Transcript Identifying and Assisting Children of Substance Abusing

Therapy 101: Introducing Medical Students to Psychotherapy
Frieda Aboul-Fotouh, M.D., Ali Abbas Asghar-Ali, M.D.
Menninger Department of Psychiatry and Behavioral Sciences,
Baylor College of Medicine
Medical students learn little about psychotherapy in
medical school. Therapy 101 aims to fill this void.
BACKGROUND
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A literature search did not identify a curriculum for medical
students that introduced psychotherapy, its application, and evidence
for its use.
Through mentorship with Dr. Asghar and discussion with leaders in
medical education and psychotherapy at Baylor, Dr. Aboul-Fotouh
developed “Therapy 101: An Introduction to Psychotherapy.”
The purpose of this pilot project was to meet a need for a curriculum
to expose medical students to psychotherapy
Increase students’ interest in therapy
Develop a broader knowledge about mental health care and a deeper
appreciation of psychiatry
THERAPY 101 CURRICULUM
Workshops:
Objectives:
Teaching Modality:
Assessing Attitudes
and Knowledge
Course overview
Assessment of knowledge
Discuss impact of media on
attitudes about psychotherapy
•Syllabus
•Video clips of ER and
In Treatment clip of Sophie
 To understand concepts of
transference, counter
transference, mentalization,
and therapeutic alliance, and
apply them to case examples
Powerpoint
•Case examples
•Rewatch In Treatment clip
Cognitive Behavioral
Therapy and
Dialectical Behavioral
Therapy
To describe CBT
To understand theoretical
basis and uses for CBT and
DBT
•Powerpoint
•Case from Cognitive Therapy
•Video case from CBT: An
Illustrated Learning Guide
Psychodynamic
Psychotherapy
Exposure to psychodynamic
therapy
To appreciate the role of the
unconscious and be able to
define resistance
•Observation of
psychodynamic concepts
within a case example
•Powerpoint
•In Treatment with Sophie
Transference,
Countertransference,
and Mentalizing
Introduce student to a theoretical basis for psychotherapy
Give students practical knowledge of the psychotherapy experience
METHODS: DEVELOPING THERAPY 101
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• Impact:
o Increase the perceived value of therapy among providers
o Better educated physicians who are able to make referrals more competently
o Strengthen medical student interest in psychiatry
Despite evidence in support of psychotherapy as a valuable
treatment modality, most physicians have only learned about
medications as a treatment tool.
GOALS OF CURRICULUM
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METHODS: DEVELOPING THERAPY 101 (cont’d)
Need: No medical student psychotherapy curriculum at Baylor
Resources needed: Time, Audiovisual, Space, Personnel
Activities: Create six modules
Output: Curriculum, Pretest/Posttest, Exit Feedback
Outcomes:
Students will be able to describe different therapies and evidence for
their use.
o Students will be able to apply the concepts of transference and
counter transference in the context of therapy and medical treatment.
o Students will better understand the experience of therapy.
WRITTEN FEEDBACK WAS CATEGORIZED
(A sampling of feedback is given below)
RESULTS
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The six workshops were given once a month over a six month time span.
Students were asked to take an anonymous fifteen question multiple
choice quiz both at the beginning and at the end of the series.
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The graph below shows the quiz results and how students self rated their
knowledge in response the question:
On a scale of 1-10, (1-no knowledge to 10-extremely knowledgeable),
how would you rate your current knowledge about psychotherapy?
Increasing the value of therapy among providers:
• “I would recommend these lectures to other medical students
because they teach you how to think about patients we all contact,
and possible psychological hurdles that could interrupt any doctorpatient relationship.”
Better educated physicians who are able to make referrals well
more competently:
• “I have much more confidence in recommending psychotherapy
and understanding when it is appropriate, and what kind.”
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12
Strengthening interest among those considering psychiatry:
• “They confirmed my interest in psychiatry because I get exposure to
more than just med check appointments.”
10
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8
Rating of
Knowledge
6
# Correct
4
To understand the theoretical
basis and uses for supportive
therapy and IPT
•Powerpoint
•Role playing of case of IPT from
Psychotherapeutic Treatments
•Role playing of case from Intro to
Supportive Psychotherapy
The Therapy
Experience
Overview of course topics
Watch recorded therapy
session
Apply knowledge from the
course to discuss therapy
session
Describe the experience of a
therapeutic session
•Powerpoint
•Recorded therapy session with
course instructor and her therapy
patient
“This series helped to confirm my interest in psychiatry, because my
interests like in communicating with the patient and participating in
the narrative of a patient’s life.”
Suggestions or negative responses:
• “More quiz-like multiple choice questions.”
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Interpersonal and
Supportive Therapies
“I am not going into the field of psychiatry, but this has certainly
allowed me to understand how to refer and recognize the need for
psychotherapy, and I think it will benefit my practice of any
specialty greatly.”
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“I would make the sessions closer together. I forgot some of the
concepts by the time the next session came around.”
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CONCLUSIONS
First Session (N=9)
Last Session (N=8)
“Before, I did not have any idea what psychotherapy
looks like in practice. Now I have a
greater understanding of what to expect,
and how actual psychotherapy works.”
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A short and engaging curriculum can be a powerful exposure
for
students at this level.
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Therapy 101 was very well accepted by student as an
introduction to psychotherapy.
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This course has been integrated into the yearly LACE-MHP at
Baylor College of Medicine.
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The success of this pilot project suggests that all medical
students may benefit from more exposure to psychotherapy.