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Beginning therapy: clinical outcomes in brief treatments by psychiatric trainees

  • Chris Mace (a1), Sally Beeken (a2) and Joan Embleton (a3)
Abstract
Aims and Method

Psychotherapy provided by inexperienced psychiatric trainees was assessed through comparison of post-treatment outcomes with a brief psychodynamic therapy and a brief integrative psychotherapy. A retrospective case–control design was applied to all patients seen by nine senior house officers (SHOs) during 6-month placements who provided follow-up data. Matching linked each patient offered simple cognitive–analytic therapy to one who had received brief psychodynamic therapy from the same SHO. Post-treatment changes were analysed by treatment received and differences between trainees were explored.

Results

Seventeen cases in each group met entry criteria. Patients receiving the integrative treatment had more severe pathology and outcomes were more variable when this model was used. Eight of the nine SHO therapists performed better with the psychodynamic intervention.

Clinical Implications

Significant clinical improvements can be achieved by inexperienced psychiatric trainees providing brief psychotherapy under supervision. Patient selection is undoubtedly important. Fundamental psychotherapy competencies need to be mastered before structured hybrid models are attempted.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Beginning therapy: clinical outcomes in brief treatments by psychiatric trainees

  • Chris Mace (a1), Sally Beeken (a2) and Joan Embleton (a3)
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eLetters

Provision of brief psychotherapy by psychiatric trainees under the new shift system.

Olubukola Kolawole, SHO in Psychiatry
24 February 2006

We read with interest the article “Clinical outcomes in brief treatments by psychiatric trainees” by Mace et al (Psychiatric Bulletin, January (2006)30,7-10.This study showed that significant improvements can be achieved by inexperienced psychiatric trainees providing brief psychotherapy under supervision.

Over the last 18 months, we have each held full time psychotherapy posts at St.Michael’s Hospital providing brief six month psychotherapy to patients under supervision. We would like to highlight the fact that the shift system in St.Michael’s Hospital also started 18 months ago and sincethen we all had two and a half weeks of night duties on a 1 in 11-shift rota system during each six-month placement. These, in addition to twelve and a half days of annual leave represented significant interruptions in the continuity of psychotherapy.

The concept of continuity of treatment by a psychotherapist is at thecore of psychotherapy. As the new shift system threatens the continuity of treatment, it may be having a negative impact on outcomes of brief psychotherapy treatment by psychiatric trainees in the UK. We feel it is important that future studies of the outcomes of psychotherapy provided by SHOs are able to investigate this further.

Olubukola Kolawole, Senior House Officer in Psychiatry, St Michael’s Hospital, Warwick CV34 5QW, e-mail: folayem@yahoo.com,Salman Mustaq, Senior House Officer in Psychiatry, St Micheals Hospital, Warwick, Satyadev Nagari, Senior House officer in Psychiatry, St Micheal’s Hospital, Warwick.
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Conflict of interest: None Declared

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