Current state of psychotherapy training: preparing for the future

This article provides an overview of what is currently being taught in psychiatry residency programs about psychotherapy in general, and to evolving changes in the field related to mental health parity and the Affordable Care Act (ACA) in particular. Future psychiatrists must have a firm grasp of not only the principles of psychotherapy but also the development of increasingly effective and evidence-based psychotherapies if they are to be effective health care leaders. We review what attracts medical students to psychiatry and how much their decision to train in psychiatry is rooted in a desire to learn both dynamic psychiatry and psychotherapy in its various modalities. It is no secret that the quality of teaching and learning psychotherapy is variable in our training programs. One reason for this can be attributed to trainees who ascribe more to the biological dimensions of our field and have less interest and commitment to more than basic skills in psychotherapy. In addition, in some settings there is a dearth of teachers trained in the various forms of psychotherapy who are committed to this pedagogical imperative. We conclude with several recommendations to residency training programs and to residents themselves regarding what we deem essential in both the curricular and clinical exposure to the challenges and shortcomings of the mental health parity and Affordable Care Act. Tomorrow's psychiatrists have a fiduciary responsibility of advocating for their complex and chronically ill patients that must include providing psychotherapy.