Psychotherapy Training
"In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?"
― Carl R. Rogers
"It is far more important to know what person the disease has than what disease the person has."
― Hippocrates
At the UC San Diego Psychiatry Residency Program we believe that a deep understanding and appreciation of psychotherapy is critical to the sophisticated practice of psychiatry and thus is a vital component of the identity of psychiatrists. We understand that some residents may wish to focus their future practices on psychopharmacology and/or interventional psychiatry whereas others may aspire to make psychotherapy an integral part of their work. We wholeheartedly support whichever path residents choose to take. Regardless, a strong psychotherapy foundation is essential to psychiatric practice no matter the focus.
Our Aims
Our aims are for all psychiatry residents to develop competency in practicing psychotherapy, make nuanced and appropriate referrals for psychotherapy, and integrate psychotherapeutic processes and theories into case conceptualizations and clinical care in order to optimize patient outcomes are primary areas of focus with additional training opportunities in psychodynamic and support psychotherapies. We also provide many specialized therapy electives as well as mentoring for residents who are interested in further exploring psychotherapy and may be considering a psychotherapy practice after graduation.
We achieve our aims through:
1) psychotherapy didactics which arc over all four years of training,
2) individual psychotherapy supervision,
3) experiential clinical psychotherapy opportunities
Each of these core components of psychotherapy training are delineated below.
Psychotherapy Didactics
Seminars and didactics on psychotherapy run throughout all four years of residency training. In fact, psychotherapy is the largest thread in the residency formalized curriculum. Additional psychotherapy themed sessions occur in the Resident Rounds series, a series which is attended by psychiatry residents in all years of training. Seminar and didactic topics include, but are not limited to:
- Cognitive Behavioral Therapy (CBT) Didactic Series
- Advanced CBT, including CBT for Psychosis
- Psychodynamic Psychotherapy Didactic Series
- Advanced Psychodynamic Psychotherapy Didactic Series
- Intensive Short-Term Psychodynamic Psychotherapy
- Interpersonal Therapy
- Trauma Focused Therapies, including Prolonged Exposure Therapy and Cognitive Processing Therapy
- Motivational Interviewing
- Acceptance and Commitment Therapy
- Mindfulness-Based Therapies
- Dialectical Behavioral Therapy
- Mentalization-Based Psychotherapy
- Integration of Psychotherapy and Pharmacotherapy
Psychotherapy Supervision
A key component of psychotherapy training in residency is learning from psychotherapy supervision. Residents are paired with individual psychotherapy supervisors to discuss their psychotherapy cases and learn from their supervisors' clinical insights and depth of clinical experience. They work with each supervisor on a weekly basis over the course of 6 months to 12 months.
Each resident is paired with a CBT supervisor during their PGY2 and PGY3 year. Interested residents can also be paired with a psychodynamic psychotherapy supervisor during their PGY3 and PGY4 year and have the option of receiving individual psychodynamic psychotherapy supervision and additional didactic training. Supervision for other modalities of psychotherapy, such as Interpersonal Psychotherapy, Acceptance and Commitment Therapy, Prolonged Exposure Therapy, and Complicated Grief Therapy, are built into the elective clinics in which residents are learning these types of psychotherapy.
Psychotherapy Clinical Cases
Our best teachers are our patients. This is especially the case with psychotherapy education. As such, the clinical experiential aspects of psychotherapy training are critical components of the residency psychotherapy education. Residents get introduced to psychodynamic and CBT case conceptualizations as well as the clinical applications of psychotherapy during their PGY1 year. Their more formalized weekly psychotherapy clinical experience paired with psychotherapy supervision begins in their PGY2 year.
- Cognitive Behavioral Therapy: 1 year during PGY2 year plus optional experiences PGY3-4 years
- Psychodynamic psychotherapy: 1 year during PGY3 year plus optional experiences PGY2-4 years
Additional clinical experiences with psychotherapy occur during elective half-day weekly clinics during the PGY3 and PGY4 years. These elective choices, comprised of longitudinal patient care combined with individual psychotherapy supervision, include:
- Interpersonal Psychotherapy
- Acceptance and Commitment Therapy
- Advanced Psychodynamic Therapy
- Marriage and Family Therapy
- Complicated Grief Therapy
- Cognitive Processing Therapy and Prolonged Exposure therapy through PTSD Clinic Elective
- Motivational Interviewing through Substance Use Clinic elective
Clinical experience with group therapy occurs in the PGY3 year and in select PGY3 and 4 elective clinic opportunities. Examples include:
- Mentalization Based Therapy Groups
- Cognitive Behavioral Therapy Groups
- Dialectical Behavioral Therapy Groups
- Acceptance and Commitment Therapy Groups