Guest Editorial
Psychotherapy Education: Innovation and Evolution
Daniel H Greben, MD, FRCPC1, Zindel V Segal, PhD2
This set of articles on psychotherapy training looks forward along 3 lines. The intent is to illuminate a selection of key issues facing psychotherapy educators in Canada at the present juncture, examining each with sufficient depth to provide a rational basis for recommendations on future directions. The review has been composed to address psychotherapeutic educational content, the form in which such education is delivered, and the overarching theoretical framework within which specific training takes place. Taken together, these papers consider psychotherapy education increasingly informed by process and outcome research literature, reflecting an integrative perspective, and delivered in innovative ways that are attentive to current knowledge about best educational practices. The authors have considered education at both postgraduate and continuing educational levels of training.
A recent review of postgraduate psychiatric training in Canada emphasized several themes (1–3). Some thematic overlap is apparent with the articles comprising the current review: they underscore the importance of evidence-based training and critical appraisal of the evolving scientific literature, evaluation of trainee competence, a broad skill set with a capacity for integrative case formulation, and facilitation of continued learning throughout psychiatrists’ careers.
Dr Piper has examined the psychotherapy research literature with an emphasis on issues of educational relevance (4). In abstracting organizing themes emerging from this vast body of literature and acknowledging points of contention about which consensus does not exist, he has provided us with a high-level view of the field and a vantage point from which to consider future findings. His discussion draws our attention to important issues without bringing premature closure to areas still under debate within the field. By making specific educational recommendations regarding each such issue, he bridges the gap between clinical research and the educational interventions needed for clinical practice to become more empirically informed.
Dr Ravitz and Dr Silver provide results from a comparative sampling of approaches to postgraduate psychotherapy training across the country (5). In cataloguing the extant range of programmatic strategies, they allow us to learn from our colleagues, encouraging reexamination of the approaches already familiar to those responsible for specific residency programs. The authors highlight principles derived from adult learning and health education research so that these may be applied in framing future psychotherapeutic educational initiatives, their fundamental goal being to enhance pedagogic effectiveness. Finally, their examples of novel uses of information technology in psychotherapy training may stimulate psychiatric educators to use creative methods to deliver psychotherapy education. New technologies offer the potential to extend our reach, providing greater access to psychotherapy education in the face of geographical barriers or limited resources.
Dr Greben considers psychotherapy training from an integrative perspective (6). Explication of the rationale for attending to integrative factors is followed by a systematic examination of integrative and pedagogic issues that bear on education in the psychotherapies. In doing so, the author seeks to provide a structured overview of this literature that will serve as a coherent introduction for psychotherapy educators not yet familiar with it. He highlights decisions that are required in planning psychotherapy education so informed and makes specific recommendations where possible. Further, he addresses the need for greater empiricism in the future development of this field.
Each paper herein specifies recommendations directed at clinical teachers or educators with planning responsibility for psychotherapy training. This reflects a primary goal of the series: to translate academic rigour in reviewing psychotherapy education into concrete suggestions for possible enhancement. Last, while supervised clinical work continues to be central to learning to become a psychotherapist, our hope is that this series will identify opportunities for further innovation within psychotherapy education, thereby optimizing its delivery and maintaining the evolution and vitality of the field.
References
1. Persad E, Leverette J. Training issues in psychiatry in Canada. Can J Psychiatry 2003;48:213–4.
2. Scheiber SC, Kramer TAM, Adamowski SE. The implications of core competencies for psychiatric education and practice in the US. Can J Psychiatry 2003;48:215–21.
3. Martin L, Saperson K, Maddigan B. Residency training: challenges and opportunities in preparing trainees for the 21st century. Can J Psychiatry 2003;48:225–31.
4. Piper WE. Implications of psychotherapy research for psychotherapy training. Can J Psychiatry 2004;49:000–0.
5. Ravitz P, Silver I. Advances in psychotherapy education. Can J Psychiatry 2004;49:000–0.
6. Greben DH. Integrative dimensions of psychotherapy training. Can J Psychiatry 2004;49:000–0.
Author(s)
1. Deputy Clinical Director and Head, Ambulatory Services, General Psychiatry Program, Centre for Addiction and Mental Health; Associate Head, Psychotherapy Program and Assistant Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario.
2. Head, Cognitive Therapy Unit, Centre for Addiction and Mental Health; Morgan Firestone Chair and Head, Psychotherapy Program, Professor, Departments of Psychology and Psychiatry, University of Toronto, Toronto, Ontario.
e-mail:daniel_greben@camh.net
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