The state of psychotherapy supervision: recommendations for future training.

This paper reviews the current state of psychotherapy supervision in psychiatric training programmes. A focused literature search was carried out that examined three questions concerning the content, process and outcome of psychotherapy supervision. Results indicate that although requirements for training have broadened somewhat, methods of instruction in supervision have remained the same for many decades. In addition, there is a lack of discussion on what supervision outcomes should be assessed. This paper explores these areas and provides some suggestions for the future of psychotherapy supervision that are evidence-based and generalizable to an international audience. It is time to arrive at an international consensus about guidelines for psychotherapy supervision in psychiatry training programmes. This paper attempts to provide a starting place for psychotherapy supervisors and educators so that we can advance the field forward.

Psychotherapy training for IMGs: attending to the "how to" and "what to" teach.

International Medical Graduates (IMGs) make up a significant portion of the United States and Canadian workforce, and are well represented in psychiatry residency training programs. A review of the literature indicates that before entering residency training, many IMGs have minimal exposure to the behavioral sciences and poor communication skills-training; significant issues for learning psychotherapy. Given the lack of clear direction in the literature, this article presents empirically-informed guidelines relevant to the training of International Medical Graduates in psychotherapy.

Psychotherapy training for residents: reconciling requirements with evidence-based, competency-focused practice.

OBJECTIVE: The Accreditation Council for Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) changed the training requirements in psychotherapy, moving toward evidence-based therapies and emphasizing competence and proficiency as outcomes of training. This article examines whether the therapies selected for training are evidence based and the authors review research concerning methods for training and assessment that effectively lead to competence in these psychotherapies. METHODS: The authors searched PsycINFO and PubMed for studies from 2000 to 2009 using the terms meta-analysis, meta-analyses, and psychotherapy combined with specific psychotherapies listed in the ACGME and RCPSC requirements to determine if high-level evidence supported the use of these therapies in patients with psychiatric disorders. A similar systematic search was carried out using the same search engines for all years with the terms psychotherapy, competence, training, evaluation, and therapist rating scales for the specific therapies selected by the ACGME and the RCPSC to determine if empirically validated therapist competency scales and specific teaching methods that enhance competence could be identified. RESULTS: Meta-analyses support the use of several psychotherapies in the treatment of patients with psychiatric disorders and specifically those selected for training. Empirically validated rating scales assess therapist competence in several therapies, and specific teaching methods enhance therapist skill. CONCLUSION: The Accreditation Council for Graduate Medical Education and the Royal College of Physicians and Surgeons of Canada have incorporated evidence-based psychotherapies in their new guidelines. Evidence-based methods for assessing competence and for teaching psychotherapy are available and could be encouraged or required in the future.

Competency assessment in the McMaster Psychotherapy Program.

In January 2001 the Residency Review Committee (RRC) mandated that all psychiatric training programs must demonstrate competency in five forms of psychotherapy. Assessing competency in psychotherapy is a complex and difficult task, with many conceptual and practical issues needing consideration before programs are implemented. Existing competency-based programs can offer some assistance to institutions struggling with this issue. This paper discusses competency assessment in the McMaster Psychotherapy Program, paying special attention to instruments used in the evaluation process. Preliminary results with respect to resident satisfaction with the Program and resident competency in certain therapies are also discussed.