Psychotherapy is integral to the training of psychiatrists and is part of the core curriculum for general psychiatry ST1-6.

The psychotherapy training requirements at ST1-3, pre MRCPsych exam are outlined in the core curriculum, with specific guidance on how to acquire psychotherapy experience.

• Higher Specialist training ST4-6
• Psychotherapy training for ST4-6 in specialties other than Psychotherapy

• CPD psychotherapy training for SAS and consultant psychiatrists
• Psychotherapy tutors
• Psychotherapy WpBAs

ST1-3 Core Training

The PMETB curriculum ST1-6 core training and ST4-6 Higher Specialist Training in Psychotherapy include methods of assessment  for psychotherapy competency. These are the Structured Assessment of Psychotherapy Expertise (the SAPE) and Case Based Discussion group (CBD) rating forms for junior doctors. For higher specialist trainees it includes the Structured Assessment of Psychotherapy Assessment (SAPA), SAPE and a modified case based discussion form.

For ST1-3 it incorporates the requirement to undertake two cases in different modalities over two durations for trainees. This means that PMETB now formally require these assessments of competence to be provided for ARCP accreditation

• An information sheet on psychotherapy training  ST1-3

• Guidance (Information Pack on Psychotherapy ) 

Higher Specialist Training ST4-6 in Psychotherapy to become a Consultant Psychiatrist in Psychotherapy

It is possible to obtain a CCT in Psychotherapy through specialising in either CBT, psychodynamic, or systemic therapy. This training comprises three years at ST 4-6 * level in a PMETB accredited Psychotherapy scheme quality assured by local deaneries through the schools of psychiatry.

Trainees acquire an in depth knowledge of theory and practice of their major approach, and also receive training in the other two (psychodynamic, CBT or systemic) approaches. The specialist curriculum is available here.

At the end of this training they will gain a CCT as specialists in psychotherapy and are able to apply to be on the Specialist Register of the GMC.

As such they will be able to train Specialty Registrars in psychotherapy and to take the role of leading multi-modal psychological therapy teams. It is also possible to spend a year in psychotherapy which will lead to an endorsement in psychotherapy (see information pack, link above).

Psychotherapy training for ST4-6 in specialties other than Psychotherapy

The curriculum indicates that trainees continue to develop their  psychotherapeutic expertise as they become higher trainees, according to their interest and specialty. For example a rehabilitation or general adult trainee might seek to gain experience of cognitive therapy of psychosis, a trainee interested in eating disorders may gain further experience of family therapy or psychodynamic psychotherapy, or training on group therapy may interest a learning disability trainee.

The combinations are many and tailored programmes of experience can be devised
 in conjunction with Psychotherapy tutors and Training Programme Directors.

• A Career in Psychotherapy ( a personal view)

• The Role of the Consultant Psychiatrist in Psychotherapy 

CPD for SAS and Consultant Psychiatrists

SAS doctors and Consultant Psychiatrists can access psychotherapy training by attachments to Departments of Psychotherapy organised via the Psychotherapy Tutors of the organisation they work in, achieving and advancing competencies in the main psychotherapy modalities, working with individuals, couples, families or groups.

Psychotherapy Tutor Role

Each core training programme should have a Psychotherapy Tutor who is a Consultant Psychiatrist in Psychotherapy.

The tutor works together with the Training Programme Director ( TPD) of core training and the Director of Medical Training of the Trust to ensure that psychotherapy training requirements are met in the training scheme. This includes ensuring case based discussion groups(CBDs) are available in years 1and 2;  CBT, psychodynamic, systemic or integrative trainings and supervision are available for trainees; liaising with and advising supervisors, who may be non- medical, of the training requirements and advising trainees when and what kind of psychotherapy cases are appropriate. The Tutor and other Consultant Psychiatrists in Psychotherapy will also conduct and advise on the workplace based assessments such as the ACE on the psychotherapy long case. The Tutor will then contribute to the review of the trainee's progress by advising the TPD whether the psychotherapy requirements have been met.

The overall aim of the Psychotherapy Tutor is to help core psychiatric trainees develop habits of self reflection and emotional curiosity, to have an understanding of the therapeutic relationship, unconscious modes of communication and learn about different models of psychotherapy enough to be able to refer or work alongside as the patient undergoes therapy.

TPDs have responsibility for managing specialty training programmes including Fixed Term Specialty Training Appointments (FTSTAs). They work to ensure that programmes deliver the specialty curriculum and enable trainees to gain the relevant competences, knowledge, skills, attitudes and experience. They take into account the collective needs of the trainees in the programme when planning individual programmes. They provide support for clinical and educational supervisors within the programme and  contribute to the annual assessment outcome process in the specialty. They have a role in careers advice. They help the Postgraduate Dean manage trainees who are running into difficulties by supporting educational supervisors in their assessments and in identifying remedial placements.

 The work involves working within the Trust with the Director of Medical education, the Schools of Psychiatry within the Deanery, delegated College/Faculty representatives (e.g. college tutors, regional advisors) and national College/Faculty training or Specialty Advisory Committees (SACs)

Each school has access to a regional representative in psychotherapy.

These person/persons ensure that the deanery is aware of the requirements for psychotherapy training for core and generic training ST1-6 and higher specialist training, offering advice on how to ensure that this is available to the trainee and that they attain appropriate competencies in psychotherapy pre and post MRCPsych Examinations.