Does protected time improve psychotherapy training in psychiatry?

Abstract

Aims and MethodWe surveyed all our senior house officers (SHOs) in 1998 to ascertain the nature and quality of their psychotherapy training. Following the introduction of a structured psychotherapy training programme, we wished to see what difference this had made to their training experience. The same questionnaire was used to survey all SHOs currently training in our trust, and compared their responses with those of the earlier cohort.ResultsThere was a statistically significant increase in the number of trainees seeing patients, in the number of psychotherapy patients being seen, and in the expectations of trainees of being able to fulfil College requirements.Clinical ImplicationsOur results demonstrate the value of a formal psychotherapy training programme for the quality of psychotherapy training at SHO level. In particular, the introduction of protected time may have been crucial in allowing the SHOs to gain the necessary experience.

Setting up and evaluating a cognitive–behavioural therapy training programme for psychiatric trainees

“…These studies have recommended improvements in the availability and quality of psychotherapy supervision. Research in this field has shown that in practice psychiatric training schemes often find it difficult to provide trainees with the opportunities of training to achieve the recommendations set out by the College, despite the requirement to do so to sit the MRCPsych II examination (Grant et al, 1993;Janmohamed et al, 2004). This is particularly so in settings where there is no dedicated psychotherapy post.…”

Cognitive–behavioural therapy by psychiatric trainees: can a little knowledge be a good thing?

“…Obstacles to participation cited by trainees included well-documented reasons of work pressures 11 , 15 and lack of protected time. 13 As the structured feedback shows, trainees who did participate found it a positive experience.…”

“… 9 To date, much of the literature on psychiatric trainees delivering CBT has focused on comparing the recommendations of the Royal College of Psychiatrists with clinical practice 9 , 10 and looking at strategies to improve its organisation. 11 Recommendations such as improving the availability of supervision, 12 protected time 13 and suitable cases have been made. 14 , 15 Although there has been literature published on the assessment of psychotherapy competencies for psychiatric trainees, 16 , 17 to the best of our knowledge, there is little published on the competency of psychiatric trainees to actually deliver CBT based on structured feedback from supervisors and the use of structured tools such as those found on postgraduate psychotherapy courses.…”

Psychotherapy requirements as recommended by the College: awareness and achievement by senior house officers

“…These training cases can be difficult to provide as it requires 9-12 h of assessment time by psychotherapy consultants to yield one patient suitable for psychodynamic psychotherapy (Janmohamed et al, 2004). However, there is evidence to suggest that SHOs can be effective therapists (Mace et al, 2006) and can also have an important impact on service, leading to a reduction in waiting times for treatment (Janmohamed et al, 2004).…”

“…With the changes in working patterns, introduction of partial shift system, job changes every 6 months (often over a wide geographical area), patients frequently defaulting and pressure of the MRCPsych examination, this can often be an impossible task for trainees (Kolawole et al, 2006). In training schemes which implement half-day protected time for psychotherapy training, more SHOs are able to take up cases for psychotherapy (Wildgoose et al, 2002;Janmohamed et al, 2004). This is not the case across all training schemes, giving rise to widespread variation in training opportunities.…”