Zisook Sidney, McQuaid John R, Sciolla Andres, Lanouette Nicole, Calabrese Christina, Dunn Laura B
Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, 116A, La Jolla, CA 92093-116A, USA.
Am J Psychother. 2011;65(1):47-59. doi: 10.1176/appi.psychotherapy.2011.65.1.47.
Most psychiatric residents enter training intent on learning both psychopharmacologic and psychotherapeutic interventions. After graduation, however, many emphasize pharmacotherapy over psychotherapy.
A multisite survey of psychiatry residents queried psychotherapy interests, attitudes, and practice intentions. Factors associated with self-reported decreased interest in psychotherapy since beginning residency were examined.
Although 11.8% of the entire sample (n = 229 PGY1-PGY4 residents) reported decreased interest in psychotherapy during training, among PGY4s the corresponding figure was 16.4%. Positive attitudes towards psychotherapy, and self-perceived competence in cognitive-behavioral and psychodynamic psychotherapy were most highly correlated with maintained interest in psychotherapy. Dissatisfaction with the quality of psychotherapy faculty and curriculum, and viewing departmental leadership as unsupportive of psychotherapy training were correlated with decreased interest during training.
Maintaining residents' interest in psychotherapy requires improvements in curriculum, teaching, and supervision throughout training. Our data underscore the crucial role that departmental leadership must play in supporting trainees' goals of becoming comprehensively trained psychiatrists.
大多数精神科住院医师开始培训时都打算学习心理药物治疗和心理治疗干预措施。然而,毕业后,许多人更强调药物治疗而非心理治疗。
对精神科住院医师进行的多地点调查询问了他们对心理治疗的兴趣、态度和实践意向。研究了与自我报告的自开始住院医师培训以来对心理治疗兴趣下降相关的因素。
尽管整个样本(n = 229名PGY1 - PGY4住院医师)中有11.8%报告在培训期间对心理治疗的兴趣下降,但在PGY4住院医师中,这一数字为16.4%。对心理治疗的积极态度以及自我感知的认知行为和心理动力心理治疗能力与对心理治疗的持续兴趣高度相关。对心理治疗教员和课程质量的不满,以及认为部门领导不支持心理治疗培训与培训期间兴趣下降相关。
要保持住院医师对心理治疗的兴趣,需要在整个培训过程中改进课程、教学和监督。我们的数据强调了部门领导在支持学员成为全面培训的精神科医生目标方面必须发挥的关键作用。