Family therapy training in child and adolescent psychiatry fellowship programs.

OBJECTIVE: This study describes the current state of family therapy training in a sample of child and adolescent psychiatry fellowship programs. METHOD: Child and adolescent psychiatry fellows (N=66) from seven training programs completed a questionnaire assessing demographics, family therapy training experiences, common models of treatment and supervision, attitudes about family therapy, and perspectives on clinical training and clinical skill. RESULTS: Fellows ascribed a high degree of importance to family therapy skills, yet most had not seen more than one outpatient family with family therapy supervision during their training. They identified structural family therapy and family psychoeducation as the primary family treatment orientations in their programs. CONCLUSION: Although child psychiatry fellows believed that strong family therapy skills would benefit their patients, most had limited supervised experiences with families. Child and adolescent psychiatry training programs appear to offer exposure to family therapy without sufficient opportunities to develop proficiency. The author discusses educational implications for child and adolescent psychiatry.

The Impact of Postgraduate Health Technology Innovation Training: Outcomes of the Stanford Biodesign Fellowship.

Stanford Biodesign launched its Innovation Fellowship in 2001 as a first-of-its kind postgraduate training experience for teaching biomedical technology innovators a need-driven process for developing medical technologies and delivering them to patients. Since then, many design-oriented educational programs have been initiated, yet the impact of this type of training remains poorly understood. This study measures the career focus, leadership trajectory, and productivity of 114 Biodesign Innovation Fellowship alumni based on survey data and public career information. It also compares alumni on certain publicly available metrics to finalists interviewed but not selected. Overall, 60% of alumni are employed in health technology in contrast to 35% of finalists interviewed but not selected. On leadership, 72% of alumni hold managerial or higher positions compared to 48% of the finalist group. A total of 67% of alumni reported that the fellowship had been "extremely beneficial" on their careers. As a measure of technology translation, more than 440,000 patients have been reached with technologies developed directly out of the Biodesign Innovation Fellowship, with another 1,000,000+ aided by solutions initiated by alumni after their training. This study suggests a positive impact of the fellowship program on the career focus, leadership, and productivity of its alumni.

A model for reintegrating couples and family therapy training in psychiatric residency programs.

OBJECTIVE: The authors propose a family-systems training model for general residency training programs in psychiatry based on the couples and family therapy training program in Stanford's Department of Psychiatry and Behavioral Sciences. METHODS: The authors review key elements in couples and family therapy training. Examples are drawn from the family therapy training curriculum in a general psychiatric residency program. RESULTS: Conceptual and practical skills taught over the span of a psychiatric residency training program are described, focusing on: joining with the couple or family; seeing systemic patterns, recognizing the family's developmental stage, history, and culture; identifying family structure; and intervening systemically. CONCLUSION: This family-systems training model can serve as a resource for residency programs interested in integrating the couples and family therapy model more fully into their curricula.

Reintegrating family therapy training in psychiatric residency programs: making the case.

OBJECTIVE: Given the marginalization of couples and family therapy in psychiatric residency programs over the past two decades, the authors propose a rationale for the reintegration of these important psychosocial treatments into the mainstream of general psychiatric residency education. METHODS: After reviewing recent trends in the field that call for a more prominent role for couples and family therapy in residency training, the authors summarize the literature on family therapy training in psychiatry over the past four decades. RESULTS: Because biopsychosocial systemic thinking provides a powerful framework for looking at multiple levels of systems and their interrelationships, developing a strong family-systems perspective and acquiring basic "family skills" represent the minimum requirement for general psychiatric training. The authors argue for the addition of couples and family therapy to the five required psychotherapy competencies defined by the residency review committee in psychiatry. CONCLUSION: A rationale for a family-systems training model is proposed with the objective of encouraging residency programs to integrate the family-systems model more fully into their curricula.