An Open Letter To Training Directors

Helping psychotherapy trainees get more from hours spent

Despite student's interest in psychotherapy, training directors struggle with shortages of money, inspirational faculty, and teaching hours. The following paragraphs describe a recently launched online program aimed at providing a catalyst to accelerate and improve the quality of learning gained through existing hours of training, supervision, and experience in diverse orientations and modalities.

Basic science improves therapeutics

Rapid progress is being made overall in medical therapeutics as a result of detailed understanding of physiology. Biological psychiatry has sought the same breakthroughs, but has lagged behind. Surprisingly, in the field of psychotherapy, the once-mysterious infrastructure of how people change has become increasingly clear. Three well researched change mechanisms can now explain the action of existing psychotherapies. In doing so, they not only validate seemingly incompatible theories and techniques, but offer an avenue for further refinement of technique.

Efficient online psychotherapy training

The present program is aimed at giving the trainee a highly accessible, coherent, and clinically useful framework with which to navigate the therapeutic space. Within this framework, existing concepts and techniques become more accessible and immediately understandable. The trainee no longer has to apply a formula blindly and wait for results. Instead, universal processes can be observed and followed as they unfold, enhancing confidence and satisfaction in the work.

The ten-class, self-paced, online program grew out of teaching in the residency at New York Medical College. A class handout grew in parallel with the evolution of my own practice towards a focus on change processes, as opposed to teaching set methods. Eventually, it became a textbook of psychotherapy, unusual in that it supports all therapeutic orientations without favoring any one (Psychotherapy: A Practical Guide, Springer, 2017). In 2023, the author and a core group of trainers and trainees piloted a new, compact course based on interactive online sessions. These highly successful classes were recorded and have become the core of the present program.

The ten sessions, accompanied by a workbook and three months free membership in an ongoing psychotherapy coaching community afford learners opportunities to practice skills and a safe place to ask questions and clarify issues. The course is organized around four milestones, each with clearly defined criteria for success.

•   Mastering the Healing Moment

Starting with a universal definition of the maladaptive patterns psychotherapy aims to treat, the first three sessions explain in depth how change is achieved through memory reconsolidation and what clinical conditions fulfill neurophysiological requirements for change.

•   Mastering the Big Picture

The three sessions in this module fill out the framework of origins of pathology and paths to healing and growth. Two additional change processes, new learning (long term potentiation) and extinction are added, along with  how individual patterns relate to biology and broader dimensions such as attachment, family, and culture.

•   Managing the Relationship

Two sessions focus on establishing the relationship and dealing with problems that arise, while weaving in nonspecific factors, including safety, motivation, and arousal regulation.

•  Applying the Rosetta Stone with Existing Therapies

The final two classes help learners make use of the framework they have acquired to support and clarify theory and techniques from multiple therapies including cognitive-behavioral therapy, experiential, third wave therapies, and psychodynamically-based approaches.

Current students, ranging from trainees to advanced practitioners are laudatory.  “I'm actually sorry when we reach the end of each session because each session has been so powerfully revealing. But, there is great anticipation about what is next,” Valdemar Schmidt MD. “I found this psychotherapy course to be incredibly helpful. Dr. Smith’s focus on understanding the Common Infrastructure of psychotherapy provided a better understanding of the therapeutic process and made it clearer.” Fauzia Arain, MD

Jeffery Smith MD

[email protected]

For further information, see the "courses" menu item above or email Dr. Smith directly.

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