Postgraduate Psychiatry Residency Training

The objective of learning EFT is to focus on the fundamental skills of psychotherapy and to develop an appreciation for the importance of affect and affective exploration in therapy. The major objectives of this therapy are to help residents:

• Feel comfortable as a clinician when conducting a psychiatric interview 
• Develop good listening skills
• Develop an inner frame of reference with respect to empathy
• Be empathically attuned with their patients
• Show unconditional positive regard towards the patient
• Be a genuine therapist
• Learn techniques that promote affective exploration of patient's inner struggles
• Develop a positive therapeutic alliance with their patients

Cognitive therapy has become one of the most popular psychotherapies because it is supported by dozens of randomized controlled trials, it is relatively brief, focused on symptom and problem resolution, relatively easy to learn and practice, and empowers patients to better help themselves. This first module in cognitive therapy will provide residents with a working knowledge and skill set in the approach for depression which is where the model was first developed. These skills continue to be built upon in the cognitive behavioural therapy for anxiety disorders module.

The objective of learning CBT for Depression is to familiarize learners with the theory and practice of cognitive therapy for depression. Fundamentally, cognitive therapy is based on the assumption that the way individuals process information, particularly events with a personal meaning, is a critical determinant in one's emotional responses. Cognitive therapy helps patients to become aware of how their thoughts affect their emotional lives and behaviours. It also teaches patients a variety of skills and tools that they can use to analyze and modify their thinking so that their appraisals are more objective and functional. Through a combination of didactic presentations, independent reading, and one-on-one supervision, residents will acquire an understanding of:

• The cognitive theory of depression and the research base that supports this approach.
• How this theory translates into a clinical approach to target symptoms of depression.
• Educating patients in the biopsychosocial model of depression.
• Teaching patients to understand the connection of thinking and behaviour to emotional problems.
• Collaborating with patients to teach them to examine their patterns of negative thinking and self-defeating behaviours.

This module includes a review of the Cognitive-Behavioural paradigm with emphasis on data collection, formulation, and treatment for Anxiety Disorders (link with previous didactic, small group sessions). There will be a supervised treatment of one patient with an anxiety disorder (approximately 20 sessions) such as panic disorder, social phobia, or obsessive-compulsive disorder. 
The objective of learning CBT for Anxiety is to acquire the basic knowledge and skills to treat patients with an anxiety disorder. Through a combination of didactic presentations, independent reading, and one-on-one supervision, residents will acquire an understanding of:

• Anxiety-specific assessment and data collection utilizing self-monitoring and self-report questionnaires
• Conceptualization and formulation
• Treatment: Basic information, psychoeducation, presentation of the CBT model, Cognitive restructuring, exposure-based strategies (in vivo, interoceptive, and imaginal as indicated), response prevention and reduction of safety behaviors as indicated, integration of pharmacological and psychotherapeutic approaches

The objective of learning Group Therapy is to develop an understanding of group psychotherapy models, methods and techniques. The major goals of this therapy are to help residents:

• Acquire the basic knowledge and skills in group facilitation and leadership to assist group members to reach their goals
• Examine the application of theoretical concepts and research findings to the practice of group work in clinical settings
• Identify key group concepts: (e.g. stages of group development, group tasks, therapeutic factors, norms, leadership skills, boundaries) across key conceptual models of group functioning
• Develop an understanding of values, attitudes and techniques conducive to successful group counseling

The Family Therapy Module will expose the learner to a model for assessing, formulating and treating a family case. The learner will also have the opportunity to participate in seminars describing models of family therapy and will examine the research pertaining to the effectiveness of family therapy with children/ adolescents who present with psychiatric problems. Specific objectives of this therapy are to help residents:

• Acquire a model of organizing data from a family interview
• Conceptualize and understand a family system
• Join with the family and build a therapeutic alliance
• Develop skills to interview a family, for example; involve all family members, develop a therapeutic alliance, gather information to help delineate the diagnosis, develop a formulation and treatment plan
• Become familiar with systems theory; to develop some initial skills in assessing and treating a family
• Formulate a family case systemically
• Understand the impact of the psychiatric illness of the child/adolescent on the family system
• Develop Perceptual and Conceptual Skills
• Describe a family systemically
• Recognize and describe interactions and transactional patterns in the family system
• Recognize the effect of the family group on oneself
• Recognize one’s idiosyncratic reactions to family members
• To become familiar with the problems of various family constellations
• Develop Executive Skills
• Stimulate transactions
• Assist family members with labeling effects of interactions
• Begin to extricate oneself from the family system
• Establish a contract
• Assess a family’s capacity for change and recognize the difficulty of change for some families
• Assess the effectiveness of one’s interventions and explore alternatives 
• Develop a sense of one’s own style of intervening
• Change maladaptive transactions by: stopping a sequence and labelling the process and being confrontative in the context of support
• Deal with affect the family wishes to avoid
• Support positive changes in the family
• Focus on the content and process issues and intervening at both levels

This is an introductory course to key concepts in Psychodynamic Psychotherapy. The overall objective of this module is for students to gain an understanding of the key concepts and clinical techniques of psychodynamic psychotherapy. Specific objectives of this therapy are to help residents:

Gain a brief historical overview of the development of psychodynamic theory and therapy

Understand the significance of unconscious motivation and appreciate its power.

Develop an appreciation of the internal world.

Develop a curiosity about the person as a whole.

Recognize that symptoms are complex and multi-determined.

Learn to recognize and pay attention to affect.

Understand the meaning and use of transference and countertransference and grasp its impact on treatment.

Recognize and use one's own emotional reactions as part of understanding the patient.

Recognize the impact both patients and therapists have on the other (i.e. mutual influence, two persons as opposed to a one-person psychology)

Learn to tolerate uncertainty.

Understand the concept of quiet relatedness in contrast to the pressure for urgent interventions or solutions.

Understand that psychodynamic psychotherapy is an ongoing process.

Gain exposure to the empirical research in this area.

The Interpersonal Therapy module will expose the learner to the IPT methods and techniques used for conducting IPT sessions. Applications of IPT to other psychotherapy modalities such as group and marital psychotherapy will be covered. Research on IPT will be presented and discussed. Specific objectives of this therapy are to help residents:

• Develop an understanding of the IPT model, methods and techniques;
• Apply the IPT model to case material and develop the ability to conduct IPT sessions;
• Develop an understanding of the application of IPT to other modalities and special patient problems, and , where appropriate, conduct IPT sessions in these circumstances; and
• Critically review and discuss outcome research related to the application of IPT.

The major objective of this therapy is to help residents understand the major principles of Dialectical Behavior Therapy and how they apply to DBT skills group. Specific objectives of this therapy are to help residents:

• Learn the core DBT skills including Mindfulness, Interpersonal Effectiveness, Emotion Regulation, Distress Tolerance and Behavioral Chain Analysis;
• Understand the healing factors in groups;
• Gain a rudimentary understanding of group process, including group cohesion and norms and group interfering behavior;
• Understand how exposure and other behavioral principles are used in DBT skills group;
• Understand how DBT skills group is structured in order to ensure the safety of all participants.

• Integrated with Psychodynamic

• Integrated with CBT

Specific objectives of this therapy are to help residents:

• Learn basic principles of motivational interviewing
• Learn application of how to conduct motivational interviewing in a role play scenario
• Practice key components of motivational interviewing

• Integrated with CBT