Compentencies in Psychotherapy

Compentencies in Psychotherapy

Cognitive Behavioral Therapy

Knowledge Requirements:

  • Indications and contraindications of CBT
  • The basic principles of the cognitive model (e.g. relationship of thoughts to emotions and behavior; concepts of automatic thoughts and distortions, core beliefs, schemas, dysfunctional thoughts, and behavioral strategies)
  • Use of cognitive techniques (e.g. identifying automatic thoughts, cognitive restructuring, problem solving, advantage/disadvantage analyses, thought recording, and modification of core beliefs).
  • Use of behavioral techniques (e.g. activity scheduling, exposure and response prevention, relaxation training, graded task assignment, and rating scales)

Skills in CBT will include:

  • ability to elicit data and conceptualize patients in a CBT framework
  • ability to establish a therapeutic alliance, educate the patient about CBT principles and concepts relevant to the treatment process and goals.
  • ability to utilize CBT techniques (e.g. set an agenda and structure session, assign and review homework, utilize activity scheduling, graded task assignments, relaxation techniques, and exposure and response prevention)
  • ability to utilize the dysfunctional thought record and measure its impact on mood and behavior
  • ability to recognize and identify affects in the patient and him/herself
  • ability to effectively plan termination, utilize booster sessions, and teach relapse prevention techniques

Attitudes demonstrated during CBT will include:

  • empathy, respect, openness, and nonjudgmental collaboration with the patient
  • sensitivity to social, cultural, and socioeconomic issues in the therapy

Feedback will be provided to each resident.

  • Each resident will be evaluated with one or more of the following rating scales specific for knowledge, skills, and attitudes in CBT.  The resident must obtain a passing score.
    • The Academy of Cognitive Therapy Case Review Rating Scale: a scale of 20 is needed to pass
    • The Cognitive Therapy Scale (Young and Beck):  score of 40 is needed to pass
    • The Cognitive Therapy Awareness Scale
  • Supervisors’ direct observation of therapy sessions and process review.  The psychotherapy supervisors will provide a written evaluation every six months assessing the knowledge, skills, and attitudes necessary for competence in CBP.
  • Instructor’s written evaluation after the resident’s participation in PGY-3 Group Supervision courses in CBT.
  • The resident’s performance on the annual PRITE: psychosocial therapies subscore
  • The resident’s performance on diagnostic interview, case formulation, and treatment planning during Mock Orals held during PGY-2 through PGy-4 years.
  • The Academy of Cognitive Therapy offers certification in cognitive therapy.  This is optional but encouraged for residents.
  • CBT psychotherapy cases are to be documented in resident’s clinical log.  A minimum of two patients with at least twelve sessions devoted to CBT are expected.

Psychodynamic Psychotherapy

Knowledge requirements:

  • principles, theory, and techniques of psychodynamic psychotherapy
  • indications and contraindications of psychodynamic psychotherapy
  • understanding of the concepts of the dynamic unconscious, psychic determinism, defense mechanisms, resistance, transference, and counter transference
  • understanding of the therapeutic frame and alliance as well as the effective planning of termination of psychodynamic psychotherapy

Skills in Psychodynamic psychotherapy will include:

  • ability to develop a psychodynamic case formulation including psychodynamic psychotherapy indications and plan
  • ability to establish and maintain the therapeutic frame and alliance, with appropriate neutrality and empathy while maintaining appropriate boundaries
  • ability to effectively utilize clarification, confrontation, interpretation, and working through
  • ability to recognize and therapeutically manage defense mechanisms, resistance, transference, and counter transference
  • ability to plan and effectively implement termination of psychodynamic psychotherapy

Attitudes demonstrated during psychodynamic psychotherapy will include:

  • empathy, respect, openness, and nonjudgmental collaboration with the patient
  • sensitivity to social, cultural, and socioeconomic issues.

Feedback will be provided to each resident.

  • Each resident’s knowledge in psychodynamic psychotherapy will be assess annually on the Columbia Psychotherapy Skills Test.
  • Supervisors’ direct observation of therapy sessions and process review.  The psychotherapy supervisors will provide a written evaluation every six months assessing the knowledge, skills, and attitudes necessary for competence in psychodynamic psychotherapy.
  • Instructor’s written evaluation after the resident’s participation in the PGY-4 Group Supervision Course
  • The resident’s performance on the annual PRITE:  Psychosocial therapies subscore
  • The resident’s performance on diagnostic interview, case formulation, and treatment planning during Mock Orals held during the PGY-2 through PGY-4 years.
  • Psychodynamic psychotherapy cases are to be documented in the resident’s clinical log.  A minimum of two patients with 45 sessions is expected.

Supportive Psychotherapy

Knowledge base will include:

  • indications and contraindications for supportive psychotherap
  • the importance of the patient-therapist relationship in the treatment process
  • the objectives of supportive psychotherapy, including maintenance or improvement of the patient’s self-esteem, minimization and prevention of symptoms, assistance in problem-solving, and maximization of the patient’s coping and adaptation.

Skills in supportive psychotherapy will include:

  • ability to formulate treatment goals with the patient and establish a therapeutic alliance
  • ability to provide reassurance, feedback, and advice to the patient when appropriate
  • ability to confront any damaging or dangerous behaviors and help the patient consider more adaptive alternative behaviors
  • ability to provide the patient with problem-solving strategies to assist with mood stabilization, interpersonal relationships, and reality testing
  • ability to provide education to the patient about his/her psychiatric condition and its treatment
  • ability to recognize and identify affects in the patient and himself/herself

Attitudes demonstrated during supportive psychotherapy will include:

  • empathy, respect, openness, and nonjudgmental collaboration with the patient
  • sensitivity to social, cultural, and socioeconomic issues

Feedback will be provided to each resident.

  • Supervisors’ direct observation of therapy sessions and process review.  The psychotherapy supervisors will provide a written evaluation every six months assessing the knowledge, skills, and attitudes necessary for competence in supportive psychotherapy.
  • The resident’s performance on the annual PRITE:  psychosocial therapies subscore
  • The resident’s performance on diagnostic interview, case formulation, and treatment planning during Mock Orals held during PGY 2 through PGY 4
  • Brief psychotherapy cases are to be documented in the resident’s clinical log.  A minimum of two patients with eight sessions each is expected.