Psychoanalysis/psychotherapy in residency

[doppelganger84]

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I know this topic has been brought up in a variety of iterations in years past, but I don't see anything recent.

I'm a third year medical student about to apply to residency. I'd very much like to know the extent to which psychotherapy/psychoanalysis is integrated into the various residency programs out there. NYU appears to have a strong psychoanalytic component. I also know of a website that lists psychoanalytic training institutes that are linked to medical schools (http://apsa.org/Programs/Education_Outreach/Residency_Education.aspx).

Other than that, is there any kind of definitive, credible resource that addresses this question? Relying on hearsay and bushwhacking my way through individual program websites is a seemingly daunting task, but one I would undertake if there is no better alternative.

Thank you kindly. 🙂

(ps - I'm not very interested in debating psychotherapy vs biopsych, I think that would be more appropriate in a different thread)

 

[dl2dp2]

The reason that you are not getting any definitive answer is that there is a huge variation both between different programs and even within the same program, as the psychodynamic education becomes revised throughout the country.

First of all, psychoanalysis is a specific form of psychotherapy that uses psychodynamic principles but requires 3-4 times a week of treatment. Generally speaking, coming out of a general psychiatry residency you will not become a "psychoanalyst", which involves 3-4 days a week of both self analysis with a teaching analyst and at least 2 training cases for a number of years. This kind of training usually happens at a separate institute, some of which have some loose affiliation with the residency program. People become analysts after residency.

ACGME stipulates that every resident coming out of an accredited program would in principle be qualified to do supportive, cognitive-behavioral and psychodynamic therapy, generally in once or twice a week format. Each program spends a different proportion of time on various modalities, in terms of case load, didactics and supervision. For the most up to date information you would need to ask the program directors directly or during the interviews because often the programs themselves are changing rapidly in terms of their curriculum.

There is also per se no "debate" in reality for all intents and purposes in terms of residency education as every psychiatrist should in theory know both therapy and medications in terms of general competence, but one could consider specializing into either after residency.

I know this topic has been brought up in a variety of iterations in years past, but I don't see anything recent.

I'm a third year medical student about to apply to residency. I'd very much like to know the extent to which psychotherapy/psychoanalysis is integrated into the various residency programs out there. NYU appears to have a strong psychoanalytic component. I also know of a website that lists psychoanalytic training institutes that are linked to medical schools (http://apsa.org/Programs/Education_Outreach/Residency_Education.aspx).

Other than that, is there any kind of definitive, credible resource that addresses this question? Relying on hearsay and bushwhacking my way through individual program websites is a seemingly daunting task, but one I would undertake if there is no better alternative.

Thank you kindly. 🙂

(ps - I'm not very interested in debating psychotherapy vs biopsych, I think that would be more appropriate in a different thread)

 

[aphenomenon]

Definitely check out the interview review thread http://forums.studentdoctor.net/showthread.php?t=862811

Also, I think a good hint for programs is whether they have an analytic institute nearby/affiliated as that is where teaching faculty may associate (and you can often take extra classes or go to events etc.) And I may be wrong but at least Columbia and Emory have such institutes as parts of the programs themselves. A lot of times these are in big cities, particularly the northeast (but not always: see Atlanta). Traditionally, people associate Boston and New York. Again, you won't become an analyst but can but you around people teaching and talking about and practicing these ideas.

 

[nitemagi]

The most you can hope for from residency is decent training in psychodynamic therapy. NYC programs and UCSF are known to be dynamically oriented. Others may have it, may or may not emphasize it. If you go to a program near an institute you can always supplement your basic residency training with additional training, even during residency.

Check out "the American" website at apsa.org.

And just make sure there's a couple of quality analysts on faculty of different psychoanalytic orientations (ego psychology, self psychology, Kleinian, Bionian, etc.). Therefore you can potentially get supervisors with very different approaches.

 

[splik]

as mentioned psychoanalysis and psychotherapy are very different beasts. you want to go somewhere that will give you a strong overview of the principles of psychotherapy and a chance to develop your skills in 1 or 2 modalities. If you are interested in psychoanalysis it would be worthwhile going to a program where they have analysts on the faculty or have an analytic institute. however, more important is that you're in a city with a decent analytic institute. some places will allow you to start your analytic training in pgy3 or 4 or have evening fellowships to introduce you to the psychoanalytic texts and theories in more detail than you get in residency.

I have listed (albeit slightly tongue-in-cheek) some of the top programs for psychotherapy (not necessarily psychoanalytic) programs here: http://forums.studentdoctor.net/showthread.php?t=887721

To the add to above cities, Boston is heavily psychoanalytic as it was where American psychoanalytic tradition originated. Whilst NYC became very psychoanalytic because of the jewish emigres, well before that, the neurologists at MGH were treating patients using the psychoanalytic method and it was a Harvard professor of neurology who is credited with bringing psychoanalysis to the US (though AA Brill in New York certainly popularized it by translating Freud's works into English as terrible as the translations are).

 

[twright]

Your psychotherapy training is basically what you make of it. During your 3rd and 4th year, when your psychotherapy training really gets going in earnest, you can advocate for yourself to shape your caseload. Different programs will have different requirements (e.g., you must have X# CBT cases, X# IPT cases, etc) but beyond that you can simply contact clinical faculty to provide you with supervision. "Hi Dr. Z, I'm a resident at Program X. My program director gave me your contact information and suggested I speak with you since I am interested in learning schema therapy with a new patient I am taking on. I can come out to your office every week -- would you be able to supervise me?" One of my co-residents spent time learning dream interpretation during residency this way. Not my cup of tea, but it goes to show that you can pretty much find a supervisor for anything.

 

[HirsuteAnthony]

...the neurologists at MGH were treating patients using the psychoanalytic method and it was a Harvard professor of neurology who is credited with bringing psychoanalysis to the US (though AA Brill in New York certainly popularized it by translating Freud's works into English as terrible as the translations are).

Do neurologists ever use psychoanalysis now a days?

 

[splik]

yes there are neurologists who are trained in psychoanalysis but it is exceedingly rare. When you consider that it is rare for psychiatrists to train in psychoanalysis, and psychoanalysis is not really the most appropriate treatment for patients with conversion disorder today, with the ability to make more money doing neurology than psychoanalysis (which cant be done in an neurology outpatient clinic) its not surprising really.