Is That an Unconscious Fantasy or an Automatic Thought? Challenges of Learning Multiple Psychotherapies Simultaneously

Gastelum, Emily D.; Hyun, Aerin; Goldberg, David; Stanley, Bárbara; Sudak, Donna M.; Cabaniss, Deborah L.

doi:10.1521/jaap.2011.39.1.111

Cited by 11 publications

(5 citation statements)

References 10 publications

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“…Rather than working with one clearly defined model/approach in the treatment of Ms. L., Dr. X began with a psychotherapy that combined elements of supportive psychotherapy and exploratory/psychodynamic psychotherapy, ultimately adding elements of a dialectical-behavioral therapy (DBT). Looking back on her efforts, the resident has asked if it was good clinical practice to combine approaches with Ms. L. Her question echoes concerns voiced by Gastelum et al (2011) who have written about the difficulty learning multiple psychotherapies simultaneously during residency training.…”

Section: Discussionmentioning

confidence: 99%

“…Is it useful clinically? We know that many experienced practitioners often use more than one type of psychotherapy within a single treatment (Beitman, Goldfried, & Norcross, 1989;Gastelum et al, 2011;Smith, 1982); we also know that surveys indicate that the majority of therapists identify themselves as "eclectic" in their clinical practice (Garfield & Kurtz, 1974). In fact, "eclecticism" has been described and advocated for as its own genre of therapy (Beitman et al, 1989;Simon, 1974;Smith, 1982).…”

Section: Discussionmentioning

confidence: 99%

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The Challenge of Treating (and Supervising) Patients with Borderline Pathology in a Residents' Clinic

Occhiogrosso

Auchincloss²

2012

Psychodynamic Psychiatry

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Outpatients with borderline personality disorder (BPD) comprise up to 20% of psychiatry clinics, to which they are usually referred for treatment, not of their Axis II pathology but for comorbid Axis I conditions. The complex and intense transference and countertransference dynamics that patients with even "secondary" BPD evoke in psychotherapy treatments require careful handling and supervision. Cases can quickly lose focus, with resultant morbidity for both patient and treater alike. Little literature exists to guide supervision of psychiatry trainees treating outpatients with BPD and Axis I illness. We describe a case of a young woman with BPD with a comorbid major depressive episode (MDE) who was treated by a third-year psychiatry resident with a mixture of supportive and dynamic psychotherapy and medication management. The treatment rapidly became chaotic, with escalating levels of patient acting out and resident dissatisfaction. We outline suggestions for supervision of resident treatment of patients with comorbid or primary BPD, including importance of careful intake assessment and treatment formulation, the establishment of a clear-cut frame and/or treatment contract, and the need for contextualizing expectable transference and countertransference reactions. Last, we discuss the pros and cons of mixing psychotherapy techniques within the same treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Challenge of Treating (and Supervising) Patients with Borderline Pathology in a Residents' Clinic

Occhiogrosso

Auchincloss²

2012

Psychodynamic Psychiatry

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“…The independent features of the two therapies comprise the two branches along which training independently occurs, requiring students to be multilingual but not integrative in their work. It is the most coherent published training model we could find in which dual approaches are compared, contrasted, and advanced in pursuit of general therapeutic competence (12).…”

Section: The Y Modelmentioning

confidence: 99%

Y Model Psychotherapy Training: A Qualitative Investigation of Students’ Experiences

Ivey

Deans

2019

APT

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This article reports on a research project investigating psychology graduate students' experiences of Y model psychotherapy training at an Australian university. Focus group interviews were conducted with clinical psychology students (N=20), and thematic analysis was used to capture core aspects of their training experience. Participants felt that the dual training in cognitive-behavioral therapy and psychodynamic therapy gave them a significant advantage over students trained in only a single approach. Notwithstanding the perceived benefits of their training, participants emphasized how intellectually and emotionally demanding it was. Students struggled to shift between therapeutic orientations, both in learning about and conducting different therapies and in accommodating differing supervisory expectations. Psychodynamic therapy was viewed as the most conceptually, technically, and personally challenging component to learn, but also as the most enriching. Despite the emphasis the students placed on the psychodynamic arm of the Y model training, participants reported a variety of therapeutic identity positions, and most maintained a flexible view of how they would practice therapeutically.

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“…Residents are often confused when learning and practicing various types of psychotherapy simultaneously, especially when at first glance these approaches seem so different and hard to reconcile. A recent article by a group of residents and educators highlights the challenges involved (Gastelum et al, 2011). The resident can easily miss the forest for the trees, try to mix techniques, and even create idiosyncratic approaches.…”

Section: Using the Y Model To Teach Psychodynamic Psychotherapymentioning

confidence: 99%

Teaching Psychodynamic Psychotherapy with the Y Model

Goldberg¹,

Plakun²

2013

Psychodynamic Psychiatry

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The Y model of psychotherapy represents core components of all psychotherapies on the stem of the Y, and the specific components of psychodynamic psychotherapy and cognitive-behavioral therapy (CBT) on the arms of the Y. Familiarity with the Y model can help students cope with the confusion that emerges when trying to learn several different types of psychotherapy. The Y model also can be an important aid to teachers of psychodynamic psychotherapy. Use of the Y model helps students see how specific components of psychodynamic psychotherapy emerge from the core. It also helps students to compare psychodynamic psychotherapy with CBT (and other therapies). A student who has reached a point of confusion while doing psychodynamic psychotherapy can be invited to "zoom out" to the Y model, using it to examine this point of confusion, "zooming back in" for a fresh look at the patient-therapist interaction.

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Is That an Unconscious Fantasy or an Automatic Thought? Challenges of Learning Multiple Psychotherapies Simultaneously

Cited by 11 publications

References 10 publications

The Challenge of Treating (and Supervising) Patients with Borderline Pathology in a Residents' Clinic

The Challenge of Treating (and Supervising) Patients with Borderline Pathology in a Residents' Clinic

Y Model Psychotherapy Training: A Qualitative Investigation of Students’ Experiences

Teaching Psychodynamic Psychotherapy with the Y Model

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