I'm revamping the older memo: Information for Psychotherapy Supervisors and Registrars about Psychotherapy requirements in the 2012 Regulations currently to include Intrain aspects. Revised version will be posted shortly.
The "Psychotherapy Case"
During your training Training you need to write up a "Psychotherapy Written Case" (PWC) - a case history of therapy conducted across a minimum of 40 x 1 hour sessions, in a psychodynamic modality. As above, read the main information about this case from the college website: Psychotherapy Written Case - Main Details of the requirements extracted from the 2012 Regulations
The college information (and forms) for the case are here.
Practical advice when you're about to start your psychodynamic psychotherapy case
You'll need to locate a suitable patient and start the therapy in 2nd or (very latest) 3rd year, and then to write up and submit the case in 4th year. It had to be passed before you can complete training and achieve the fellowship. Before starting the therapy (after the assessment sessions) you need to obtain written consent from the patient using the college form. During the therapy, you'll need to do three Case Discussions (a bit like Case-based discussions but more psychotherapy-oriented and recorded on a special college form). These are done close to the start of therapy, about mid-way, and in the termination phase.
Read the information from the Regulations about the Case requirements again before starting to draft the Case History, and read the marking proforma for the Case History before finalising it. It's also crucial to get a minimum of two supervisors to read your final draft and give you feedback, before you finalise the Case.
Documenting your Experiences:
Therapy with either psychodynamic case patients or CBT patients will need to be recorded in some way so that you can bring the details to supervision session. Check with your supervisor how they prefer you to do this. Most people take notes, but some prefer to audio-record sessions and then transcribe the key issues and things that were said, afterwards.
Finding a Suitable Patient
Plan to incorporate therapy into your training from Stage 2 onwards - you need to get organised for this from the start of 2nd year. Think which runs can provide certain experiences - for example, many community runs with adult and older patients are a chance for CBT experiences. Child & adolescent community runs often offer a chance for CBT experience, as do the Maternal Mental Health run, addictions runs or even some forensic runs. Psychodynamic cases can often be referred from CMHCs and from Liaison teams. Talk to your supervisor at the start of the run about what you need to do and what the team might be able to assist with.
Felicity (your DoT/the local Psychotherapy Coordinator) can link trainees up with referrers - from time to time, emails are circulated with a patient's details and the referrer's contact information. These are usually for psychodynamic cases plus a few people suitable for CBT. If you're looking for a patient for the psychodynamic case it's a good idea to tell all suitable referrers such as colleagues at CMHCs, Liaison Psychiatry, crisis and initial assessment teams, and your local Training Facilitator.
It can be a little difficult finding a patient suitable for a novice therapist within the public system - for example, patients with severe personality disorders are not suitable. So make sure that you don't agree to commence therapy until you've presented the patient's case to your supervisor and discussed their suitability.
Finding a Supervisor
You're required to have appropriate supervision for all your psychotherapy cases. This is additional to the usual 4 hours weekly of clinical and 1:1 supervision and generally occurs each week, for an hour. Supervision may be arranged individually or in a small group, and can be provided by a suitable therapist who's not a psychiatrist. In multidisciplinary teams, psychologists often assist with this, especially for short CBT or Supportive Psychotherapy cases.
Supervision for the PWC: your Director of Training (Felicity) or the Psychotherapy Coordinator (when we get one) has a list of locally accredited PWC supervisors. Contact Felicity to organise a supervisor
Memo about submitting your PWC - practicalities, proof-reading, things not to forget, etc.
Psychotherapy Teaching and Courses
Psychotherapy teaching is provided as part of our academic programme from Stage 1 to Stage 3. The academic programme covers:
- Basics of Psychotherapy
- Psychodynamic theories and Formulation
- Motivational interviewing
Stage 2 second years
- Psychodynamic psychotherapy course
- CBT course
Stage 2 third years
- Psychodynamic formulation
- Psychodynamic supervision
- The Psychotherapy Written Case history
- Family therapy
- CBT for anxiety
- Group therapy
The Massey CBT Course
The Massey (Albany) University CBT Diploma course is on our reimbursable expenses list as CBT is a mandatory requirement of your training. You need a support letter from Felicity if you want to be reimbursed for this, and you need to be able to arrange the necessary time for the course with your team and supervisor. It is quite a lot of work, and we recommend it for Stage 3 trainees who have some experience, rather then for more junior trainees.
Some of these References are in local libraries. >The Training Centre has a number of texts from this list and is prepared to lend them out - provided they come back again - you can arrange this via Rosalynn.