Psychotherapy Tracks in US General Psychiatry Residency Programs: A Proxy for Trends in Psychotherapy Education?

OBJECTIVE: The authors studied the goals and design of psychotherapy tracks in the US general psychiatry residency programs and the perceived barriers to psychotherapy tracks in programs without them. METHODS: The authors emailed 226 US general psychiatry residency program directors, asking them to complete an anonymous, online, Qualtrics survey about psychotherapy training and tracks in their program. RESULTS: Seventy-nine programs (35%) participated. Of these, 22% (n = 17) reported having a psychotherapy track, 4% (n = 3) reported currently developing a psychotherapy track, and 74% (n = 56) reported not having a psychotherapy track. Of those without a psychotherapy track, 81% (n = 44) reported not wanting one. Time, personnel, resident interest, and funding were the most common reasons for not having a track, but programs with tracks generally reported additional personnel and funding were not needed. Most programs with a track reported being satisfied with it. A sizeable minority of reporting programs (overrepresented by those without psychotherapy tracks) did not require supervision or didactics for all three Accreditation Council for Graduate Medical Education required psychotherapy modalities. CONCLUSIONS: Commonly perceived barriers to having a psychotherapy track may not be as limiting as they seem, and the diverse types of psychotherapy tracks may offer flexibility for programs seeking to design one. The finding that not all programs offer a full complement of supervision and didactics in core psychotherapy modalities is concerning for the future of psychotherapy training in residency programs. The presence of a psychotherapy track may be a proxy for the value a program places on psychotherapy education.

Current Understanding of Religion, Spirituality, and Their Neurobiological Correlates.

Religion and spirituality (R/S) have been prominent aspects of most human cultures through the ages; however, scientific inquiry into this phenomenon has been limited. We conducted a systematic literature review of research on the neurobiological correlates of R/S, which resulted in 25 reports studying primarily R/S with electroencephalography, structural neuroimaging (MRI), and functional neuroimaging (fMRI, PET). These studies investigated a wide range of religions (e.g., Christianity, Buddhism, Islam) and R/S states and behaviors (e.g., resting state, prayer, judgments) and employed a wide range of methodologies, some of which (e.g., no control group, varying measures of religiosity, small sample sizes) raise concerns about the validity of the results. Despite these limitations, the findings of these studies collectively suggest that the experience of R/S has specific neurobiological correlates and that these correlates are distinct from non-R/S counterparts. The findings implicate several brain regions potentially associated with R/S development and behavior, including the medial frontal cortex, orbitofrontal cortex, precuneus, posterior cingulate cortex, default mode network, and caudate. This research may suggest future clinical applications and interventions related to R/S and various disorders, including mood, anxiety, psychotic, pain, and vertiginous disorders. Further studies with more rigorous study designs are warranted to elucidate the neurobiological mechanisms of R/S and their potential clinical applications.