We believe that excellent psychotherapy training is essential for all psychiatry residents, regardless of their ultimate career goals. Psychotherapy training at UW includes clinical and didactic experiences designed to help residents progress from understanding basic principles underlying all forms of psychotherapy to familiarity with more specialized psychotherapeutic approaches.
Training experiences include didactics, small seminars, required and elective clinical rotations, individual supervision, and group supervision. Outpatient continuity clinics are equipped with the capability for video recording sessions to review with supervisors. Psychotherapy supervision and teaching are provided by both our core faculty as well as our courtesy faculty, which includes a large pool of providers (psychiatrists, psychologists, social workers, and other therapists) with expertise in a range of modalities.
Core Training
We provide a robust training in each of the three core psychotherapy modalities specified by the ACGME:
- Supportive psychotherapy: 4 months, R2 year
- Psychodynamic psychotherapy: 6 months, R2 year
- Cognitive Behavioral Therapy (CBT): 6 months, R3 year
We dedicate a half day per week of continuity clinic to learning each of these three core psychotherapies, starting in the R2 year. The training in each core psychotherapy includes each of the following:
- Videotaping of sessions for feedback from supervisors
- Weekly group supervision
- Weekly individual supervision
- Preparatory didactics
- Weekly clinic-based seminar
Electives
R3s and R4s may participate in elective psychotherapy clinical rotations, including:
- Dialectical Behavior Therapy (DBT)
- Couples & Family Therapy
- Acceptance and Commitment Therapy (ACT)
- Advanced Cognitive Behavior Therapy
- Trauma-Focused Psychotherapy
- Hypnosis
- Two-day training in Cognitive Processing Therapy
Some residents choose to complete coursework through our local psychoanalytic institute, The Seattle Psychoanalytic Society and Institute (SPSI).
Didactics
Psychotherapy didactics are tailored to skills residents will be using in their clinical work during each year of training.
- R1 Year includes therapeutic interviewing skills, supportive techniques in the inpatient setting, DBT skills in the inpatient setting, therapeutic crisis response planning, how to work with families, how to lead groups.
- R2 Year includes the common factors of psychotherapy, motivational interviewing (MI), mentalization based therapy (MBT), preparation to start supportive psychotherapy, preparation to start psychodynamic psychotherapy, and preparation to start cognitive behavioral therapy.
- R3 Year includes using therapy skills during medication appointments, including skills from DBT, CBT, psychodynamic therapy, and Good Psychiatric Management.
- R4 Year includes advanced psychodynamic theory, couples & family therapy, group therapy, and interpersonal therapy.
Additionally, R3s participate in a weekly Clinical Interaction Seminar using resident case material to explore countertransference and the doctor-patient relationship.
Supervision
Dedicated psychotherapy supervision supplements supervision from core clinical rotations. We have a cohort of courtesy faculty experts who volunteer to supervise residents in psychotherapy.
- R1 Year includes one hour per week of Off Ward Supervision, which is a dedicated time to discuss therapeutic formulation and techniques with patients on acute services.
- R2 Year includes one hour per week of supportive and psychodynamic supervision.
- R3 Year includes one hour per week of CBT supervision in addition to one hour per week of ongoing psychodynamic supervision.
- R4 Year includes one hour per week in the modality of the resident’s choosing.
Case Load Supervision
Each resident is assigned to a Case Load Supervision (CLS) group at their continuity clinic. Groups are composed of 3-5 residents and 1-2 faculty attendings. The group meets weekly to regularly discuss cases. The assigned faculty member also signs the residents notes and is available to the resident during the week for consultation.
T Group/Balint Group
All residents have the opportunity to participate in a T-group during protected didactic time, which is a support group facilitated by two members of the clinical faculty. T-groups are organized by PG-year and continue, with the same faculty facilitators, for all four years of training. This group is intended to provide support for residents and to give them an experiential introduction to group dynamics. Residents are assigned to T group for R1 year and then they may choose to continue in T group or to switch into a Balint Group for their later years of training. Balint Group is composed of R2s-R4s and led by trained facilitators. This is a structured group that meets to process strong countertransference reactions.
Psychotherapy Pathway
Residents who are interested in getting further training in psychotherapy may choose to participate in the Psychotherapy Pathway and graduate with an Area of Distinction (AOD) in Psychotherapy. Residents pursuing an AOD find a project mentor and complete a scholarly project or concentration, which can include completion of an internal or external elective training, clinical study, completion of a paper or chapter for a professional journal or book, preparation and teaching of a curriculum, or other approved project.
Pathway meetings are open to all residents and occur every two months during protected didactic time. Topics are determined on a yearly basis by current resident interest. Prior pathway meetings have included teaching on specific therapeutic modalities not taught in the core curriculum as well as special topics. Examples of prior presentations include trauma therapy in a correctional setting, cognitive behavioral analysis system of psychotherapy (CBASP), acceptance and commitment therapy (ACT), transgender issues in psychotherapy, shifting between psychotherapeutic frames, hypnosis, narrative therapy, technology in psychotherapy, radically open dialectical behavior therapy, schema-based cognitive behavior therapy (CBT), relational psychoanalysis, psychodynamic perspectives on shame, psychotherapeutic boundaries, psychotherapy termination, and psychotherapeutic approaches to specific disorders (including insomnia, conversion disorder, eating disorders, suicidality, and substance abuse).
Supplemental evening events hosted by the pathway have included a movie night discussion of Inception through the lens of psychoanalytic dream analysis, career panels, and panel discussions of a case by providers from different therapeutic orientations (e.g. compaing and contrasting approaches by a DBT therapist and psychodynamic therapist).