Donna M. Sudak

Trends in Psychotherapy Training: A National Survey of Psychiatry Residency Training.

ObjectiveThe authors sought to determine current trends inresidency training of psychiatrists.MethodThe authors surveyed U.S. general-psychiatry training directors about the amount of didactic training, supervised clinical experience, and numbers of patients treated in the RRC-mandated models of psychotherapy (psychodynamic, cognitive-behavioral therapy [CBT], and supportive). Questions regarding other models of psychotherapy and about challenges in training were also included.ResultsThe results demonstrate a wide range of experiences in psychotherapy education. Psychodynamic training is the most robust, but has the greatest variability. CBT training has advanced significantly over the past decade. Supportive psychotherapy is the most widely practiced, but receives the least amount of didactic time and supervision.ConclusionThe authors discuss next steps in the evolution of psychotherapy education for psychiatrists.

The Y Model: An Integrated, Evidence-based Approach to Teaching Psychotherapy Competencies

Objective The authors goal was to develop an integrated model for teaching psychotherapy competencies across schools of therapy. Method The authors surveyed the comparative psychotherapy process literature to identify core features of psychotherapy shared across schools and differentiate those features from the defining features of psychodynamic therapy and cognitive-behavioral therapy. Results The resulting Y Model for teaching psychotherapy competencies locates core processes of therapy that are shared across schools on the stem of the Y, differentiates psychodynamic therapy and cognitive-behavioral therapy on the branches of the Y, and locates supportive therapy largely on the stem of the Y. Conclusions The Y Model offers an efficient, integrated, evidence-based system for teaching psychotherapy competencies across schools in a conceptually clear way that is free of competition and bias between schools. (Journal of Psychiatric Practice 2009;15:5–11).

Training in Cognitive Behavioral Therapy in Psychiatry Residency: An Overview for Educators

In January 2001, Accreditation Council of Graduate Medical Education accredited general psychiatry training programs were charged with the requirement to train residents in cognitive-behavioral therapy (CBT) to a level of competence. Programs were given the responsibility to delineate standards for trainees, to determine measures of competence, and to provide remediation for deficiencies in performance. Effective education in CBT in general and child and adolescent psychiatry residency training can be more successful when educators understand the barriers to implementation of empirically supported therapies (ESTs). Robust training programs in CBT must take into account cultural barriers to psychotherapy training and the educational demands placed on residents in adult and child and adolescent psychiatry. Resources for training and evaluation materials are available to training directors and teachers.

Terapia cognitivo-comportamental da depressão

OBJECTIVE: To describe the use of cognitive techniques and to review studies on the efficacy of CBT in the treatment of depression. METHOD: A non-systematic review of the literature of original studies complemented with data from meta-analyses and specialized textbooks. RESULTS: The fundamentals of cognitive-behavioral therapy in the treatment of depression are described and the evidence of short- and long-term efficacy is reviewed. The use of pharmacological therapy in conjunction with CBT is also discussed. CONCLUSIONS: CBT in the treatment of depression is one of the therapeutic modalities with the highest empirical evidence of efficacy, whether applied alone or in combination with pharmacotherapy.

Cognitive Behavioral Therapy for Depression

CBT is a valuable treatment for mild, moderate, and severe forms of major depression. It is equally effective and more durable than medication alone, and the combination of medication and CBT may increase the response rate and extend durability when CBT is employed after pharmacotherapy is successful. Therapist competence has been shown to influence outcomes in CBT for depression. Practitioners who wish to learn more about CBT may access a wide variety of educational materials: basic texts, course offerings at major scientific meetings, and local and national training centers are available. The Academy of Cognitive Therapy website (www.academyofct.org) provides detailed information about obtaining training and certification in CBT.

Efficacy of the trial-based thought record, a new cognitive therapy strategy designed to change core beliefs, in social phobia

What is known and Background:u2002 Social anxiety disorder (SAD) often follows a chronic course and is associated with substantial impairment in functioning. Although results from clinical trials clearly establish evidence for efficacy of cognitive behavioural therapy in treating this disorder, up to 50% of patients with SAD show little or no improvement. Thus, new approaches that have promised in improving the efficacy of treatment for SAD are needed. One such approach is the trial‐based thought record (TBTR), which targets the restructuring of patients’ core beliefs.

Suicide on facebook.

Current suicide assessment relies primarily on the patient’s oral history. This article describes the case of a patient who was hospitalized after making an impulsive suicide attempt. Subsequently, social media was used to identify the events leading up to the attempt and to reconstruct a timeline. This evidence helped the patient gain more insight into the severity of his condition and agree to participate in treatment. Facebook and other social media may prove to be helpful adjuncts to suicide prevention efforts both in treatment and in screening for high-risk individuals who may not voluntarily come to clinical attention. (Journal of Psychiatric Practice 2014;20:141–146)

Mindfulness-based interventions for chronic pain: Evidence and applications

Chronic pain is estimated to occur in from 5.5% to 33% of the worlds adult population (Gureje et al., 1998). Chronic pain is frequently treated with opiates, which has produced an opiate addiction crisis (Dowell et al., 2016). Several non-pharmacological treatment alternatives can help manage chronic pain. There is moderate evidence that mindfulness-based interventions (MBIs) such as meditation, yoga, and stress reduction lower the perception of pain, increase mobility, improve functioning and well-being. By integrating MBIs and other therapeutic interventions in a multi-disciplinary pain management plan, clinicians can improve treatment outcomes and potentially decrease pain-related medication utilization.

Changing core beliefs with trial-based cognitive therapy may improve quality of life in social phobia: a randomized study

OBJECTIVEnTo determine whether there are differences in quality of life (QoL) improvement after treatment with the trial-based thought record (TBTR) versus conventional cognitive therapy (CCT) in patients with social anxiety disorder (SAD).nnnMETHODnA randomized trial comparing TBTR with a set of CCT techniques, which included the standard 7-column dysfunctional thought record (DTR) and the positive data log (PDL) in patients with SAD, generalized type.nnnRESULTSnRepeated measures analysis of variance (ANOVA) revealed a significant time effect in the general health, vitality, social functioning, and mental health domains of the Short Form 36. It also indicated significant treatment effects on the bodily pain, social functioning, role-emotional, and mental health domains, with higher scores in the TBTR group. One-way analysis of covariance (ANCOVA), using pretreatment values as covariates, showed that TBTR was associated with significantly better QoL post-treatment (bodily pain, social functioning and role-emotional) and at follow-up (role-emotional). A significant treatment effect on the role-emotional domain at 12-month follow-up denoted a sustained effect of TBTR relative to CCT.nnnCONCLUSIONnThis study provided preliminary evidence that TBTR is at least as effective as CCT in improving several domains of QoL in SAD, specifically when the standard 7-column DTR and the PDL are used.

Is That an Unconscious Fantasy or an Automatic Thought? Challenges of Learning Multiple Psychotherapies Simultaneously

Today, psychiatry residents learn multiple psychotherapeutic techniques during their training. Learning these different modalities at the same time can cause confusion in the areas of assessment, making a psychotherapeutic recommendation, and conducting a treatment. To investigate these issues, we presented a complex training case to three psychotherapy experts. Although they had somewhat different ideas about how to treat the patient, there was general consensus that adhering to a single conceptual formulation is key to treating individual patients in psychotherapy. A final discussion addresses the pedagogical implications of this perspective.