The new milestones: do we need to take a step back to go a mile forward?

The Milestones Project, like all previous systems and changes in graduate psychiatric education, for example, moving from 3 to 4 years of training or adopting six competency domains, has been devised without any supporting data and does not assess meaningful outcomes, such as improved patient outcomes. No evidence is presented that Milestones-based training will produce better psychiatrists. There is a path forward.

Learning psychotherapy in the digital age.

There is substantial literature documenting the process factors that lead to effective psychotherapy. Similarly, there is now a wealth of data attesting to the effectiveness of several psychotherapy brands. Little is known about the elements that facilitate learning how to be an effective clinician.

Psychotherapy training for residents: reconciling requirements with evidence-based, competency-focused practice.

Objective: The Accreditation Council for Graduate Medical Education (ACGME) and the Royal College of Physicians and Surgeons of Canada (RCPSC) changed the training requirements in psychotherapy, moving toward evidence-based therapies and emphasizing competence and proficiency as outcomes of training. This article examines whether the therapies selected for training are evidence based and the authors review research concerning methods for training and assessment that effectively lead to competence in these psychotherapies.

Methods: The authors searched PsycINFO and PubMed for studies from 2000 to 2009 using the terms meta-analysis, meta-analyses, and psychotherapy combined with specific psychotherapies listed in the ACGME and RCPSC requirements to determine if high-level evidence supported the use of these therapies in patients with psychiatric disorders.

Personality traits related to chronic pain location.

Background: Previous research has yielded inconsistent findings on the relationship between personality characteristics and chronic pain. The present study examines measures of alexithymia, somatosensory amplification, attachment, counterdependency, and emotional distress in 140 consecutive general medical outpatients seen in psychiatric consultation.

Methods: Forty-five subjects having no chronic pain (NP) were compared to 49 subjects with chronic pain restricted to their back and/or extremities (BE) and with 46 subjects having pain involving other regions of the body (OP).

Evaluating competence in psychotherapy.

Background: The Residency Review Committee (RRC) for Psychiatry has recently charged psychiatry training programs with developing methods to demonstrate competence of trainees in five areas of psychotherapy. Each program must decide what specific skills are essential for competence in each of the five listed psychotherapies. This requires determining whether those skills that are necessary are also sufficient for effective psychotherapy and whether additional specific skills are required for each one.