National survey of psychotherapy training in psychiatry, psychology, and social work.
BACKGROUND
Approximately 3% of the US population receives psychotherapy each year from psychiatrists, psychologists, or social workers. A modest number of psychotherapies are evidence-based therapy (EBT) in that they have been defined in manuals and found efficacious in at least 2 controlled clinical trials with random assignment that include a control condition of psychotherapy, placebo, pill, or other treatment and samples of sufficient power with well-characterized patients. Few practitioners use EBT.


OBJECTIVE
To determine the amount of EBT taught in accredited training programs in psychiatry, psychology (PhD and PsyD), and social work and to note whether the training was elective or required and presented as a didactic (coursework) or clinical supervision.


METHODS
A cross-sectional survey of a probability sample of all accredited training programs in psychiatry, psychology, and social work in the United States. Responders included training directors (or their designates) from 221 programs (73 in psychiatry, 63 in PhD clinical psychology, 21 in PsyD psychology, and 64 in master's-level social work). The overall response rate was 73.7%. Main Outcome Measure Requiring both a didactic and clinical supervision in an EBT.


RESULTS
Although programs offered electives in EBT and non-EBT, few required both a didactic and clinical supervision in EBT, and most required training was non-EBT. Psychiatry required coursework and clinical supervision in the largest percentage of EBT (28.1%). Cognitive behavioral therapy was the EBT most frequently offered and required as a didactic in all 3 disciplines. More than 90% of the psychiatry training programs were complying with the new cognitive behavior therapy requirement. The 2 disciplines with the largest number of students and emphasis on clinical training-professional clinical psychology (PsyD) and social work-had the largest percentage of programs (67.3% and 61.7%, respectively) not requiring a didactic and clinical supervision in any EBT.


CONCLUSIONS
There is a considerable gap between research evidence for psychotherapy and clinical training. Until the training programs in the major disciplines providing psychotherapy increase training in EBT, the gap between research evidence and clinical practice will remain.
Weissman
Myrna M
MM
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, New York, New York 10032, USA. mmw3@columbia.edu
Verdeli
Helen
H
Gameroff
Marc J
MJ
Bledsoe
Sarah E
SE
Betts
Kathryn
K
Mufson
Laura
L
Fitterling
Heidi
H
Wickramaratne
Priya
P
D003430:Cross-Sectional Studies; D003479:Curriculum / Q000592:standards / Q000706:statistics & numerical data; D004500:Education, Graduate / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D010865:Pilot Projects; D015397:Program Evaluation; D011570:Psychiatry / Q000193:education*; D011584:Psychology / Q000193:education; D011586:Psychology, Clinical / Q000193:education*; D011613:Psychotherapy / Q000193:education* / Q000379:methods*; D012947:Social Work / Q000193:education; D012949:Social Work, Psychiatric / Q000193:education*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods / Q000592:standards; D014481:United States