Background: The use of synchronous telemental health for therapy group is a relatively new area of exploration. While telegroups have demonstrated they can be helpful in providing psychoeducation, there is less known about whether synchronous remote groups can develop group cohesion and whether patients can receive the benefit of a supportive group setting.Methods: A pilot study was conducted comparing group cohesion between patients who participated in a dialectical behavior therapy (DBT) group via video teleconferencing (VTC) and patients who participated in an in-person group.Results: Findings indicate that while both groups felt equally connected to the facilitator, there were significant differences between the online and in-person groups on the group cohesion scale. Those in the online group did not feel as connected to other group members as those in the in-person group. Qualitative statements indicate that while an in-person group may have been preferable, the convenience of the online group outweighed any negative effects. Attendance was significantly better in the online group, suggesting that use of this technology may help to overcome barriers preventing treatment participation. The focus of this study was on group cohesion and changes in psychiatric symptoms were not evaluated.Conclusions: The use of telemental health for group therapy appears to be a viable alternative to traditional in-person groups, especially when no other treatment options are available. However, facilitators may need to take extra steps to build group cohesion when members are participating remotely.

Prevalence rates for depression among medical students are three times higher than the prevalence rates of depression in the general population. In order to understand these high prevalence rates, the authors discuss the underlying psychodynamics of a subset of medical students who seek therapy for depression and suicidality during their medical school years. Does medical school screen for people who are more prone to depression or does medical school cause high depression rates? The authors describe students with the combination of harsh/critical aspects from their early family life coupled with emotional misattunement of caregivers. The authors then discuss how the medical school environment may lead to reeexperiencing of these dynamics, triggering depression and suicidal ideation. The article provides recommendations for identifying these students and referring them to mental health services.

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IntroductionTeaching evidence-based medicine (EBM) skills to physicians in training has garnered support from accreditation groups and is widely incorporated into medical education. [1][2][3] The content of EBM curriculum and the standard for successful application of EBM are remaining concerns. For instance, Rao and Kanter, 4 summarizing EBM curricula topics for medical students from reports and articles published between 1999 and 2009, found that less than onethird addressed the statistical aspects of research design, analysis, and results. A review of instruments used to evaluate the effectiveness of EBM educational efforts for students, postgraduate trainees, physicians, and nonphysicians concluded that validity instruments were available for evaluating some domains but that instruments were needed to evaluate more recently emphasized skills.5 Of the 16 instruments meeting the 2 highest levels of validity data in this article, only 2 address the design and statistical skills called for by Rao and Kantor. 4 Moreover, these instruments target different levels of training and specialty groups.We developed a model of teaching EBM to psychiatric residents that addresses the essential skills identified in the literature.6-8 Typically, described as the 6 As, these skills include the ability to assess a patient, ask a clinical question, acquire the information, appraise the information, apply the information to the patient, and assess the outcome with a patient. For a copy of the Colorado Psychiatry evidence-based test or scoring rubric, please e-mail the principal investigator of the study (B.R.). MethodsOur goal was to develop an authentic test of full EBM practice taught in training programs such as the model EBM curriculum adopted by the American Association for Directors of Psychiatric Residency Training (AADPRT). AbstractBackground Evidence-based medicine (EBM) has become an important part of residency education, yet many EBM curricula lack a valid and standardized tool to identify learners' prior knowledge and assess progress.