Beveridge, Ed

Dover, Deborah

King, Michael

Leavey, Gerry

English

Holt

Gelder

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Personal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatrist
http://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]
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Abstract
The Psychiatrist (2009) 33: 433-436. doi: 10.1192/pb.bp.108.023440
© 2009 The Royal College of Psychiatrists
Education & Training
Personal psychotherapy in psychiatric training: study of four London
training schemes
Deborah Dover, Specialist Registrar in Child & Adolescent Psychiatry
*Child and Family Department, Tavistock Centre, 120 Belsize Lane, London NW3 5BA, email:
deborah.dover@gmail.com
Ed Beveridge, Consultant Psychiatrist
St Charles Hospital, London
Gerry Leavey
Research and Development Department, St Ann’s Hospital, London
Michael King
Department of Mental Health Sciences, University College London, UK
Declaration of interest
None.
 Abstract
 
AIMS AND METHOD
We carried out a web-based survey to establish the proportion of London psychiatry senior house officers who undertake
personal psychotherapy. Demographics, training characteristics and psychotherapy experience were examined using descriptive
statistics. Predictors of personal psychotherapy status were examined using logistic regression.
RESULTS
The majority of trainees who undertook personal psychotherapy included training as a reason for doing so. Of the participants,16% had
undergone personal psychotherapy and of the remainder, 73% reported that they would consider it in the future. Ethnicity was the only predictor
of psychotherapy status, with White British trainees nearly four times more likely to pursue it.
CLINICAL IMPLICATIONS
Personal psychotherapy appeared to have relevance to training from both a pastoral and a learning perspective. If training schemes wish to
support this practice they will need to address difficulties trainees may face in accessing therapy. Trainees might also be encouraged to think
about the effect of cultural factors on their attitudes towards psychological therapies.
 Introduction
 
There has been a long-standing tradition of psychiatrists undergoing psychotherapy or psychoanalysis during training. However,
 
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Personal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatrist
http://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]
Introduction
Method
Results
Discussion
References
TOP
Abstract
Introduction
Method
Results
Discussion
References
figures from the USA suggests that although 70% of psychiatry trainees underwent psychotherapy in the 1950s,1 only 32% of
current trainees undertake personal psychotherapy.2 There are no data available for the UK and the uptake of personal
psychotherapy here remains unknown. However, anecdotal evidence suggests a similar decrease in this country. Should this be
the case, it may reflect a significant attitudinal shift regarding the utility of psychotherapy in the National Health Service (NHS)
and the direction of psychiatric care.
Psychiatrists are increasingly asked to prescribe and undertake psychological therapies for a range of conditions3 and training in psychological
therapies is thought to be essential.4 Some psychiatrists believe that personal psychotherapy has an important role in training,5,6 but there is
much debate over the issue. According to one perspective, personal psychotherapy may provide the trainee with useful insights, experiential
learning and support; other perspectives suggest it is lacking in evidence, costly and irrelevant. However, there is evidence that psychiatrists
have high rates of stress7 compared with other doctors and that trainees are currently under particular strain.8 Doctors often find it hard to
recognise and report their own illness,9 and some trainees may be using personal psychotherapy as a way of coping. There is also a view that
psychotherapy may help clinicians differentiate their own psychopathology from that of their patients.
Some would also argue that since psychiatrists in training are expected to conduct psychodynamic psychotherapy with patients,10 they should
conform to the same standards as those of trainee psychodynamic psychotherapists (i.e. mandatory personal psychotherapy). This would clearly
have major financial and structural implications for training schemes.
Studies of the impact of personal psychotherapy on trainee therapists’ practice have demonstrated no measurable effect on client outcomes, but
a positive effect on therapists’ empathy, warmth and genuineness.11 However, other studies have suggested that it may have a negative impact
on client work because of an increase in trainees’ emotional distress.11,12
A recent college debate on this subject revealed that many psychiatrists remain interested in this topic, and that many hold strong views. As
such, this study was designed to explore this issue in more detail. The aims were to determine the popularity of personal psychotherapy among
psychiatry senior house officers working in London, the types of therapy pursued, the number of senior house officers who would consider
therapy, the reasons given for pursuing therapy, the guidance available and the factors that predicted the pursuit of therapy. In the current
study the term ‘personal psychotherapy’ is used to refer to ‘any psychological treatment’13 where the psychiatrist was the client rather than the
therapist.
 Method
 
Ethical approval was obtained from the Barnet, Enfield & Haringey Research Ethics Committee in London. Four of the eight
psychiatry senior house officer training schemes in London were approached to participate in the study. The four schemes were
chosen based on their geographical position, in order to gain as representative sample as possible. All senior house officers on
these schemes at the time of the study were eligible to be participants except for those in stand-alone, non-training and
general practitioner vocational training scheme posts. The survey was administered online and included a consent form, which
was completed separately from the questionnaire to ensure anonymity.
As no appropriate, validated questionnaire was available, one was designed and created online by the authors using a web-based survey tool
(www.surveymonkey.com). The first section contained questions on participants’ sociodemographic details (age, gender, self-assigned ethnic
category, religious affiliation and marital status), and their medical and psychiatric training. A second section explored their experience of
personal psychotherapy. Those without experience of personal psychotherapy were asked whether they had previously considered it or would
do so in future. The questionnaire was piloted with 20 junior doctors who had already completed senior house officer training. Following
feedback and analysis, a number of minor changes were made to the questionnaire.
The participating training scheme administrators provided trainees’ names and current training posts. They then sent an email to all trainees
explaining the study and containing a link to the online questionnaire. Administrators sent a follow-up email 2–4 weeks later. Paper copies of
the survey were sent to those without email addresses and to non-responders. Doctors’ paper questionnaires that were returned to sender
(indicating that the job list was incorrect) were removed from the final total number of questionnaires sent.
Analysis
The results were transferred from the survey website to the Statistical Package for the Social Sciences (SPSS) version 14.0 for Windows, double
checked with printed copies of the responses and analysed. Demographics, training characteristics and psychotherapy experience were
examined using descriptive statistics. Predictors of having or considering personal psychotherapy were examined using logistic regression.
 Results
Personal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatrist
http://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]
TOP
Abstract
Introduction
Method
Results
Discussion
References
TOP
Abstract
Introduction
Method
Results
Discussion
References
 
In total, 140 questionnaires were returned from a total of 294 senior house officers contacted. Seven questionnaires were
returned to sender and deducted from the denominator leaving an overall response of 48.7%.
Demographic characteristics
The mean age of participants was 29 years (s.d. = 3.2) and the majority (n = 87, 63%) of the sample were men. Just under half
of respondents graduated from a medical school outside the UK, suggesting that ethnic minority groups had not been
systematically excluded. The mean number of psychiatry training posts undertaken was 4.0 (s.d. = 2.0) (Table 1).
View this table:
[in this window]
[in a new window]
 
Table 1. Demographic and training characteristics of participants (n = 140)
Psychotherapy experience and views about therapy
Twenty-two participants (16%) had undertaken personal psychotherapy. The mean length of therapy was 15.2 months (range 0.2–104, s.d. =
23.8). Fifteen were currently in therapy.
The most common type of therapy was psychodynamic (45%), with others including counselling, eclectic, group, systemic and cognitive –
behavioural therapies. Frequency of therapy ranged between one session per week (68% of participants) and four sessions per week. Of the
trainees who had no direct experience of personal psychotherapy, 28 (26%) stated that they had not considered psychotherapy and would never
consider it.
Of the participants who undertook psychotherapy, 48% said it was for personal reasons, 39% for both training and personal reasons, and 13%
for training alone. Respondents who had undergone personal psychotherapy were asked if guidance in finding a therapist was available from
training schemes. Only 5% had received formal guidance. The remaining 95% stated that they had received informal guidance.
Respondents were divided into two groups for subgroup comparison purposes (Group A and B). Group A comprised those with direct experience
of therapy or those stating that they had considered it in the past or would consider it in the future, whereas Group B comprised those that had
no experience of personal psychotherapy and said they would never consider it (Table 2).
View this table:
[in this window]
[in a new window]
 
Table 2. Psychotherapy experience
Sociodemographic and training characteristics were combined into binary variables for subgroup analysis. Ethnicity was the only significant
predictor of attitudes to personal psychotherapy. White British respondents, the largest single ethnic group, were found to be four times more
likely than others to be in Group A (Table 3).
View this table:
[in this window]
[in a new window]
 
Table 3. Predictors of respondents being in Group A, derived from logistic regression analysisa
 Discussion
 
Psychiatry trainees are the consultants of the future, and many will go on to prescribe psychotherapy and manage psychotherapy
services. As such, their experience of, and attitudes towards, psychotherapy will determine the place of psychotherapy in the
NHS.
We were primarily interested in whether the practice of personal psychotherapy really mattered to trainees, training schemes or
to psychiatry in general. The fact that only 16% of participants had direct experience of their own psychotherapy may suggest
Personal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatrist
http://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]
TOP
Abstract
Introduction
Method
Results
Discussion
References
that it is merely of interest to a minority. However, our findings also indicated that many trainees had or would consider
psychotherapy for themselves, suggesting that many felt it had some value or role.
So, given that many participants felt personal psychotherapy has a value, what was the nature of the value added? We initially hypothesised that
personal psychotherapy was providing support or an acceptable form of treatment for these doctors. However, the study raised the possibility
that trainees have other reasons for undertaking therapy. More than 50% of the participants in the study who were in psychotherapy gave
training as one of the reasons for undertaking therapy, and some cited training as the only reasons for doing so (13%). This raises the question
of what personal psychotherapy may be providing, which is not being provided elsewhere in training. In the psychoanalytic world, personal
psychotherapy is a compulsory part of training, and is thought to provide important experiential learning. This experiential learning may be the
value trainees are interested in, especially in a profession where reflective practice is encouraged. Furthermore, in our new competency-based
trainings, there may be few other opportunities to experience this degree of reflective learning.
Having established that personal psychotherapy has a pastoral and training value, we were also interested in the popularity of personal
psychotherapy and what this suggest for the future. In the absence of any historical data from the UK, we can only speculate as to whether our
finding of 16% uptake is a decline. However, comparison with the USA prevalence (32%) does suggest that the practice of personal
psychotherapy is less popular in the UK than in the USA.
Given that the majority of our participants said they would consider psychotherapy, we were curious as to why so few had pursued it. In order to
answer this question, we explored the predictors of personal psychotherapy among participants. The study found that the only significant
predictor was ethnicity. This finding may have reflected valid cultural differences, but may also have indicated inequalities in access to personal
psychotherapy. If this is the case, training schemes may wish to think about how they can address this matter, to counter the impact this may
have on our trainees and their attitudes to psychotherapy.
Limitations
With a modest response rate, the findings of this survey must be interpreted with some caution. In particular, the finding of 16% prevalence for
uptake of personal psychotherapy may be an overestimate of the true uptake due to the influence of self-selection bias.
Another limitation of the study is that the sample was unlikely to be representative of all trainees in England. However, since the participants
came from all geographical regions of London, the results are likely to be representative of those in London. We can also postulate that personal
psychotherapy may be more common among London trainees than those located elsewhere, due to the greater availability of psychotherapy and
the proximity to psychotherapy training institutions. It will be important to repeat the study in other regions to establish the psychotherapy
experience and attitudes nationwide. The range of experience reported suggests that the sample mirrored the population under investigation.
There was a good spread of age and gender in the study population and the fact that half of the sample graduated outside the UK and half
described themselves as White British, indicates a culturally diverse sample.
Use of an online survey tool
One strength of the study was the use of the online survey for data collection. This is a relatively novel technique in the NHS and proved
accessible, relatively inexpensive and efficient. In the near future, online methods may be a useful way of reaching larger populations and
improving response rates.
 Acknowledgments
 
This work is dedicated to the memory of Dr Richard Lucas OBE who supported and inspired us. We would also like to thank Dr Tina Rothi and
the Research Support Department at the University of Hertfordshire for their helpful input and advice.
 References
 
1
Holt RR, Luborsky L. Personality patterns of psychiatrists. Menninger Foundation 1958; 2: 20-7.2
Moran, M. Is personal psychotherapy still crucial for residents? Psychiatr News 2007; 42: 6-26.[Free Full Text]3
National Institute for Health and Clinical Excellence. Depression Clinical Guidance CG23 . NICE, 2004 (amended in 2007).4
Agarwal S, Singh Y, Palanisamy V, Basker R, Van der Speck R. Psychotherapy requirements as recommended by the College:
awareness and achievement by senior house officers. Psychiatr Bull 2007; 31: 394 -6.[Abstract/Free Full Text]5
Mace C. Personal therapy in psychiatric training. Psychiatr Bull 2001; 25: 3-4.[Free Full Text]6
Personal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatrist
http://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]
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Abstract 
Full Text (PDF)
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Articles by King, M.
Hollins S. ‘Experience in psychotherapy is a necessary part of psychiatric training’. Debate, Royal College of Psychiatrists Annual General
Meeting, Edinburgh, 2005 .7
Fothergill A, Edwards D, Burnard P. Stress, burnout, coping and stress management in psychiatrists: findings from a systematic review. Int J Soc
Psychiatry 2004; 50: 54-65.[Abstract/Free Full Text]8
Lydall GJ, Malik A, Bhugra D. Mental health of applicants seems to be deteriorating. BM J 2007; 334: 1335.[Free Full Text]9
McKevitt C, Morgan M. Illness doesn’t belong to us. JR Soc Med 1997; 90: 491-5.[Abstract]10
Royal College of Psychiatrists. Requirements for Psychotherapy Training as Part of Basic Specialists Psychiatric Training. Royal College of
Psychiatrists, 2002 (http://www.rcpsych.ac.uk/PDF/ptBasic.pdf).11
Macran S, Shapiro DA. The role of personal therapy for therapists: a review. Br J Med Psychol 1998; 71: 13-25.[Medline]12
Dubovsky S L, Scully JH. Hazards of long-term psychotherapy during psychiatric residency. Psychiatry 1990; 53: 185-94.[Medline]13
Gelder M, Gath D, Mayou R, Cowen P. Oxford Textbook of Psychiatry (3rd edn). Oxford University Press,1996.
© 2009 The Royal College of Psychiatrists.
Online ISSN: 1758-3217
Print ISSN: 1758-3209


Personal psychotherapy in psychiatric training: study of four London training schemes

Tavistock and Portman E-Prints Online

Personal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatristhttp://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]This ArticleAbstract Full Text (PDF)Submit an eLetterAlert me when this article is citedAlert me when eLetters are postedAlert me if a correction is postedCitation MapServicesEmail this article to a friendSimilar articles in this journalAlert me to new issues of the journalDownload to citation managerCiting ArticlesCiting Articles via CrossRefCiting Articles via Google ScholarCiting Articles via ScopusGoogle ScholarArticles by Dover, D.Articles by King, M.Search for Related ContentPubMedArticles by Dover, D.Articles by King, M.TOPAbstractIntroductionMethodResultsDiscussionReferencesTOPAbstractThe Psychiatrist (2009) 33: 433-436. doi: 10.1192/pb.bp.108.023440© 2009 The Royal College of PsychiatristsEducation & TrainingPersonal psychotherapy in psychiatric training: study of four Londontraining schemesDeborah Dover, Specialist Registrar in Child & Adolescent Psychiatry*Child and Family Department, Tavistock Centre, 120 Belsize Lane, London NW3 5BA, email:deborah.dover@gmail.comEd Beveridge, Consultant PsychiatristSt Charles Hospital, LondonGerry LeaveyResearch and Development Department, St Ann’s Hospital, LondonMichael KingDepartment of Mental Health Sciences, University College London, UKDeclaration of interestNone. Abstract AIMS AND METHODWe carried out a web-based survey to establish the proportion of London psychiatry senior house officers who undertakepersonal psychotherapy. Demographics, training characteristics and psychotherapy experience were examined using descriptivestatistics. Predictors of personal psychotherapy status were examined using logistic regression.RESULTSThe majority of trainees who undertook personal psychotherapy included training as a reason for doing so. Of the participants,16% hadundergone personal psychotherapy and of the remainder, 73% reported that they would consider it in the future. Ethnicity was the only predictorof psychotherapy status, with White British trainees nearly four times more likely to pursue it.CLINICAL IMPLICATIONSPersonal psychotherapy appeared to have relevance to training from both a pastoral and a learning perspective. If training schemes wish tosupport this practice they will need to address difficulties trainees may face in accessing therapy. Trainees might also be encouraged to thinkabout the effect of cultural factors on their attitudes towards psychological therapies. Introduction There has been a long-standing tradition of psychiatrists undergoing psychotherapy or psychoanalysis during training. However, HOME CURRENT ARCHIVE FEEDBACK SUBSCRIBE HELPUser NamePasswordAdvanced Search »Institution: Swets Blackwell Ltd | Sign In via User Name/PasswordPersonal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatristhttp://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]IntroductionMethodResultsDiscussionReferencesTOPAbstractIntroductionMethodResultsDiscussionReferencesfigures from the USA suggests that although 70% of psychiatry trainees underwent psychotherapy in the 1950s,1 only 32% ofcurrent trainees undertake personal psychotherapy.2 There are no data available for the UK and the uptake of personalpsychotherapy here remains unknown. However, anecdotal evidence suggests a similar decrease in this country. Should this bethe case, it may reflect a significant attitudinal shift regarding the utility of psychotherapy in the National Health Service (NHS)and the direction of psychiatric care.Psychiatrists are increasingly asked to prescribe and undertake psychological therapies for a range of conditions3 and training in psychologicaltherapies is thought to be essential.4 Some psychiatrists believe that personal psychotherapy has an important role in training,5,6 but there ismuch debate over the issue. According to one perspective, personal psychotherapy may provide the trainee with useful insights, experientiallearning and support; other perspectives suggest it is lacking in evidence, costly and irrelevant. However, there is evidence that psychiatristshave high rates of stress7 compared with other doctors and that trainees are currently under particular strain.8 Doctors often find it hard torecognise and report their own illness,9 and some trainees may be using personal psychotherapy as a way of coping. There is also a view thatpsychotherapy may help clinicians differentiate their own psychopathology from that of their patients.Some would also argue that since psychiatrists in training are expected to conduct psychodynamic psychotherapy with patients,10 they shouldconform to the same standards as those of trainee psychodynamic psychotherapists (i.e. mandatory personal psychotherapy). This would clearlyhave major financial and structural implications for training schemes.Studies of the impact of personal psychotherapy on trainee therapists’ practice have demonstrated no measurable effect on client outcomes, buta positive effect on therapists’ empathy, warmth and genuineness.11 However, other studies have suggested that it may have a negative impacton client work because of an increase in trainees’ emotional distress.11,12A recent college debate on this subject revealed that many psychiatrists remain interested in this topic, and that many hold strong views. Assuch, this study was designed to explore this issue in more detail. The aims were to determine the popularity of personal psychotherapy amongpsychiatry senior house officers working in London, the types of therapy pursued, the number of senior house officers who would considertherapy, the reasons given for pursuing therapy, the guidance available and the factors that predicted the pursuit of therapy. In the currentstudy the term ‘personal psychotherapy’ is used to refer to ‘any psychological treatment’13 where the psychiatrist was the client rather than thetherapist. Method Ethical approval was obtained from the Barnet, Enfield & Haringey Research Ethics Committee in London. Four of the eightpsychiatry senior house officer training schemes in London were approached to participate in the study. The four schemes werechosen based on their geographical position, in order to gain as representative sample as possible. All senior house officers onthese schemes at the time of the study were eligible to be participants except for those in stand-alone, non-training andgeneral practitioner vocational training scheme posts. The survey was administered online and included a consent form, whichwas completed separately from the questionnaire to ensure anonymity.As no appropriate, validated questionnaire was available, one was designed and created online by the authors using a web-based survey tool(www.surveymonkey.com). The first section contained questions on participants’ sociodemographic details (age, gender, self-assigned ethniccategory, religious affiliation and marital status), and their medical and psychiatric training. A second section explored their experience ofpersonal psychotherapy. Those without experience of personal psychotherapy were asked whether they had previously considered it or woulddo so in future. The questionnaire was piloted with 20 junior doctors who had already completed senior house officer training. Followingfeedback and analysis, a number of minor changes were made to the questionnaire.The participating training scheme administrators provided trainees’ names and current training posts. They then sent an email to all traineesexplaining the study and containing a link to the online questionnaire. Administrators sent a follow-up email 2–4 weeks later. Paper copies ofthe survey were sent to those without email addresses and to non-responders. Doctors’ paper questionnaires that were returned to sender(indicating that the job list was incorrect) were removed from the final total number of questionnaires sent.AnalysisThe results were transferred from the survey website to the Statistical Package for the Social Sciences (SPSS) version 14.0 for Windows, doublechecked with printed copies of the responses and analysed. Demographics, training characteristics and psychotherapy experience wereexamined using descriptive statistics. Predictors of having or considering personal psychotherapy were examined using logistic regression. ResultsPersonal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatristhttp://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]TOPAbstractIntroductionMethodResultsDiscussionReferencesTOPAbstractIntroductionMethodResultsDiscussionReferences In total, 140 questionnaires were returned from a total of 294 senior house officers contacted. Seven questionnaires werereturned to sender and deducted from the denominator leaving an overall response of 48.7%.Demographic characteristicsThe mean age of participants was 29 years (s.d. = 3.2) and the majority (n = 87, 63%) of the sample were men. Just under halfof respondents graduated from a medical school outside the UK, suggesting that ethnic minority groups had not beensystematically excluded. The mean number of psychiatry training posts undertaken was 4.0 (s.d. = 2.0) (Table 1).View this table:[in this window][in a new window] Table 1. Demographic and training characteristics of participants (n = 140)Psychotherapy experience and views about therapyTwenty-two participants (16%) had undertaken personal psychotherapy. The mean length of therapy was 15.2 months (range 0.2–104, s.d. =23.8). Fifteen were currently in therapy.The most common type of therapy was psychodynamic (45%), with others including counselling, eclectic, group, systemic and cognitive –behavioural therapies. Frequency of therapy ranged between one session per week (68% of participants) and four sessions per week. Of thetrainees who had no direct experience of personal psychotherapy, 28 (26%) stated that they had not considered psychotherapy and would neverconsider it.Of the participants who undertook psychotherapy, 48% said it was for personal reasons, 39% for both training and personal reasons, and 13%for training alone. Respondents who had undergone personal psychotherapy were asked if guidance in finding a therapist was available fromtraining schemes. Only 5% had received formal guidance. The remaining 95% stated that they had received informal guidance.Respondents were divided into two groups for subgroup comparison purposes (Group A and B). Group A comprised those with direct experienceof therapy or those stating that they had considered it in the past or would consider it in the future, whereas Group B comprised those that hadno experience of personal psychotherapy and said they would never consider it (Table 2).View this table:[in this window][in a new window] Table 2. Psychotherapy experienceSociodemographic and training characteristics were combined into binary variables for subgroup analysis. Ethnicity was the only significantpredictor of attitudes to personal psychotherapy. White British respondents, the largest single ethnic group, were found to be four times morelikely than others to be in Group A (Table 3).View this table:[in this window][in a new window] Table 3. Predictors of respondents being in Group A, derived from logistic regression analysisa Discussion Psychiatry trainees are the consultants of the future, and many will go on to prescribe psychotherapy and manage psychotherapyservices. As such, their experience of, and attitudes towards, psychotherapy will determine the place of psychotherapy in theNHS.We were primarily interested in whether the practice of personal psychotherapy really mattered to trainees, training schemes orto psychiatry in general. The fact that only 16% of participants had direct experience of their own psychotherapy may suggestPersonal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatristhttp://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]TOPAbstractIntroductionMethodResultsDiscussionReferencesthat it is merely of interest to a minority. However, our findings also indicated that many trainees had or would considerpsychotherapy for themselves, suggesting that many felt it had some value or role.So, given that many participants felt personal psychotherapy has a value, what was the nature of the value added? We initially hypothesised thatpersonal psychotherapy was providing support or an acceptable form of treatment for these doctors. However, the study raised the possibilitythat trainees have other reasons for undertaking therapy. More than 50% of the participants in the study who were in psychotherapy gavetraining as one of the reasons for undertaking therapy, and some cited training as the only reasons for doing so (13%). This raises the questionof what personal psychotherapy may be providing, which is not being provided elsewhere in training. In the psychoanalytic world, personalpsychotherapy is a compulsory part of training, and is thought to provide important experiential learning. This experiential learning may be thevalue trainees are interested in, especially in a profession where reflective practice is encouraged. Furthermore, in our new competency-basedtrainings, there may be few other opportunities to experience this degree of reflective learning.Having established that personal psychotherapy has a pastoral and training value, we were also interested in the popularity of personalpsychotherapy and what this suggest for the future. In the absence of any historical data from the UK, we can only speculate as to whether ourfinding of 16% uptake is a decline. However, comparison with the USA prevalence (32%) does suggest that the practice of personalpsychotherapy is less popular in the UK than in the USA.Given that the majority of our participants said they would consider psychotherapy, we were curious as to why so few had pursued it. In order toanswer this question, we explored the predictors of personal psychotherapy among participants. The study found that the only significantpredictor was ethnicity. This finding may have reflected valid cultural differences, but may also have indicated inequalities in access to personalpsychotherapy. If this is the case, training schemes may wish to think about how they can address this matter, to counter the impact this mayhave on our trainees and their attitudes to psychotherapy.LimitationsWith a modest response rate, the findings of this survey must be interpreted with some caution. In particular, the finding of 16% prevalence foruptake of personal psychotherapy may be an overestimate of the true uptake due to the influence of self-selection bias.Another limitation of the study is that the sample was unlikely to be representative of all trainees in England. However, since the participantscame from all geographical regions of London, the results are likely to be representative of those in London. We can also postulate that personalpsychotherapy may be more common among London trainees than those located elsewhere, due to the greater availability of psychotherapy andthe proximity to psychotherapy training institutions. It will be important to repeat the study in other regions to establish the psychotherapyexperience and attitudes nationwide. The range of experience reported suggests that the sample mirrored the population under investigation.There was a good spread of age and gender in the study population and the fact that half of the sample graduated outside the UK and halfdescribed themselves as White British, indicates a culturally diverse sample.Use of an online survey toolOne strength of the study was the use of the online survey for data collection. This is a relatively novel technique in the NHS and provedaccessible, relatively inexpensive and efficient. In the near future, online methods may be a useful way of reaching larger populations andimproving response rates. Acknowledgments This work is dedicated to the memory of Dr Richard Lucas OBE who supported and inspired us. We would also like to thank Dr Tina Rothi andthe Research Support Department at the University of Hertfordshire for their helpful input and advice. References 1Holt RR, Luborsky L. Personality patterns of psychiatrists. Menninger Foundation 1958; 2: 20-7.2Moran, M. Is personal psychotherapy still crucial for residents? Psychiatr News 2007; 42: 6-26.[Free Full Text]3National Institute for Health and Clinical Excellence. Depression Clinical Guidance CG23 . NICE, 2004 (amended in 2007).4Agarwal S, Singh Y, Palanisamy V, Basker R, Van der Speck R. Psychotherapy requirements as recommended by the College:awareness and achievement by senior house officers. Psychiatr Bull 2007; 31: 394 -6.[Abstract/Free Full Text]5Mace C. Personal therapy in psychiatric training. Psychiatr Bull 2001; 25: 3-4.[Free Full Text]6Personal psychotherapy in psychiatric training: study of four London training schemes -- Dover et al. 33 (11): 433 -- The Psychiatristhttp://pb.rcpsych.org/cgi/content/full/33/11/433[04/05/2010 17:04:06]This ArticleAbstract Full Text (PDF)Submit an eLetterAlert me when this article is citedAlert me when eLetters are postedAlert me if a correction is postedCitation MapServicesEmail this article to a friendSimilar articles in this journalAlert me to new issues of the journalDownload to citation managerCiting ArticlesCiting Articles via CrossRefCiting Articles via Google ScholarCiting Articles via ScopusGoogle ScholarArticles by Dover, D.Articles by King, M.Search for Related ContentPubMedArticles by Dover, D.Articles by King, M.Hollins S. ‘Experience in psychotherapy is a necessary part of psychiatric training’. Debate, Royal College of Psychiatrists Annual GeneralMeeting, Edinburgh, 2005 .7Fothergill A, Edwards D, Burnard P. Stress, burnout, coping and stress management in psychiatrists: findings from a systematic review. Int J SocPsychiatry 2004; 50: 54-65.[Abstract/Free Full Text]8Lydall GJ, Malik A, Bhugra D. Mental health of applicants seems to be deteriorating. BM J 2007; 334: 1335.[Free Full Text]9McKevitt C, Morgan M. Illness doesn’t belong to us. JR Soc Med 1997; 90: 491-5.[Abstract]10Royal College of Psychiatrists. Requirements for Psychotherapy Training as Part of Basic Specialists Psychiatric Training. Royal College ofPsychiatrists, 2002 (http://www.rcpsych.ac.uk/PDF/ptBasic.pdf).11Macran S, Shapiro DA. The role of personal therapy for therapists: a review. Br J Med Psychol 1998; 71: 13-25.[Medline]12Dubovsky S L, Scully JH. Hazards of long-term psychotherapy during psychiatric residency. Psychiatry 1990; 53: 185-94.[Medline]13Gelder M, Gath D, Mayou R, Cowen P. Oxford Textbook of Psychiatry (3rd edn). Oxford University Press,1996.© 2009 The Royal College of Psychiatrists.Online ISSN: 1758-3217Print ISSN: 1758-3209

Experience in psychotherapy is a necessary part of psychiatric training’. Debate, Royal College of Psychiatrists Annual General Meeting,

Personality patterns of psychiatrists. Menninger Foundation 1958; 2:

The Royal College of Psychiatrists.

Personal psychotherapy in psychiatric training.  Study of four London training schemes

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Personal psychotherapy in psychiatric training. Study of four London training schemes

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