title: Medical countertransference and the trainee:  identifying a training gap.
abstract: OBJECTIVE
  Although consultation-liaison (CL) psychiatrists are implicitly expected to recognize and consider interpersonal dynamics in clinical settings when offering recommendations, few guiding principles have been established, strongly suggesting the presence of a training gap.
  
  
  METHODS
  Trainees in psychiatry residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) were invited to complete an Internet-based, 20-item, Likert scale questionnaire assessing practices and opinions concerning countertransference management and training.
  
  
  RESULTS
  Of 192 respondents, 162 (84%) reported having participated in a rotation on the CL service for at least some period of time and were eligible to complete the survey; 136 (71%) reported having completed at least 2 months of CL rotations. Approximately 80% identified a frequent need to address countertransference reactions when working with primary medical/surgical teams, but less than a quarter reported doing so regularly. The motivation for addressing such issues in over half of the respondents was the belief that it would be "clinically beneficial" to patients, although 40% of respondents also feared that this practice could "worsen the relationship between the CL consultant and the primary team." Regarding training, 95% of respondents felt didactics addressing counter-transference would be "clinically beneficial"; however, three fifths of the respondents reported that "very few" to none of their didactics explored this issue.
  
  
  CONCLUSIONS
  Results of this study suggest that discrepancies exist between trainee perceptions of the utility of countertransference management in CL psychiatry and actual training in this area. The authors discuss possible explanations for these discrepancies and advocate for the establishment of formal guidelines in training CL residents in such aptitudes. (Journal of Psychiatric Practice 2012;18:109-117).
authors.affiliation: JIMÉNEZ and THORKELSON: Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. jimenezxf@upmc.edu
authors.forename: Xavier
authors.initials: X
authors.lastname: Jiménez
authors.forename: Gregory
authors.initials: G
authors.lastname: Thorkelson
mesh_terms: D000068:Accreditation / Q000592:standards; D000328:Adult; D003379:Countertransference; D006801:Humans; D020407:Internet; D007396:Internship and Residency / Q000592:standards*; D010348:Patient Care Team; D011570:Psychiatry / Q000193:education*; D011795:Surveys and Questionnaires; D056164:Teaching Rounds / Q000458:organization & administration / Q000592:standards