Psikiyatri İhtisasında Psikoterapi Eğitiminin Yeri: Türkiye’den Bir Sunum

Year 2023, Volume: 8 Issue: 2, 251 - 259, 06.06.2023

Esra Yazıcı Ebru Türker Mercandağı Yavuz Selim Oğur Elif Merve Kurt Tunagür Ahmet Bülent Yazıcı

https://doi.org/10.26453/otjhs.1278610

Abstract

Amaç: Bu çalışma, Türkiye'de psikiyatri asistanlığı eğitimi sırasında standartlar ve uygulamalar konusundaki bilgi eksikliğini ele alan bir anket aracılığıyla psikiyatri asistanlarının psikoterapi eğitim deneyimlerini araştırmayı amaçlamıştır.
Materyal ve Metot: Çalışma, Türkiye'deki psikiyatri asistanlarına özel WhatsApp ve e-posta grupları aracılığıyla gerçekleştirilmiştir.
Bulgular: Çalışmamızda psikiyatri asistanlarının %80,5'i asistanlığı süresince psikoterapi eğitimi alırken, özellikle dört yıl ve üzeri asistanlık yapanların %97'si teorik, %68'i süpervizyon eğitimi almıştır. Ayrıca, asistanların önemli bir kısmı (%90,3) mezun olduktan sonra psikoterapi eğitimi almayı planladığını ifade etmiştir. Eğitim alanların %63,7'si eğitim aldığı kurumdan, %89,0'ı ise diğer merkezlerden almıştır. Ayrıca psikoterapi eğitiminin %47,8'i kurum içi öğretim üyeleri tarafından verilmiştir. Asistanlar arasında en çok tercih edilen psikoterapi türü Bilişsel Davranışçı Terapi oldu. Psikoterapi eğitimine erişimde en yaygın olarak bildirilen engel, yüksek maliyetiydi.
Sonuç: Çalışma, Türkiye'deki psikiyatri asistanlarının çoğunun psikoterapi eğitimi aldığı sonucuna varmıştır. Psikiyatri asistanlığında psikoterapi eğitiminin arttırılması, engellerin aşılması ve süpervizyonun iyileştirilmesi ele alınması gereken kritik konulardır.

Keywords

Eğitim, psikoterapi, tıp, uzmanlık

Psychotherapy Training in Psychiatry Residency: Insights from Türkiye

Abstract

Objective: This study aimed to investigate the psychotherapy training experiences of psychiatry residents through a questionnaire, addressing the knowledge gap on standards and practices during psychiatry residency training in Türkiye. .
Materials and Methods: The study was conducted via WhatsApp and e-mail groups specific to psychiatry residents in Türkiye.
Results: In our study, 80.5% of psychiatry residents received psychotherapy training during their residency, whereas, especially in those who have been in residence for four years or more, 97% received theoretical training, and 68% received supervision training. Moreover, a substantial portion (90.3%) of residents expressed plans to pursue psychotherapy training after graduation. Of those who received training, 63.7% obtained it from their educational institution, while 89.0% obtained it from other centres. Furthermore, 47.8% of the psychotherapy training was provided by in-house faculty members. Cognitive Behavioral Therapy was the most preferred type of psychotherapy among the residents. The most commonly reported barrier to accessing psychotherapy training was its high cost..
Conclusion: The study concluded that most psychiatry residents in Türkiye received psychotherapy training. Enhancing psychotherapy training in psychiatry residency, overcoming barriers, and improving supervision are critical issues to be addressed

Keywords

Psychotherapy, training, medical, residency

References

• 1. Crocker EM, Brenner AM. Teaching Psychotherapy. Psychiatric Clinics of North America. 2021;44(2):207-216. doi:10.1016/j.psc.2020.12.004
• 2. Bhugra D, Tasman A, Pathare S, et al. The WPA-Lancet Psychiatry Commission on the Future of Psychia-try. Lancet Psychiatry. 2017;4(10):775-818. doi:10.1016/S2215-0366(17)30333-4
• 3. Frank A, Welton R, Crocker E. Psychotherapy Education in Psychiatry Residency Training. In: Graduate Medical Education in Psychiatry. 2022:191-214.
• 4. Mayer S, van der Gaag RJ, Dom G, et al. European Psychiatric Association (EPA) guidance on post-graduate psychiatric training in Europe. Eur Psychiatry. 2014;29(2):101-106. doi:10.1016/j.eurpsy.2014.01.002
• 5. Rim JI, Cabaniss DL, Topor D. Psychotherapy Tracks in US General Psychiatry Residency Programs: A Proxy for Trends in Psychotherapy Education? Acad Psychiatry. 2020;44(4):423-426. doi:10.1007/s40596-020-01245-6
• 6. Brittlebank A, Hermans M, Bhugra D, et al. Training in psychiatry throughout Europe. Eur Arch Psychiatry Clin Neurosci.2016;266(2):155-164. doi:10.1007/s00406-016-0679-4
• 7. Baessler F, Zafar A, Gargot T, Pinto da Costa M, Biskup EM, De Picker L, et al. Psychiatry training in 42 European countries: A comparative analysis. European Neuropsychopharmacology. 2021;46:68-82.
• 8. World Health Organization. Atlas: Psychiatric education and training across the world. 2005.Geneva.
• 9. TUKMOS. Ruh Sağlığı ve Hastalıkları Uzmanlık Eğitimi Çekirdek Müfredatı v.2.4.1 (2020) [Core Curricu-lum of Psychiatry Speciality Education]. https://tuk.saglik.gov.tr/Eklenti/41102/0/ruhsagligivehastaliklarimufredat-v241pdf.pdf. Accessed Septem-ber 13, 2021.
• 10. Ertekin E, Ergun BM, Sungur MZ. Psikiyatristler ve psikiyatri asistanlarında bilişsel-davranışçı terapi hakkında mitler ve yanlış bilinenler. Anatolian Journal of Psychiatry/Anadolu Psikiyatri Dergisi. 2015;16(1):60-64.
• 11. Yazici AB, Yazici E, Ozakkas T. Integrative Approach to the Psychotheraphy Training During Psychiatry Education: Current Status and Notes to the future. TBPD. 2021;4(7):1-15.
• 12. Kitts RL, Isberg RS, Lee PC, Sharma N, Goldman V, Hunt J. Child Psychotherapy Training in the United States: A National Survey of Child and Adolescent Psychiatry Fellowship Program Directors. Acad Psychia-try. 2019;43:23–27. doi:10.1007/s40596-018-0998-z
• 13. Saeed SA, Johnson TL, Bagga M, Glass O. Training Residents in the Use of Telepsychiatry: Review of the Literature and a Proposed Elective. Psychiatr Q. 2017;88(2):271-283. doi:10.1007/s11126-016-9470-y
• 14. Osborne LM, MacLean JV, Barzilay EM, Meltzer-Brody S, Miller L, Yang SN. Reproductive Psychiatry Residency Training: A Survey of Psychiatric Residency Program Directors. Acad Psychiatry. 2018;42(2):197-201. doi:10.1007/s40596-017-0672-x
• 15. Eissazade N, Shalbafan M, Eftekhar Ardebili M, Pinto da Costa M. Psychotherapy training in Iran: A sur-vey of Iranian early career psychiatrists and psychiatric trainees. Asia‐Pacific Psychiatry. 2021;13(1):e12434.
• 16. Torales J, González I. Perspectives on psychiatry education in Latin America. International Review of Psy-chiatry. 2020;32(2):122-127. doi:10.1080/09540261.2019.1655716
• 17. Chaimowitz G, Weerasekera P, Ravitz P. Psychotherapy in Psychiatry. Can J Psychiatry. 2021;66(11):999-1004.
• 18. Plakun EM, Villela RM. Psychotherapy in Psychiatry: Fighting Alternative Facts. J Psychiatr Pract. 2019;25(6):466-469. doi:10.1097/PRA.0000000000000422
• 19. Robert J. Gregory, M.D. ,, David Mintz, M.D.,, Jessica Yakeley, F.R.C.Psych. Should Psychotherapy Be-come a Subspecialty of Psychiatry? American Journal of Psychotherapy. 2019;72(2):36-7.
• 20. Pheister M, Cowley D, Sanders W, et al. Growing the Psychiatry Workforce Through Expansion or Creation of Residencies and Fellowships: the Results of a Survey by the AADPRT Workforce Task Force. Acad Psy-chiatry. 2022;46(4):421-427. doi:10.1007/s40596-021-01509-9
• 21. Buckman J, Saunders R, Leibowitz J, Minton R. The barriers, benefits and training needs of clinicians deliv-ering psychological therapy via video. Behav Cogn Psychother. 2021;49(6):696-720. doi:10.1007/s40596-021-01509-9
• 22. Rietmeijer CBT, Huisman D, Blankenstein AH, et al. Patterns of direct observation and their impact during residency: general practice supervisors’ views. Med Educ. 2018;52(9):981–991. doi:10.1111/medu.13631
• 23. Ruble AE, Romanowicz M, Bhatt-Mackin, S, Topor D, Murray A. Teaching the Fundamentals of Remote Psychotherapy to Psychiatry Residents in the COVID-19 Pandemic. Acad Psychiatry. 2021;45:629–635. doi:10.1007/s40596-021-01484-1
• 24. Mehrtens IK, Crapanzano K, Tynes LL. Current Risk Management Practices in Psychotherapy Supervision. The journal of the American Academy of Psychiatry and the Law. 2017;45(4):409-414.
• 25. Frank HE, Becker-Haimes EM, Kendall PC. Therapist training in evidence-based interventions for mental health: A systematic review of training approaches and outcomes. Clin Psychol (New York). 2020;27(3):e12330. doi:10.1111/cpsp.12330
• 26. Pagano J, Kyle BN, Johnson TL, Saeed SA. Training psychiatry residents in psychotherapy: The role of manualized treatments. Psychiatric Quarterly. 2017;88(2):285-294.
• 27. Tavakoli S. The place of psychotherapy in contemporary psychiatry. Iran J Psychiatry Behav Sci. 2014;8(4):1-6.
• 28. Grover S, Avasthi A, Jagiwala M. Clinical Practice Guidelines for Practice of Supportive Psychotherapy. Indian J Psychiatry. 2020;62(Suppl 2):173-182.
• 29. Fefergrad M, Mulsant BH. Psychotherapy Training in a Competency-Based Medical Education Psychiatry Residency: A Proposal for a Practical and Socially Responsible Model. Can J Psychiatry. 2022;67(6):423-427.
• 30. Marriott BR, Kliethermes MD, McMillen JC, Proctor EK, Hawley KM. Implementation of a Low-Cost, Mul-ti-component, Web-Based Training for Trauma-Focused Cognitive-Behavioral Therapy. Adm Policy Ment Health. 2023;50:392-399. doi:10.1007/s10488-022-01246-7