Kovach Jessica G, Dubin William R, Combs Christopher J
Temple University School of Medicine, Philadelphia, PA, USA.
Acad Psychiatry. 2015 Oct;39(5):567-74. doi: 10.1007/s40596-014-0187-7. Epub 2014 Jul 10.
This survey examined actual training hours in psychotherapy modalities as reported by residents, residents' perceptions of training needs, and residents' perceptions of the importance of different aspects of psychotherapy training.
A brief, voluntary, anonymous, Internet-based survey was developed. All 14 program directors for Accreditation Council for Graduate Medical Education accredited programs in Pennsylvania, New Jersey, and Delaware provided email addresses for current categorical residents. The survey inquired about hours of time spent in various aspects of training, value assigned to aspects of training, residents' involvement in their own psychotherapy, and overall resident wellness. The survey was e-mailed to 328 residents.
Of the 328 residents contacted, 133 (40.5%) responded. Median reported number of PGY 3 and 4 performed versus perceived ideal hours of supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic therapy did not differ. Answers for clinical time utilizing these modalities ranged from "none or less than 1 h" per month to 20+ h per month. PGY 3 and 4 residents reported a median of "none or less than 1 h" per month performed of interpersonal, dialectical behavior therapy, couples/family/group, and child therapies but preferred more time using these therapies. Residents in all years of training preferred more hours of didactic instruction for all psychotherapies and for medication management. Residents ranked teaching modalities in the following order of importance: supervision, hours of psychotherapy performed, personal psychotherapy, readings, and didactic instruction. Residents engaged in their own psychotherapy were significantly more likely to rank the experiential aspects of psychotherapy training (personal psychotherapy, supervision, and hours performed) higher than residents not in psychotherapy.
Current psychotherapy training for psychiatry residents is highly variable, but overall, residents want more psychotherapy education than they are receiving. Further research and discussion about how much psychotherapy training is feasible in an evolving field is required.
本调查研究了住院医师报告的心理治疗方式的实际培训时长、住院医师对培训需求的看法以及住院医师对心理治疗培训不同方面重要性的看法。
开展了一项简短、自愿、匿名的基于网络的调查。宾夕法尼亚州、新泽西州和特拉华州所有经研究生医学教育认证委员会认证项目的14位项目主任提供了在读分类住院医师的电子邮箱地址。该调查询问了在培训各方面花费的时间、对培训各方面的重视程度、住院医师参与自身心理治疗的情况以及住院医师的整体健康状况。调查通过电子邮件发送给328名住院医师。
在联系的328名住院医师中，133名（40.5%）做出了回应。报告的PGY 3和PGY 4住院医师进行支持性治疗、认知行为疗法（CBT）和心理动力疗法的实际时长与理想时长的中位数无差异。使用这些方式的临床时间回答范围从每月“无或少于1小时”到每月20多小时。PGY 3和PGY 4住院医师报告人际、辩证行为疗法、夫妻/家庭/团体及儿童疗法每月实际进行的时长中位数为“无或少于1小时”，但希望增加使用这些疗法的时间。所有培训年份的住院医师都希望增加所有心理治疗和药物管理方面的理论教学时长。住院医师对教学方式的重要性排序如下：督导、进行心理治疗的时长、个人心理治疗、阅读材料和理论教学。接受自身心理治疗的住院医师比未接受心理治疗的住院医师更有可能将心理治疗培训的体验方面（个人心理治疗、督导和进行治疗的时长）排在更高位置。
目前针对精神科住院医师的心理治疗培训差异很大，但总体而言，住院医师希望获得比目前所接受的更多的心理治疗教育。需要对在这个不断发展的领域中多少心理治疗培训是可行的进行进一步研究和讨论。
