Domains of discussion in psychotherapy: what do patients really want?

Little quantitative data exist on what the content of non-manualized psychotherapy in contemporary clinical settings actually is, and what patients and clinicians think it ought to be. This descriptive pilot study identified potential content areas to address in psychotherapy, quantified the relative importance of these domains of discussion to patients vs. clinicians, and attempted to measure the frequency with which these domains are actually addressed in current clinical practice at two academic, urban hospitals. The conteni areas assessed included health habits, avocations, work, family, friendships, community involvement, spirituality/religion, finance, sexuality, political activities, educational and cultural pursuits, and ethnicity/race. Overall, clinicians and patients agreed about the relative personal importance and importance to treatment of these content areas, and they rated work, family, friends, and sexuality as the most important domains of discussion for psychotherapy. Also, this sample of patients did not feel that clinicians undervalue the importance of religion and spirituality.

Getting our own house in order: improving psychiatry education to medical students as a prelude to medical school education reform.

OBJECTIVE: The authors summarize efforts to revitalize psychiatry teaching to medical students at Harvard Medical School (HMS) in advance of a major overhaul of the medical school curriculum. METHODS: This preliminary report chronicles key challenges and the organization of the reform effort within the departments of psychiatry affiliated with the medical school. RESULTS: Based upon a comprehensive internal review of psychiatric education at the medical school, the HMS Psychiatry Executive Committee and psychiatry faculty concluded that psychiatry teaching was underresourced and lacked cohesion and consistent standards and expectations across clinical sites involved in psychiatry teaching. Through a willingness to identify and vigorously address deficiencies in medical student education within a large decentralized program, psychiatry has earned a reputation as an effective reform agent at the medical school. CONCLUSIONS: Psychiatry education improvements have strengthened our partnership with the medical school as it is undertaking major educational reform of its entire curriculum.