Professional Documents
Culture Documents
Therapy 101:
A Psychotherapy Curriculum for
Medical Students
Objective: This pilot project, designed and taught by a resident, benefit from more exposure to psychotherapy as taught by a
created a curriculum to introduce medical students to the prac- resident.
tice of psychotherapy. Medical students who are knowledgeable
about psychotherapy can become physicians who are able to Academic Psychiatry 2010; 34:248 –252
refer patients to psychotherapeutic treatments. A search of the
literature did not identify a curriculum that introduced psycho-
therapy, its applications, and evidence for its use. P hysicians across a variety of medical specialties
screen and refer patients for psychiatric treatment.
Primary care doctors are expected to understand and start
Methods: The authors worked closely with a faculty mentor to first-line medication treatments for depressive illness and
create a course that fulfilled a perceived need for more psycho- anxiety disorders. Psychotherapy is also an effective, well-
therapy teaching of medical students. “Therapy 101: An Intro- proven intervention for many mental illnesses. More pa-
duction to Psychotherapy” is a 6-hour curriculum that employs tients may have the opportunity to benefit from psycho-
creative teaching techniques such as video clips from TV shows, therapy when their physicians are aware of the concepts of
role play, and recordings of therapy sessions. The series was and indications for psychotherapy.
evaluated using a multiple-choice pre/postcourse test with ques-
Medical school provides a key opportunity for students
tions on psychotherapy, written feedback, and perceived knowl-
to be exposed to psychotherapy as a treatment option. The
edge of psychotherapy.
Association of Directors of Medical Student Education in
Results: The scores from the pre/postcourse test measuring the
Psychiatry (ADMSEP) (1) wrote the following in its 2007
students’ knowledge of psychotherapy did not change signifi- Clinical Learning Objectives with regard to the medical
cantly. However, students’ self-rating of knowledge greatly in- school psychiatry curriculum:
creased after the series. Written feedback showed substantial
Regardless of medical specialty, an effective practitioner should
enthusiasm for the course. have a basic understanding of psychotherapy, recognize the rele-
vance of psychotherapy principles to the doctor-patient relation-
Conclusion: Students can benefit from a short and engaging ship, be aware of those psychotherapies with evidence-based effi-
curriculum on psychotherapy. “Therapy 101” was very well cacy for particular disorders, and be able to refer patients for
psychotherapy.
accepted by students and has been integrated into the curriculum
for students in the mental health pathway. Medical students may At Baylor College of Medicine, the 2-month psychiatry
core clerkship devotes 1 hour to an overview of psycho-
Received June 1, 2009; revised August 9 and October 14, 2009, and therapy, in contrast to the 6 hours devoted to psychotropic
January 10 and March 9, 2010; accepted March 9, 2010. The authors are
affiliated with the Menninger Department of Psychiatry and Behavioral medications. This brief didactic time is insufficient for
Sciences at Baylor College of Medicine in Houston, Texas; Dr. Aboul- most students to appreciate the range of psychotherapies,
Fotouh is also affiliated with Harvard/Massachusetts General Hospital in
Boston; Dr. Asghar-Ali is also affiliated with the Michael E. DeBakey
their indications, techniques, and evidence for use. At
VA Medical Center, Mental Health Careline, in Houston. Address cor- medical school, no core rotation opportunities provide any
respondence to Ali Abbas Asghar-Ali, M.D., Michael E. DeBakey VA substantial exposure to psychotherapeutic interventions.
Medical Center, Mental Health Careline, 2002 Holcombe Blvd, MHCL-
116, Houston, TX 77030; asgharal@bcm.edu (e-mail). As future physicians, medical students can benefit from
Copyright © 2010 Academic Psychiatry exposure to different treatments for mental illnesses. A
student’s experience and understanding of the practice of prepare residents for careers as clinician-educators and is
psychiatry may influence whether he or she pursues a described in another article in this issue (10). The program
career in the field. On reflecting on her own medical requires that participants develop a scholarly project that
school education, the resident author (FA) believed that focuses on an educational activity.
she would have been more confident in her career choice Through mentorship with a faculty member of the Cli-
of psychiatry if, as a student, she had had a better under- nician Educator Track (AA) and discussion with leaders in
standing of psychotherapy. Psychotherapy is an exciting medical education and psychotherapy at Baylor, “Therapy
and integral part of psychiatric practice that can be attrac- 101: An Introduction to Psychotherapy” was developed as
tive to medical students who are interested in pursuing a six 1-hour lectures using electronic presentation software,
career in psychiatry. She felt that her student peers were case examples, and video clips to cover the concepts and
underexposed to therapy during their psychiatry didactics applications of psychotherapy. The course was integrated
and rotations. This personal experience inspired her to into an elective longitudinal mental health experience at
examine how other programs approach teaching students Baylor College of Medicine.
about psychotherapy.
We searched PubMed, PsycINFO, Med Ed Portal, and Methods
the EMBASE databases for the period between 1950 to
June 2009 for a psychotherapy curriculum for medical The resident physician (FA) and faculty mentor (AA)
students using the medical subject heading terms medical met regularly prior to initiating the course to discuss the
students and psychotherapy. Two articles focused on psy- resident’s goals for the project, which included using
chotherapeutic concepts within all doctor-patient relation- slides, developing and teaching a curriculum, and learning
ships, while another two argued for the importance of how to solicit and use student feedback. “Therapy 101”
teaching medical students about these concepts (2–5) was then constructed with four main goals for its students:
without including a recommended curriculum. In 1961, to give students basic theoretical and practical knowledge
Ornstein (6) described a medical student course that intro- of major psychotherapies, to interest students in therapy
duced psychotherapeutic concepts, analyzed a 3-hour ther- and deepen their appreciation of the value of psychother-
apy session, and discussed the role of hypnosis in treat- apy, to give students a broader appreciation for mental
ment. One article (7) discussed teaching French medical health treatments and thus expose them to a different side
students to perform behavioral therapy. In 1999, Cabaniss of psychiatry, and to provide a model of student education
(8) wrote about introducing medical students to psycho- in psychotherapy (Table 1).
analysis over five 1-hour seminars, with 1 hour dedicated The course introduced the theoretical constructs and
to the introduction of concepts and types of psychotherapy application of the most commonly practiced types of psy-
and the remaining 4 hours reading process notes. Among chotherapy. The integration of media and examples of
these articles, only one resident-taught course was found therapy cases prompted students to examine their impres-
(9); it introduced medical students to personality disorders sions of therapy and engaged them in learning how a
in four 1.5-hour weekly sessions using movie clips and patient may be “prescribed” a certain type of psychother-
role plays. Although principles of transference and coun- apy. Finally, the instructor used her recent transition from
tertransference were introduced in this context, no other medical student to resident therapist to relate to students
emphasis on psychotherapy appeared. the personal experience of a therapy session.
Although there is literature on teaching medical stu- We planned each session together to ensure that the
dents about a certain aspect of psychotherapy, we did not goals and the course objectives were being met. Special
find a curriculum that gives students an overview of basic attention was paid to using different teaching techniques to
concepts and applications of multiple types of psychother- keep the students engaged. Each workshop incorporated
apy. This article describes the creation and implementation video clips from TV shows, role play, case examples, and
of a curriculum aimed at educating medical students about electronic slides.
psychotherapy by a third-year psychiatric resident (FA) Eight third-year medical students in the Longitudinal
who is a member of the Clinician Educator Track in the Ambulatory Clinical Experience–Mental Health and Be-
Menninger Department of Psychiatry and Behavioral Sci- havioral Sciences Pathway at the Baylor College of Med-
ences at Baylor College of Medicine. The Clinician Edu- icine participated in this pilot project. At Baylor, students
cator Track is a specialized training track designed to choose from several longitudinal pathway experiences and
are selected to a particular pathway on the basis of essays about psychotherapy with a multiple-choice test and a
expressing their interest. The mental health pathway spans discussion. Media portrayals of psychotherapy were dis-
the academic year and involves weekly meetings with an cussed with two video clips. One clip from the TV show
ambulatory preceptor and community site visits. It teaches ER (11) demonstrated a physician using supportive tech-
students to take an in-depth approach to the psychosocial niques with a grieving patient, exemplifying psychother-
issues associated with mental and physical wellness. apeutic concepts being implemented outside of a therapy
Through collaboration with the faculty directors of the session. The other clip from the HBO series In Treatment
mental health pathway, 1 hour per month was assigned to (12) showed a therapist’s first meeting with his patient and
“Therapy 101.” Institutional review board approval was began a discussion on what brings a patient to therapy and
received to collect data on this project and the medical the challenges of the first session. These two videos were
students were provided cover letters explaining the pur- used to ignite dialogue about media portrayals of the phy-
pose for collecting data. Attendance was not recorded, and sician-patient relationship and psychotherapists in partic-
students were informed that attendance and participation ular.
in the series would not influence their grades for the men- The second session explored transference, mentalizing,
tal health pathway. The first session introduced the lecture and therapeutic alliance, which were considered to be core
series and assessed students’ knowledge and attitudes concepts in a range of psychotherapies. In addition to case
absence of a real-life context. She identified with the stu- try Education of Medical Students. Omaha, Ne, ADMSEP,
dents’ needs to hear about theory and practice together. 2007. Available at http://www.admsep.org/Clinical_LO_
Guide_Outline_Format_Nov_07.doc
Her recent experience helped her create a course that
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a trainee, a faculty mentor provides additional experience 7. Agathon M, Samuel-Lajeunesse B: Teaching behavioral as-
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One of the goals of the Clinician Educator Track at Baylor 2010; 34:269 –276
11. Amblin Entertainment: ER. Season 8, episode 20. “The Let-
is to support and develop resident educators. This course
ter.”
met that goal and resulted in an enduring curriculum for
12. HBO: In Treatment. “In Treatment: Sophie: Session 1.”
medical students. Available at http://www.youtube.com/watch?v⫽M1iev0zph3o
By increasing an understanding of psychotherapy, the 13. Gabbard G: Psychodynamic Psychotherapy in Practice.
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1–24
grated as an elective at Baylor College of Medicine and to
18. Wright JH, Basco MR, Thase ME: Learning CBT: An Illus-
be replicated at other medical schools. trated Guide. DVD. Washington, DC, American Psychiatric
Publishing, 2006
At the time of submission, the authors reported no competing 19. HBO: In Treatment. “Sophie’s Sexual Problem Part 1.” Avail-
interests. able at http://www.youtube.com/watch?v⫽pF6cmqYJk10
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