National Survey of Psychotherapy Training in Psychiatry, Psychology, and Social Work

Teachers College, Columbia University, New York, New York, United States
Archives of General Psychiatry (Impact Factor: 14.48). 09/2006; 63(8):925-34. DOI: 10.1001/archpsyc.63.8.925
Source: PubMed


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.
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.
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.
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.
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.

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Available from: Helen Verdeli, Feb 01, 2014
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    • "In the first step didactic learning is used to transfer the background and knowledge about the method. In the second step supervision is offered where the therapist discusses the client with a supervisor (Beidas & Kendall,2010;Sholomskas et al., 2005;Weissman et al., 2006). Fairburn and Cooper (2011) discusses some fundamental shortcomings of this training format. "
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    • "Fewer than half of social work schools provide such integrative EBP experiences (Bellamy, Bledsoe, & Traube, 2006; Bledsoe et al., 2007; Hoge et al., 2009; Mullen, Schlonsky, Bledsoe, & Bellamy, 2005; President's New Freedom Commission, 2003; Weissman et al., 2006). By design, most social work programs offer incomplete training in EBP (Berger, 2013; Bledsoe et al., 2007; Savaya, Peleg-Oren, Strange, & Geron, 2003; Weissman et al., 2006) because the schools " outsource " experiential components to community-based field instructors. Although the time and skills of field instructors are valued, field instructors often lack the extent of familiarity with EBP concepts needed to reinforce what is didactically taught in classrooms (Mullen & Bacon, 2004), thereby short-circuiting the bridge between classroom and practice. "

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    • "Despite the development and identification of evidencebased psychological interventions (EBPIs) for a variety of disorders and problems and demonstration of their successful transport into the community (Franklin et al. 2000; Juster et al. 1995; Simons et al. 2010), EBPIs have not been widely adopted in clinical practice. One common reason cited for this disconnect is the dearth of providers who are trained to deliver EBPIs (Weissman et al. 2006). In response to this shortage of providers, policymakers have issued mandates, provided incentives, and devoted billions of dollars to train providers from a variety of disciplines (e.g., social work, psychology, drug and alcohol counselors ) in public mental health settings to utilize EBPIs (Karlin et al. 2010; McHugh and Barlow 2010). "
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