Brochure For Prospective Residents
Introductory Letter
Overview of Program
Rotation Schedule and Objectives
Resident Seminars
Psychotherapy Training
Career Opportunities
Faculty Research By Group
Stipends and Benefits
Map For Applicants
From Garage to Renard
(PDF)
From Garage to Renard
(JPEG)
Residents
Current Residents
National Achievements of Residents
Resident Photos
Other Items of Interest
Department Faculty
Faculty Research Interests
Department Publications
Department Grants
Weekly Seminars
Residency Program
Psychotherapy Experience
It is extremely important for residents to develop critical thinking regarding all aspects of psychiatric treatments. Our residents appropriately learn to consider the efficacy and risk/benefit ratio of somatic treatments. Our residents also gain strong psychotherapeutic skills and by the end of their training have the confidence to assess the efficacy and risk/benefit ratio of psychotherapeutic treatments as well.
One component of a program that is successful in training residents in a wide range of skills is providing them with exposure to a sufficient number of patients with a variety of psychiatric disorders. A program with too few patients cannot provide exposure to the fascinating diversity of psychiatric symptoms. Our rotations provide excellent volume of patients with appropriate supervision. We are aware of the didactic limitations of either too few or too many patients and we continually work at maintaining the optimal number of patients.
Supervised treatment of a reasonable number of patients is necessary, however it is not sufficient to provide solid training in psychotherapeutic skills. Our approach to training residents in psychotherapy involves a combination of formal lectures, demonstrations, observations, and practice throughout the four-year training period.
The development of excellent psychotherapeutic skills involves learning about the non-specific benefits of all psychotherapies and the specific benefits of certain therapies. This latter aspect of training evolves as research demonstrates which therapies are effective in treating specific conditions.
Our didactic psychotherapy curriculum begins during the introductory summer course for the PGY-1 residents with several discussions dealing with interviewing skills, the patient-physician relationship, and an overview of specific therapies.
During the inpatient psychiatry rotation in the PGY-1 year, residents improve their interviewing skills by conducting patient interviews in front of their colleagues and teaching attendings. In addition residents learn basic psychotherapeutic skills. Residents also observe faculty interviews. Several conferences during this year include specific discussions concerning inpatient psychotherapy and issues of transition to outpatient management. In addition, issues related to somatic and psychologic patient management are discussed during daily attending rounds.
A Tuesday morning course dealing with personality and personality disorders is offered during all years of training. Issues of psychotherapies and personality profiles are covered in this four-year curriculum.
During the second year, residents continue to gain psychotherapeutic skills from supervised patient management coupled with didactics from daily teaching rounds. Each PGY-2 resident takes a "mock board" oral exam and receives direct feedback from a board certified member of the faculty. During this PGY-2 year, residents participate in group therapy on the Chemical Dependency Unit. They also have the opportunity to choose rotations that offer additional group experiences, e.g., day hospital selective. During the second year child rotation, all residents are introduced to Family Therapy. On the Consult Services, experience is gained in certain types of brief therapies. Also, crisis intervention skills are enhanced from the ER experience.
Substantial training in psychotherapy occurs in the third year when residents spend the entire year caring for patients in the outpatient clinic. As described in the accompanying letter from Keith Garcia, MD, PhD, the head of this clinic, the curriculum associated with this rotation includes behavioral and cognitive therapies, interpersonal therapy, group therapy, psychodynamic therapy, and supportive therapeutic approaches. Residents are expected to use these techniques in the care of their patients. Residents who are interested in more in-depth training in one of these modalities are encouraged to choose a supervisor with such expertise and work with that supervisor.
Most patients in our clinic receive psychotherapy and medications. A curriculum on "advanced integrative psychopharmacology" targets the integrated use of these modalities in complex clinical scenarios.
Finally, in the PGY-4 year, residents continue to refine their psychotherapeutic skills as they continue to take care of long-term patients. In addition, residents who wish to have more training in psychotherapy may opt to utilize their elective time to gain more experience in this area.
Letter from the Clinic Director:
July 1, 2006
Dear Psychiatry Resident Applicant:
The third year of the psychiatry residency begins the outpatient curriculum. This 12-month rotation is an exciting year during which residents have the opportunity to consolidate their skills in diagnostic evaluation, treatment planning, and psychotherapeutic approaches. The outpatient curriculum is based on the combination of direct patient care and focused educational seminars. Each resident will evaluate and treat approximately 150 patients. The outpatient educational series includes three courses that meet weekly: seminars in psychotherapy, ongoing case conferences, and professor's patient presentations.
Seminars in Psychotherapy
Seminars in psychotherapy cover major psychotherapeutic modalities: brief psychotherapy models, cognitive behavior therapy, behavior modification, psychodynamic psychotherapy, interpersonal therapy, and group, family and couples therapy.
The cognitive behavior section of the course covers cognitive approaches to psychiatric disorders. This is followed by more traditional behavioral modification. Lastly, methods of cognitive behavior therapy are applied to panic disorder and agoraphobia, obsessive-compulsive disorder, and other psychiatric disorders.
Psychoanalysts from the Psychoanalytic Institute cover psychodynamic psychotherapy. Basic techniques of psychodynamic psychotherapy, as well as the action of psychodynamic principles in the therapeutic relationship are presented.
Another section of the course is devoted to interpersonal psychotherapy. Basic concepts are reviewed and integrated into other psychotherapies such as supportive psychodynamic and cognitive behavioral therapy.
The fourth section covers group, family and couples psychotherapy. Group and family interactions and dynamics, and group leadership are all discussed. During the outpatient curriculum residents are offered group therapy experience.
The remainder of the year covers special topics in outpatient treatment. Topics include grief, trauma, managing patients with medical and psychiatric illnesses, charting issues, forensic issues, informed consent, and psychotherapy in early development and late life. Practical issues such as beginning a private practice are discussed.
Ongoing Case Conference
Our second major teaching activity is the ongoing case conference and evidence based treatment. This conference focuses on a practical application of the psychotherapeutic approaches taught in "Seminars in Psychotherapy". A case is presented to a psychiatrist or psychologist with the opportunity to follow the patient over several weeks.
As part of the ongoing case conferences we include an interactive seminar that discusses principles of evidence-based analysis of pharmacological treatment data, and systematically reviews the evidence for the use of specific treatments in chronic psychosis. This evidence-based approach can then be extended to the treatment of affective and anxiety disorders.
Professor's Case Presentations
The outpatient curriculum includes a professor's case presentation rounds. A patient is presented to the professor and interviewed in front of the group. This allows special topics to be discussed, including diagnostic dilemmas and the management of difficult patients.
Psychotherapy Supervision
Two hours of psychotherapy supervision are required each week during the outpatient rotation. Residents have the opportunity to choose their supervisors. Numerous supervisors are available, including all members of the full-time faculty, part-time clinical faculty (private practitioners), psychologists, and social workers. This flexibility allows the resident to select several areas of interest, and exposes them to different backgrounds and techniques. Supervisors use audio or videotapes, process notes, or an informal dialog to review the resident's patients.
In summary, our outpatient curriculum is designed so that residents enhance their clinical skills and conduct excellent patient care in a diverse outpatient setting, using a variety of treatment options.
Sincerely,
Keith Garcia, M.D., Ph.D.
Director, Barnes/Jewish Psychiatry Clinic