Supplementing Psychiatry Resident Training with a Tiered Psychotherapy Pathway
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EDUCATIONAL CASE REPORT
Supplementing Psychiatry Resident Training with a Tiered Psychotherapy Pathway Laurel D. Pellegrino 1
&
Stephanie K. Chang 1 & Cara Alexander 1 & Barbara S. McCann 1
Received: 8 June 2020 / Accepted: 5 October 2020 # Academic Psychiatry 2020
Psychotherapy is a core element of psychiatric training [1, 2], and residents are eager for more psychotherapy education than they currently receive [3–5]. The Accreditation Council for Graduate Medical Education (ACGME) requires instruction in three evidence-based psychotherapies (supportive, cognitive-behavioral, and psychodynamic) [6, 7], which has been implemented with varying success and rigor across psychiatry residencies [8, 9]. This requirement omits many evidence-based therapies that would be impossible to include in the core curriculum of a single program [10]. Pathways, specialized tracks within psychiatry residencies, are a means of offering supplemental training to residents [11–17]. This paper describes the formation of a psychotherapy pathway that introduces residents to additional therapies according to resident interest. Psychiatrists can leverage these skills across settings, whether using supportive interventions during a medication management visit, performing in a liaison capacity on a psychiatry consult service, or working with a team in a collaborative care model. This elective pathway has two tiers for participation in order to serve residents with varying degrees of interest in psychotherapy. Those with strong interest may undertake intensive study and earn an area of distinction (AOD) upon graduation, but all residents may participate in pathway meetings. To our knowledge, this is the first description of a tiered psychotherapy pathway. This description may be useful to psychiatry residency programs that have identified barriers to starting a psychotherapy pathway at their institution [9].
* Laurel D. Pellegrino [email protected] 1
University of Washington, Seattle, WA, USA
Formation of the Psychotherapy Pathway The psychotherapy pathway was founded in 2013 by a chief resident (C.A.) and a faculty member (B.M.) who submitted a proposal to the Resident Education Steering Committee. Some members of the committee were concerned that creating a psychotherapy pathway would signal that therapy is a special interest rather than a core part of every psychiatrist’s identity. Therefore, the committee specified that the pathway would allow interested residents to deepen their knowledge of one specific modality beyond what they learn through the core curriculum. Initially, pathway members met every other month and created a personalized educational plan for intensive study of a particular psychotherapeutic modality in addition to completing a scholarly project.
Evolution of the Pathway and Lessons Learned A steering committee of volunteer faculty members and senior residents was formed to oversee the pathway. Over time, the committee honed the pathway requirements to balance accessibility and rigor. These modifications have allowed p
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