Top Programs for Psychotherapy

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splik

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Using a ranking system more flawed and less transparent than USNews I have created a list of top programs for psychotherapy with some deliberately controversial inclusions and omissions! There is some truth in it, but like most rankings don't take it too seriously but it would be nice if it started off a discussion and caused aggrieved residents to come and defend their program!

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UCSD’s residency program lurks within in a biologically-oriented locale, with a biologically oriented department. But psychotherapy training is safeguarded by Program Director Sid Zisook, who is a national proponent of psychotherapy training in psychiatry. With a slight psychodynamic bias, there is also training in CBT, integrative therapy, supportive therapy, short term dynamic therapy, and opportunities for group therapy, and family therapy. UCSD is also one of those sensible programs that offers training in hypnotherapy, which widens the treatment portfolio, and emphasizes important aspects of any therapy: rapport building, communication styles, relaxation, imagery and metaphor. There may be more psychotherapy training at UCSF, but Southern California’s more biological bent means UCSD deserves high commendation for its psychotherapy focus in a hostile climate.
 
An oasis in the wasteland that is the Midwest, competing for residents with its East Coast rivals, it is easy to overlook the program that puts the Wolverines on the couch. Well maybe not, and Michigan could easily fall into the ‘biological psychiatry’ camp, but Michigan certainly offers one of the most balanced psychotherapy curricula in the country, with psychodynamic, supportive, cognitive behavioral, interpersonal, DBT, and family approaches considered through a robust didactics program. Michigan favors the ‘evidenced-based’ aka ‘alphabet soup’ therapies, but you will learn all the foundations here. There is a non-affiliated psychoanalytic institute that offers a psychoanalytic fellowship or to start analytic training during residency should you prefer objects to schemas, cathexis to cognitive distortions, and Bion to Beck…
 
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It doesn’t have the prestige of MGH/McLean, nor does it have the psychotherapeutic emphasis of Cambridge – but make no mistake Longwood has top quality psychodynamic training. Boston, being Boston, many psychiatrists at the Psychoanalytic Institute are major players in the residency training. What is more remarkable, is even in psychoanalysis-dominated Boston, Longwood is used as a model of strong CBT training by the Academy of Cognitive Therapy. Further, Mass Mental Health Center provides the opportunity for residents to hone their DBT skills. Even on the consult service at the Brigham, you may find yourself talking about the dynamics of medical demoralization and Longwood’s forensic hotshot Tom Gutheil provides a fascinating psychoanalytic bent on the interface of psychiatry and the law for those who are interested.
 
Yes, it’s in New Haven. And yes, many people would rather be brutally $odomized by a priapic goat on Viagra than live there, but this research powerhouse has always been a friend of the psychoanalyst, and remains so to this day. Affiliated with the Western New England Psychoanalytic Institute, residents can supplant the already robust psychodynamic training with further didactics and, should they wish, consider their unconscious motivations for flirting so flagrantly with Thanatos by living in New Haven, undertaking personal analysis and analytic training. The Yale Child Study Center maintains strong links with University College London and the Anna Freud Center. Cognitive Behavioral Therapy and supportive therapy round off the requirements, with generous flexibility and elective time to indulge in group therapy, family therapy, Cognitive Processing Therapy, Hypnosis, Sexual Therapy, and so on.
 
Despite having built up a small army of neuroscientists in recent years, Cornell arguably deserves the title of ‘Most Psychoanalytic Psychiatry Department’. Although Cornell attracts some serious neuroscience researchers into their residency, it is not possible to escape analysis…professional and probably personal as well. Psychoanalytic heavyweights of a byegone era still walk the halls of Payne Whitney, chief amongst them Otto Kernberg. The inpatient personality disorders unit provides a fairly unique confrontation with extreme characterology of the extremely wealthy. Cornell is very similar to Columbia in many respects, not least with some almost identical didactics. But Cornell’s slavish adherence to psychoanalytic approaches above other therapeutic modalities places them lower down. Whilst other programs teach exposure therapy for panic disorder, Cornell privileges brief psychodynamic approaches. Bizarrely, crude behaviorism can also be found – the largely defunct Token Economy is still in use on one of their units!
 
The Chair of Psychiatry may be one of the godfathers of schizophrenia research, but that has not shaken out the psychoanalytic dogma that persists and the closely linked psychoanalytic institute. Along with the plethora of researchers in neuroscience, genetics, psychopharmacology, phenomenology, evidence-based psychotherapy, epidemiology, and psychometrics, lurk faculty preoccupied with the more lurid machinations of their residents and you could easily spend more time talking about erotic transference than dosing efexor. What is more impressive is that despite New York’s almost Oedipal fixation with psychoanalysis, Columbia pays more than lip service to other approaches including cognitive-behavioral therapy, and interpersonal therapy. Many a resident pursues analytic training, and successfully milk bored housewives in exchange for listening to their upper-middle class meanderings upon graduation.
 
At the birthplace of Cognitive Therapy, Penn residents receive more training in cognitive-behavioral therapy than anywhere else. They also receive top notch psychodynamic training, and there are a number of leading analysts on the faculty who are involved in research into process and outcomes in psychotherapy. There is a psychotherapy track which allows those interested to gain more experience in a specific psychotherapy, learn from leading psychotherapists, and participate in a fascinating didactic program that varies year to year but has considered issues outside the scope of modern psychiatry such as the psychology of terrorism.
 
So it might not be the best overall training in Texas, and it might enslave unsuspecting FMGs into exhaustion, but it does have top notch psychoanalytic training, there is strong emphasis placed on the psychiatrist as psychotherapist, and also some didactics on the very useful mentalization-based treatment for borderline personality disorder. Some big name analysts (e.g. Lomax, Gabbard) contribute to the teaching, and they do more than most programs on group therapy, couples therapy and hypnosis. There are opportunities to undertake further group therapy training or begin analytic training in PGY-3 or unwind with co-residents and faculty at the analytically-based movie night.
 
The bitter cold, pharma-bankrolled researchers and a medical school on probation distract from what is on offer here: one of the most well thought out psychotherapy curricula for psychotherapy residents anywhere. Using the martini-glass model, residents begin by learning the basic tenets of common to all psychotherapy before learning the specifics of psychodynamic, cognitive behavioral, interpersonal, integrative, supportive and other therapies. A psychotherapy track is available, as well opportunities to learn EMDR, systems centered therapy, and dynamic deconstructive therapy that are not readily available elsewhere. Glen Gabbard adds to the didactic program skyping from sunnier climbs and even the most cynical must concede he is an excellent teacher and writer and can only boost the experience.
 
Cambridge Health Alliance is traditionally the most psychodynamically oriented of the Harvard programs, and considering the Boston area is one of the last bastions of psychoanalysis, that is saying something. There is a strong emphasis on psychodynamic therapy, with a large number of psychotherapeutically oriented grand-rounds, and residents are expected to carry 4 psychodynamic patients during PGY-2 – more than any other program. Residents also gain experience of short term psychodynamic, cognitive-behavioral therapy, DBT, family therapy, group therapy, supportive therapy, and have opportunities to learn interpersonal therapy and hypnosis. CHA is crawling with analysts, and almost all residents have their own psychotherapy during residency. Although the emphasis is definitely psychodynamic, this program is one of the few that mandates experience in most of the other modalities. Residency applicants have been known to be asked questions about their childhood, sex life, experiences of love, and how they would deal with erotic transference.
 
Really glad you put Michigan on this list. Their strong psychotherapy training is often overlooked because of their reputation of being a research institution.
 
UCSD’s residency program lurks within in a biologically-oriented locale, with a biologically oriented department. But psychotherapy training is safeguarded by Program Director Sid Zisook, who is a national proponent of psychotherapy training in psychiatry. With a slight psychodynamic bias, there is also training in CBT, integrative therapy, supportive therapy, short term dynamic therapy, and opportunities for group therapy, and family therapy. UCSD is also one of those sensible programs that offers training in hypnotherapy, which widens the treatment portfolio, and emphasizes important aspects of any therapy: rapport building, communication styles, relaxation, imagery and metaphor. There may be more psychotherapy training at UCSF, but Southern California’s more biological bent means UCSD deserves high commendation for its psychotherapy focus in a hostile climate.

Being a UCSD grad, I would add that carrying a CBT patient (at least) during 2nd year is required, and that 3rd year gives the opportunity to learn/practice DBT (I co-led a group for a full year), as well as abundant opportunities to learn prolonged exposure for PTSD within the VA system. There's also the Psychoanalytic Institute in San Diego that does a lot of teaching, and some people choose to do the 2-year psychodynamic training there starting in their 3rd year of residency.
 
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Yes, it’s in New Haven. And yes, many people would rather be brutally $odomized by a priapic goat on Viagra than live there, but this research powerhouse has always been a friend of the psychoanalyst, and remains so to this day. Affiliated with the Western New England Psychoanalytic Institute, residents can supplant the already robust psychodynamic training with further didactics and, should they wish, consider their unconscious motivations for flirting so flagrantly with Thanatos by living in New Haven, undertaking personal analysis and analytic training. The Yale Child Study Center maintains strong links with University College London and the Anna Freud Center. Cognitive Behavioral Therapy and supportive therapy round off the requirements, with generous flexibility and elective time to indulge in group therapy, family therapy, Cognitive Processing Therapy, Hypnosis, Sexual Therapy, and so on.

Not to derail the conversation, but I really don't understand why New Haven gets such grief when it comes to these residency discussions. The food, theater, arts and culture puts it light years ahead of Waco, Texas or Syracuse, New York. It's at least comparable to Ann Arbor, Michigan, while only being a train ride away from Boston or New York. Maybe its geography is not a selling point, but I don't see how it deserves special mention over some of the other cities that get thrown out on this board.

Anyway, I'm going against the popular sentiment and putting in a plug for psychotherapy at Stanford. It gets a short shrift because its always compared to the other big West Coasters (UCLA, UCSF, UCSD), but I was really impressed by their range. The new chairwoman seems very intent on expanding the department past its biological reputation, and they offer early long term exposure in PGY-II. If you want to talk about medical hypnosis, David Spiegel is one of the top in the country. Their multidisciplinary divisions actually seem to respect psychiatry, so you can have opportunities to practice CBT in the context of sleep medicine or pain management. Sure, they try to radioablate patient's refractory depression and they fMRI every possible condition, but I don't think a strong neuroscience department precludes training in other modalities.
 
Well New Haven was in the news last year as being the 4th most dangerous city in the US, I have a few friends at Yale who have no intention of staying there for residency, and met applicants on the interview trail doing post-docs at yale who seemed keen to escape. It seemed all right to me but I only saw Downtown and the Yale campus.

Stanford gets short shrift because it was the general opinion that they did not provide as high quality training as you might expect at a top psychiatry department. They are frequently cited as an example of a program where quality of training is not guaranteed by name brand. They have also had some unhappy customers over the years. Also they have been one of the worst offenders in terms of drug money. I would agree they have some top psychotherapists on the faculty who are also great teachers (I have been to workshops by some Speigel and Maldonado) but historically that has not translated into quality psychotherapy training. With a new chair and PD I agree things could change but we shall see...
 
How about Northwestern's psychotherapy? They have two full days of clinic starting Jan of second year...
 
Using a ranking system more flawed and less transparent than USNews I have created a list of top programs for psychotherapy with some deliberately controversial inclusions and omissions! There is some truth in it, but like most rankings don't take it too seriously but it would be nice if it started off a discussion and caused aggrieved residents to come and defend their program!

Originally Posted by OldPsychDoc
Until the NCAA finally gets off its ***** and institutes a true national playoff system, we'll never know for sure.
 
Using a ranking system more flawed and less transparent than USNews I have created a list of top programs for psychotherapy with some deliberately controversial inclusions and omissions! There is some truth in it, but like most rankings don't take it too seriously but it would be nice if it started off a discussion and caused aggrieved residents to come and defend their program!

One week away from the match, and I'd love to revive some discussion on this topic, given all us medical student tend to really value therapy training in making our decision, but truthfully have no idea how to evaluate it. Here is my ranking of the top ten programs (really in no particular order) from the handful of programs I interviewed at, which is mostly an amorphous impression from the half day or so at each program, but ill try to throw in some objective details.

1. Cornell- my interviewers were psychoanalyzing me super intense, with an old fashioned blank slate kind of persona that may strike some people as cold if they aren't used to the tradition. . One deliberately set me up with a question to make me feel insecure and see how I reacted spontaneously to stressful situations, which was actually kinda cool on hindsight. The PD is described as a psychoanalytic surgeon, was recruited from PP, and wrote a textbook on psychoanalysis with a revision coming out soon. They do some psychoanalytic research too. Supervision can include sessions with video recording.

2. Cambridge- I got asked personal questions during the interview with the PD, and was (deliberately I think) asked a potentially awkward question to answer in front of the group. The residents were super warm and genuinely interested in your life experiences, so somewhat of a different feel to Cornell's psychoanalytic tradition. PD talked about (possibly unique?) supervision that reviews session audio tapes. 3month DBT at mass mental with longwood residents.

3. Mount Sinai. Another psychodynamically trained PD, and young APD with clear passion for psychoanalysis. Super flexible PGY3 outpatient t year to carve out your own caseload, with strong supervision it seems. It's is based on their formal affiliation with the reputedly best psychoanalytic institute in manhattan (NYU also uses this institute), with the institutes director leading a case interview at the inpatient ward during weekly rounds for residents to observe. One PGY3 talked about his decision to go there mainly because of a child psychoanalyst that transferred there, and has a handful of such cases as part of his caseload.

4. MGH McLean- has PiP (program in psychotherapy) and Dr waldinger was mentioned repeatedly on the NY interview trail when asked about strength of Boston's psychoanalytic training. He is the codirector recruited from LW recently. Formally affiliated with the most formal and traditional analytic institute in the area. Tons of supervisory faculty available. And McLean has kind of the old school analytic feel to their grounds, like the old Payne Whitney clinic.

5. Columbia- reportedly the only department to have it own analytic training department embedded within. Well known director of psychotherapy education, who writes and publishes quite a bit.

6. UPenn- has Dr Sommers as co- program director, and the only NIH funded psychotherapy research in the country (per website).

7. UCSF- best in the west by reputation, with strong analytic institutes in the city and a hippie culture that probably embraces alternative therapies more than SoCal.

8. AECOM- very psychodynamic feel to all of their leadership, obvious in the interview questions. Warm and fuzzy type of psychodynamics.. Residents take pride in their therapy training.

9. UW Seattle- Linehan and DBT is incorporate into seemingly everywhere, from VA Inpatient ward to maximum security juvenile detention center.

10. Stanford- Irvin Yalom, father of group psychotherapy and author of several fascinating books, APD is psychodynamically trained, and lots of affiliated faculty to supervise. Have to self initiate opportunities tho, as their curriculum is known for flexibility and does not incorporate it into their mandatory curriculum.

11. Longwood- BIDMC has a psychodynamic reputation, and residents get to choose between a 3m CBT or DBT rotation at mass mental, which are both well known (CBT for psychosis, and DBT led by a direct mentee of Linehan).
 
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Seems like Longwood should be included on this list.
 
any honorable mentions?

Longwood for sure, but I don't know too much other than that BIDMC has a psychodynamic reputation, and residents get to choose between a 3m CBT or DBT rotation at mass mental, which are both well known (CBT for psychosis, and DBT led by a direct mentee of Linehan).

Yale probably has a good program too, being sandwiched between NY and Boston.
 
Bump, and another question for Splik. How about programs in the South? MUSC, Palmetto, etc?
 
Bump, and another question for Splik. How about programs in the South? MUSC, Palmetto, etc?

I know this area pretty well.

Virginia: UVA is a solid program. Very well balanced. Happy residents. Great reputation. Awesome town. Not a huge research place, but it's here if you want it. VCU is ok, but probably #2 in town. EVMS and Roanoke should be further down any list.

NC: UNC is a very good program. Duke is a big name, but has a reputation for working people pretty hard. Wake didn't impress me. ECU is a nice program, but more of a backup. Seemed like nice people, just not strong.

SC: two superstars. USC-Palmetto and MUSC. Palmetto is a strong community program with very good didactics and one of the cushiest schedules in psychiatry. MUSC is more rigorous academic medicine, but not abusive. You'll work hard and learn well.

GA: I don't know much. Augusta is pretty small. Emory has a rep for hard work.

FL: I've heard ok things but vague about UF and USF. Tampa is a great city though. Maybe others can add more. Worth checkin out though. Not sure about Miami.

Other: Vandy is super awesome and deserves a look. UK is also very good and I think deserves a look.

My non-south favorites were Indiana (which I thought was incredible) and Iowa (also very good).

Hope that's somewhat helpful. I've posted extensively about this in the past. Check my post history for more. Interview review threads too.
 
I can understand that medical students have a difficult time trying to judge a programs qualities in this area. I have no intention of commenting on the list of programs, which I personally think is more misleading then helpful - nobody really knows what the best psychotherapy training looks like, it is highly dependent on the supervisors you end up with and indeed the kinds of patients you happen to encounter. However, there are some things that are perhaps a little helpful to look out for (and I offer these suggestions with utmost humility);

- Does the philosophy of the department accommodate psychodynamic perspectives sufficiently? For example, how often will analysts or other experienced therapists be presenting at case conferences or grand rounds? This might give a sense of how much this perspective is valued.

- Is there an affiliation with a psychoanalytic institute? Of course this is totally not essential, but it can't be a disadvantage, right? 🙂

- How early on in the program do you pick up long term patients?

- What is the diversity of supervisors available? As many people will point out residency is far too short a time to become competent in several types of psychotherapy, but having potential supervisors with experience in MI, trauma-focused psychotherapy, group therapies, family therapy and DBT is important if you hope to focus on any of these areas, or would just like some exposure too them.

- Are any of the graduates pursuing psychotherapy in their practices?

- How much flexibility do you have in your outpatient months to arrange a more psychotherapy dominant experience?

I hope this is somewhat helpful.
 
listen to small bird - his observations are spot on. mine are about as useful as any 'top 10' lists of anything, which is to say not very. also it is a curious relic of american psychiatry (not true of clinical psychology) to equate psychotherapy with psychodynamics and analytic therapy. I really think the absolutely essential things you should be able to get out of residency psychotherapy wise are:

- applying the principles of dynamically-informed supportive psychotherapy
- using motivational interviewing
- using exposure therapy in the treatment of phobias and other neurotic states
- use hypnosis and progressive muscle relaxation in anxiety and stress-related conditions
- using cognitive therapy in depressive and anxiety disorders
- working therapeutically with families
- being able to apply psychodynamic, cognitive-behavioral, systemic, and sociocultural aspects of formulation to understand your patients

No program is really going to train you to a skilled psychotherapy there just isn't enough time and this is no longer the focus of psychiatric practice. You need to use you elective time and availability of supervisors to learn more, and attend additional trainings, conferences and workshops. most analytic institutes now offer a 2-year certificate course to enhance your understanding of psychoanalytic principles, the Beck Institute has a scholarship to learn CBT with the Becks for residents, and you need to make it a priority for you. also be mindful of those programs that are so dogmatic that they believe in a biological or dynamic approach to the detriment of other therapeutic approaches
 
How about Northwestern's psychotherapy? They have two full days of clinic starting Jan of second year...
How about Northwestern's psychotherapy? They have two full days of clinic starting Jan of second year...

Northwestern deserves a mention. Psychotherapy didactics lean heavily toward psychodynamics (Kohut is slightly emphasized over other theorists, for obvious reasons)but there are also brief lecture series on CBT, DBT, supportive, and family/couples. Half way through second year, residents see at least 6 psychotherapy patients per week as well as have two therapy supervisors. Some residents see therapy patients twice per week if needed. Residents continue to see these same therapy patients until the end of residency, if indicated. Many residents do electives at the analytic institute over the course of many months. One night per week for six months, residents complete a required rotation in family/couples therapy with excellent continuity.
 
Northwestern deserves a mention. Psychotherapy didactics lean heavily toward psychodynamics (Kohut is slightly emphasized over other theorists, for obvious reasons)but there are also brief lecture series on CBT, DBT, supportive, and family/couples. Half way through second year, residents see at least 6 psychotherapy patients per week as well as have two therapy supervisors. Some residents see therapy patients twice per week if needed. Residents continue to see these same therapy patients until the end of residency, if indicated. Many residents do electives at the analytic institute over the course of many months. One night per week for six months, residents complete a required rotation in family/couples therapy with excellent continuity.

6 weekly patients? If so, that's awesome.
 
When applicants are evaluating programs what are some of the things you can look for that may be signs the therapy experience is less than ideal? Seems like it is very easy for all of them to say you get training in x therapies at y locations, but seems like it would be super hard to evaluate if the logistics and patient population of that clinic/work environment are actually conducive to good training?
 
When applicants are evaluating programs what are some of the things you can look for that may be signs the therapy experience is less than ideal? Seems like it is very easy for all of them to say you get training in x therapies at y locations, but seems like it would be super hard to evaluate if the logistics and patient population of that clinic/work environment are actually conducive to good training?
Long lists of modalities really mean precious little. Programs will add the latest acronym after an hour of didactics gets scheduled.

The way I would suggest doing a first pass is to find out the number of therapy hours that are required and the amount of supervision. You are much better off with decent clinical exposure with appropriate supervision than a boatload of lectures. Programs often will tout starting supervision halfway through intern year or starting in second year, but I think this is less relevant than the meat of longitudinal care you start providing mid-way through after decent training. The fact is that even if you devote every didactic hour to psychotherapy (which would be a disaster to your clinical training), you won't really be able to practice it in any remotely meaningful way until you have the basics of outpatient psychiatry down, which typically doesn't start happening until somewhere well into your PGY-2 year.

Ask how many cases you are required to keep throughout the year, how many hours of supervision you receive specifically for psychotherapy, and what that supervision entails.
 
Northwestern deserves a mention. Psychotherapy didactics lean heavily toward psychodynamics (Kohut is slightly emphasized over other theorists, for obvious reasons)but there are also brief lecture series on CBT, DBT, supportive, and family/couples. Half way through second year, residents see at least 6 psychotherapy patients per week as well as have two therapy supervisors. Some residents see therapy patients twice per week if needed. Residents continue to see these same therapy patients until the end of residency, if indicated. Many residents do electives at the analytic institute over the course of many months. One night per week for six months, residents complete a required rotation in family/couples therapy with excellent continuity.

I second this. Northwestern is an absolutely awesome program.
 
Can anyone help in my effort to find strong psychotherapy programs which accept D.O. students? I've found plenty of forums relating to this but they tend to be old discussions and potentially outdated. Thanks.
 
Baylor isn't too competitive. They take IMGs, so I assume they probably take DOs too.
 
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