Psychotherapy training for residents: reconciling requirements with evidence-based, competency-focused practice.
OBJECTIVE
The Accreditation Council for Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) changed the training requirements in psychotherapy, moving toward evidence-based therapies and emphasizing competence and proficiency as outcomes of training. This article examines whether the therapies selected for training are evidence based and the authors review research concerning methods for training and assessment that effectively lead to competence in these psychotherapies.


METHODS
The authors searched PsycINFO and PubMed for studies from 2000 to 2009 using the terms meta-analysis, meta-analyses, and psychotherapy combined with specific psychotherapies listed in the ACGME and RCPSC requirements to determine if high-level evidence supported the use of these therapies in patients with psychiatric disorders. A similar systematic search was carried out using the same search engines for all years with the terms psychotherapy, competence, training, evaluation, and therapist rating scales for the specific therapies selected by the ACGME and the RCPSC to determine if empirically validated therapist competency scales and specific teaching methods that enhance competence could be identified.


RESULTS
Meta-analyses support the use of several psychotherapies in the treatment of patients with psychiatric disorders and specifically those selected for training. Empirically validated rating scales assess therapist competence in several therapies, and specific teaching methods enhance therapist skill.


CONCLUSIONS
The Accreditation Council for Graduate Medical Education and the Royal College of Physicians and Surgeons of Canada have incorporated evidence-based psychotherapies in their new guidelines. Evidence-based methods for assessing competence and for teaching psychotherapy are available and could be encouraged or required in the future.
Weerasekera
Priyanthy
P
St. Joseph's Hospital, Psychiatry and Behavioural Neurosciences, 301 James Street South, Fontbonne, F439, Hamilton, Ontario, L8P 3B6 Canada. weerasek@mcmaster.ca
Manring
John
J
Lynn
David John
DJ
D000068:Accreditation; D002170:Canada; D002983:Clinical Competence; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D007396:Internship and Residency; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011570:Psychiatry / Q000193:education*; D011613:Psychotherapy / Q000193:education*