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Psychotherapy Training

"In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?"

― Carl R. Rogers


"It is far more important to know what person the disease has than what disease the person has."

― Hippocrates


We at the UCSD Psychiatry Residency Program believe that a deep understanding and appreciation of psychotherapy is critical to the sophisticated practice of psychiatry and thus is a vital component of the identity of psychiatrists. We understand that some residents may wish to focus their future practices on psychopharmacology and/or interventional psychiatry whereas others may aspire to make psychotherapy an integral part of their work. We wholeheartedly support whichever path residents choose to take. Regardless, a strong psychotherapy foundation is essential to psychiatric practice no matter the focus.

 

Our aims are for all psychiatry residents to develop competency in practicing psychotherapy, make nuanced and appropriate referrals for psychotherapy, and integrate psychotherapeutic processes and theories into case conceptualizations and clinical care in order to optimize patient outcomes—no matter whether a resident is seeing a patient for five minutes, 30 minutes, or twice-weekly hour-long sessions. Psychodynamic psychotherapy, supportive psychotherapy, and cognitive behavioral therapy are primary areas of focus. We also provide many specialized therapy electives as well as mentoring for residents who are interested in further exploring psychotherapy and may be considering a psychotherapy practice after graduation. We achieve our aims through 1) psychotherapy didactics which arc over all four years of training, 2) individual psychotherapy supervision, 3) experiential clinical psychotherapy opportunities, and 4) residents' own individual and group psychotherapy. Each of these core components of psychotherapy training will be delineated below.  


Psychotherapy Didactics

Seminars and didactics on psychotherapy run throughout all four years of residency training. In fact, psychotherapy is the largest thread in the residency formalized curriculum. Additional psychotherapy themed sessions occur in the Resident Rounds series, a series which is attended by psychiatry residents in all years of training. Seminar and didactic topics include, but are not limited to:

  • Cognitive Behavioral Therapy (CBT) Didactic Series
  • Advanced CBT, including CBT for Psychosis
  • Psychodynamic Psychotherapy Didactic Series
  • Advanced Psychodynamic Psychotherapy Didactic Series, including "In Treatment" and Transference Focused Psychotherapy
  • Intensive Short-Term Psychodynamic Psychotherapy
  • Interpersonal Therapy
  • Trauma Focused Therapies, including Prolonged Exposure Therapy and Cognitive Processing Therapy
  • Motivational Interviewing
  • Acceptance and Commitment Therapy
  • Mindfulness Based Therapies
  • Dialectical Behavioral Therapy
  • Mentalization Based Psychotherapy
  • Existential Psychotherapy and Meaning Oriented Therapy
  • Hypnotherapy
  • Integration of Psychotherapy and Pharmacotherapy 

Psychotherapy Supervision

A key component of psychotherapy training in residency is learning from psychotherapy supervision. Residents are paired with individual psychotherapy supervisors to discuss their psychotherapy cases and learn from their supervisors' clinical insights and depth of clinical experience. They work with each supervisor on a weekly basis over the course of 6 months to 12 months.

 Each resident is paired with a CBT supervisor during their PGY2 year. Each resident is paired with a psychodynamic psychotherapy supervisor during their PGY3 year. Additionally, PGY2 residents and PGY4 residents have the option of receiving individual psychodynamic psychotherapy supervision and each PGY3 and PGY4 resident has the option of receiving additional individual CBT supervision. Supervision for other modalities of psychotherapy, such as Interpersonal Psychotherapy, Acceptance and Commitment Therapy, Prolonged Exposure Therapy, and Complicated Grief Therapy, are built into the elective clinics in which residents are learning these types of psychotherapy. 

Psychotherapy Clinical Cases

Our best teachers are our patients. This is especially the case with psychotherapy education. As such, the clinical experiential aspects of psychotherapy training are critical components of the residency psychotherapy education. Residents get introduced to psychodynamic and CBT case conceptualizations as well as the clinical applications of psychotherapy during their PGY1 year. Their more formalized weekly psychotherapy clinical experience paired with psychotherapy supervision begins in their PGY2 year.

  • Cognitive Behavioral Therapy: 1 year during PGY2 year plus optional experiences PGY3-4 years
  • Psychodynamic psychotherapy: 1 year during PGY3 year plus optional experiences PGY2-4 years

Additional clinical experiences with psychotherapy occur during elective half-day weekly clinics during the PGY3 and PGY4 years. These elective choices, comprised of longitudinal patient care combined with individual psychotherapy supervision, include:

  • Interpersonal Psychotherapy
  • Acceptance and Commitment Therapy
  • Advanced Psychodynamic Therapy
  • Marriage and Family Therapy
  • Complicated Grief Therapy
  • Cognitive Processing Therapy and Prolonged Exposure therapy through PTSD Clinic Elective
  • Motivational Interviewing through Substance Use Clinic elective

Clinical experience with group therapy occurs in the PGY3 year and in select PGY3 and 4 elective clinic opportunities. Examples include:

  • Mentalization Based Therapy Groups
  • Cognitive Behavioral Therapy Groups
  • Dialectical Behavioral Therapy Groups
  • Acceptance and Commitment Therapy Groups

Individual and Group Psychotherapy for Residents

Engagement in one's own individual psychotherapy promotes self-insight, empathy, and sophistication with understanding and working with countertransference and resistance. As such, UCSD psychiatry residents are encouraged, although not required, to engage in their own individual psychotherapy during their training. We have a unique program that allows for no-cost psychotherapy during the PGY3 or PGY4 year of training.

Additionally, residents grow personally and collectively through their meaningful participation in process group. Process group serves an additional role of teaching residents group therapy by having them experientially do their own group therapy.

Opportunities for residents' own individual and group therapy include:

  • No cost psychodynamic psychotherapy for one year in the PGY3 or PGY4 year of training
  • PGY1 weekly process group
  • PGY2 weekly process group

Additional Psychotherapy Experiences

In addition to the formal and elective psychotherapy experiences delineated above, UCSD psychiatry residents also engage in many additional educational opportunities to further their study of psychotherapy. These more in-depth experiences take place on evenings or weekends and are often led by our remarkable voluntary faculty. They include, but are not limited to:

  • Intensive Short-Term Psychodynamic Psychotherapy
  • Gestalt Psychotherapy
  • Hypnotherapy
  • Dream Analysis
  • Film and Psychotherapy
  • Dialectical Behavioral Therapy
  • Transference Focused Psychotherapy

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