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Are Advanced Psychiatry Residents More Skillful Than Beginning Residents in the Conduct of Psychodynamic Psychotherapy?

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Abstract

The psychotherapy skills of psychiatry residents were assessed by using a structured-response supervisor inventory, the Supervisor Report (SR). Longitudinal data on the same resident across time showed a small but positive trend toward the acquisition of skill in doing psychodynamic psychotherapy. Mixed cross-sectional and longitudinal comparisons between ratings of the beginning residents and advanced residents demonstrated a significant, but small, increase in skill over the course of outpatient training. SR score changes also corroborated observational data on individual residents. While these findings suggest the utility of the SR in measuring changes in psychotherapy skill, the results must be considered in light of the relatively poor interrater reliability and only somewhat better test-retest reliability.

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References

  1. Graduate Medical Education Directory (1977). American Medical Association, Chicago, IL, pp. 265–266

  2. Shanfield S, Terrell C, Littlefield J: Using narratives to evaluate psychiatry residents’ competence. Academic Psychiatry 1997; 21:98–106

    Article  CAS  PubMed  Google Scholar 

  3. Rabinowitz C: Supervision of residents: teaching must keep pace with knowledge. Academic Psychiatry 1990; 14:142–145

    Google Scholar 

  4. Strupp H, Butler S, Rosser C: Training in psychodynamic therapy. J Consult Clin Psychol 1988; 56:689–695

    Article  CAS  PubMed  Google Scholar 

  5. Shanfield S, Mohl P, Matthews K, et al: A reliability assessment of the psychotherapy supervisory inventory. Am J Psychiatry 1989; 146:1447–1450

    CAS  PubMed  Google Scholar 

  6. Shanfield S, Mohl P, Matthews K, et al: Quantitative assessment of the behavior of psychotherapy supervisors. Am J Psychiatry 1992; 149:352–357

    CAS  PubMed  Google Scholar 

  7. Alberts G, Edelstein B: Therapist training: a critical review of skill training studies. Clin Psychol Rev 1990; 10:497–511

    Article  Google Scholar 

  8. Liston E, Yager J, Strauss G: Assessment of psychotherapy skills: the problem of inter-rater reliability. Am J Psychiatry 1981; 138:1069–1074

    CAS  PubMed  Google Scholar 

  9. Buckley P, Conte H, Plutchik R, et al: Learning dynamic psychotherapy: a longitudinal study. Am J Psychiatry 1982; 139:1607–1610

    CAS  PubMed  Google Scholar 

  10. Bonis J, Yager J: Ongoing evaluation in psychiatry: the first step toward quality. Am J Psychiatry 1986; 143:1415–1419

    Google Scholar 

  11. Yager J, Bonis J, Rabinowitz C: Developing minimal national standards for clinical experience in psychiatric training. Am J Psychiatry 1988; 45:1409–1413

    Google Scholar 

  12. Mohl P, Lomax J, Tasman A, et al: Psychotherapy training for the psychiatrist of the future. Am J Psychiatry 1990; 145:7–13

    Google Scholar 

  13. Holloway E, Neufeldt S: Supervision: its contribution to treatment efficacy. J Consult Clin Psychol 1995; 63:207–213

    Article  CAS  PubMed  Google Scholar 

  14. Fix A, Haffke E: Relationship between psychotherapy skills and level of training. Soc Sci Med 1975; 9: 489–491

    Article  CAS  PubMed  Google Scholar 

  15. Gaston L, Ring J: Preliminary results in the inventory of therapeutic strategies. J Psychother Pract Res 1992; 1:135–146

    CAS  PubMed Central  PubMed  Google Scholar 

  16. Svartberg O: Monitoring the competence of dynamic psychotherapists: a practical demonstration. Acta Psychiatr Scand 1989; 80:292–296

    Article  CAS  PubMed  Google Scholar 

  17. Stein M, Lambert M: Graduate training in psychotherapy: are therapy outcomes enhanced? J Consult Clin Psychol 1995; 63:182–196

    Article  CAS  PubMed  Google Scholar 

  18. Beutler L, Kendall P: Introduction to the special section: the case for training in the provision of psychological therapy. J Consult Clin Psychol 1995; 63:179–181

    Article  CAS  PubMed  Google Scholar 

  19. Fuqua D, Newman J, Scott T, et al: Variability across sources of performance ratings: further evidence. Journal of Counseling Psychology 1986; 33:353–356

    Article  Google Scholar 

  20. Moline R, Winer J: Assessment of residents’ ability to do psychotherapy. Journal of Psychiatric Education 1985; 9:267–277

    Google Scholar 

  21. Winer J, Mostert M: Evaluation of residents’ dynamic psychotherapy skills. Journal of Psychiatric Education 1988; 12:329–337

    Google Scholar 

  22. Koenigsberg H, Kernberg O, Haas G, et al: Development of a scale for measuring techniques in the psychotherapy of borderline patients. J Nerv Ment Dis 1985; 173:424–431

    Article  CAS  PubMed  Google Scholar 

  23. Howard K, Orlinsky D, Lueger R: The design of clinically relevant outcome research: some considerations of an example, in Research Foundations for Psychotherapy Services, edited by Aveline M, Shapiro D, Sussex, UK, John Wiley & Sons, 1995, pp. 3–47

  24. Jones S, Krasner R, Howard K: Components of supervisors’ ratings of therapists’ skillfulness. Academic Psychiatry 1992; 16:29–36.

    Article  CAS  PubMed  Google Scholar 

  25. Krasner R, Brown A, Howard K: The acquisition of psychotherapeutic skill: an empirical study. J Clin Psychol 1998; 54:895–903

    Article  CAS  PubMed  Google Scholar 

  26. Chevron E, Rounsaville B: Evaluating the clinical skills of psychotherapists. Arch Gen Psychiatry 1983; 40:1129–1132

    Article  CAS  PubMed  Google Scholar 

  27. O’Malley S, Foley S, Rounsaville B, et al: Therapist competence and patient outcome in interpersonal psychotherapy of depression. J Consult Clin Psychol 1988; 56: 649–695

    Google Scholar 

  28. Linacre J, Engelhard G, Tatum D, et al: Measurement with judges: many faceted conjoint measurement. International Journal of Educational Research 1994; 21, 569–577

    Article  Google Scholar 

  29. Woehr D, Huffcutt A: Rater training for performance appraisal: a quantitative review. Journal of Occupational and Organizational Psychology 1994; 67:189–205

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Northwestern University Medical School, 303 E. Superior St., Rm. 594, Chicago, IL, 60611, USA

    Ronald F. Krasner M.D. (Vice Chairman and Director of Psychiatric Education), Sarah R. Shelby A.B. (Ph.D. student in clinical psychology) & Kenneth I. Howard Ph.D. (Professor of Psychology)

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  1. Ronald F. Krasner M.D.
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  2. Sarah R. Shelby A.B.
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  3. Kenneth I. Howard Ph.D.
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Correspondence to Ronald F. Krasner M.D..

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Krasner, R.F., Shelby, S.R. & Howard, K.I. Are Advanced Psychiatry Residents More Skillful Than Beginning Residents in the Conduct of Psychodynamic Psychotherapy?. Acad Psychiatry 23, 88–94 (1999). https://doi.org/10.1007/BF03354248

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  • DOI: https://doi.org/10.1007/BF03354248

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