Psychotherapy training for psychiatrists: UK and global perspectives

Psychotherapy training for psychiatrists has often been honoured more in the breach than the observance. While most training schemes pay lip service to psychotherapy, few provide the comprehensive training to which national and international bodies aspire. Recent educational changes, especially the move from course completion to competency evaluation, and the implementation of 'requirements' as opposed to 'recommendations', provide an opportunity for psychotherapy to become more central to psychiatric training. Based on international systematic enquiry and specific experience in the UK, this article makes a number of theoretical and practical suggestions: (a) mentalization as a relevant indicator of psychological mindedness for trainees and ways in which it might be measured (b) the importance of identifying the small number of trainees at risk for dangerous practice and remedial measures (c) the importance of local and national leadership if change is to be initiated and followed through over a number of years (d) ways in which the paradox of underdevelopment of psychotherapy training can be overcome via the reinforcement of existing expertise and values as well as the use of visiting 'experts' and modern IT aids.