively differentiated between both levels of skill. Conclusions: The CCSS appears to be a feasible, reliable, and valid instrument. Nonetheless, its psychometric criteria should be investigated further in clinical samples, with licensed therapists, and in other languages.

Audit on availability, quality and frequency of clincal and educational supervision

AimsGMC defines clinical supervisor as a trainer who is responsible for overseeing a specified trainee's clinical work throughout a placement in a clinical or medical environment and is appropriately trained to do so¹.This AUDIT aimed to review the frequency, content and quality of clinical supervision for psychiatric trainees within Somerset NHS Foundation Trust. Both Severn deanery and Somerset NHS Foundation Trust both recommend psychiatry trainees have one hour of supervision per week, involving exploration of trainee clinical and educational needs.MethodAll trainees working in Somerset NHS Foundation Trust psychiatry from February 2020 were invited to participate. A survey was designed to quantify the frequency of supervision amongst this cohort. Survey online software, SurveyMonkey, was chosen for the accessibility and user friendly modality and disseminated via email to all junior doctors (n = 27). Survey responses were collected in the last month of the placement (July–August 2020).Questions on accomplishing workplace based assessments (WPBA), managing e-portfolio requirements were asked, with Likert scale responses available. Quality of supervision was explored via white space answers.Surveys were reviewed by the AUDIT authors and descriptive data collected.Result63% trainees responded (17 out of 27). Educational objectives were discussed at the beginning of the placement. Over half the respondents stated that time was not set aside to look at e-portfolio.Workplace based assessments (WBPAs), and Case based discussions (CBDs) were more frequently achieved than observed assessments of clinical encounters (ACEs/Mini-ACEs) (assessment of clinical encounter).30% core psychiatry trainees respondents (4 out of 7) discussed their audits/QI projects with their supervisors most/always. 42% (3 out of 7) had a discussion sometimes.2 GP and foundation trainees stated they were unable to obtain community mental health experience. The response rate to this question was disappointing and we think it may be secondary to the pressures of the pandemic.100% respondents described educational supervisors as supportive and approachable.ConclusionWhilst all respondents found their supervisors approachable and supportive, completion of formal WPBAs and portfolio reviews was suboptimal.Following regional presentation of results, the pertinence of these findings for all trainees was highlighted. A supervision template has been created and extension of this initial audit to a regional quality improvement project is underway.Specific recommendations included brief and regular supervisor check-ins with trainees regarding projects and psychotherapy competencies and a mid-placement review of portfolio.