Beginning therapy: Clinical outcomes in brief treatments by psychiatric trainees

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.