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Belinati Loureiro V, Ratzke R, Nogueira Dutra JC, Mesadri Gewehr D, Cantilino A, Pinto da Costa M. Psychotherapy training in Brazil: Experiences of psychiatric trainees and early career psychiatrists. Medicine (Baltimore) 2023; 102:e35388. [PMID: 38115245 PMCID: PMC10727625 DOI: 10.1097/md.0000000000035388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 12/21/2023] Open
Abstract
Understanding and skills in psychotherapy are fundamental aspects of clinical psychiatry practice. Learning about psychotherapy during the training of psychiatrists offers solid opportunities for developing high standards of psychiatric practice and providing better outcomes for patients. However, little is known about the extent that psychotherapy training is available to psychiatrists in America. This study aimed to analyze the status of psychotherapy training in Brazil through the experiences of early-career psychiatrists. This is a cross-sectional survey conducted between July and November 2021. A 16-item questionnaire was used to investigate: the quality of psychotherapy training; the organizational aspects of psychotherapy training; and satisfaction with training in psychotherapy. The majority of participants reported having mandatory training in psychotherapy, mainly in cognitive-behavioral therapy and psychodynamic therapy. However, only had some practical experience with psychotherapy training. This study highlights the frequent use of psychotherapy training among Brazilian early career psychiatrists. The consensus on the necessity of mandatory psychotherapy training underscores its importance in shaping psychiatric practice. While participants express satisfaction with psychotherapy supervision, the financial burden for advanced training raises concerns. These findings advocate for the improvement of the quality of psychotherapy training in Brazil.
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Affiliation(s)
| | | | | | | | | | - Mariana Pinto da Costa
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
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Casanova Dias M, Sönmez Güngör E, Naughton S, Ryland H, Gargot T, Pinto da Costa M, Kanellopoulos A, Baessler F, De Picker L. Psychiatric training in perinatal mental health across Europe. Arch Womens Ment Health 2022; 25:501-506. [PMID: 35238993 PMCID: PMC8921130 DOI: 10.1007/s00737-022-01216-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/17/2022] [Indexed: 11/27/2022]
Abstract
Perinatal mental illness is associated with considerable maternal and infant morbidity and mortality. However, there are currently no specific guidelines on the standards and structure of postgraduate perinatal psychiatric training in Europe. We describe the characteristics of available and desired specialist perinatal psychiatry training from the perspective of European psychiatrists in training. An online survey was conducted among 34 national psychiatric trainee association representatives of the European Federation of Psychiatric Trainees (EFPT). Participants from the countries in which perinatal psychiatry training was available were invited to participate in in-depth follow-up interviews. Six countries out of 34 (18%) reported that specialist training in perinatal mental health was available (Finland, France, Germany, Ireland, Malta, and the UK). The nature of available training varied in duration, the supervision and assessment model employed, and the training scheme context. Of the 28 countries where specialist perinatal psychiatry training was unavailable, the majority of national representatives (22 countries, 76%) wanted specialist perinatal psychiatry training to be included in their national training curricula. There is a gap between the expected skills and the available training for psychiatrists to meet the mental healthcare needs of women in the perinatal period. Given the prevalence and impact of perinatal mental illness and the expressed desires of trainees themselves for specialist training, this finding should prompt urgent action.
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Affiliation(s)
- Marisa Casanova Dias
- MRC Centre for Neuropsychiatric Genetics and Genomics, National Centre for Mental Health, Cardiff University, Cardiff, Wales, UK.
- Section of Women's Mental Health, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK.
| | - Ekin Sönmez Güngör
- University of Health Sciences, Erenköy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Sean Naughton
- Specialist Perinatal Mental Health Service, Rotunda Hospital, Dublin, Ireland
| | - Howard Ryland
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Thomas Gargot
- Child and Adolescent Psychiatry Department, UMR U1253 « Imaging and Brain », iBrain, University Hospital of Tours, Tours, France
| | - Mariana Pinto da Costa
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Athanasios Kanellopoulos
- Center for Adolescent Medicine, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - Franziska Baessler
- Centre for Psychosocial Medicine, Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Heidelberg, Germany
- Heidelberg Academy of Sciences and Humanities, Heidelberg, Germany
| | - Livia De Picker
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium
- University Psychiatric Hospital Campus Duffel, Antwerp, Belgium
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Pereira-Sanchez V, Gürcan A, Gnanavel S, Vieira J, Asztalos M, Rai Y, Erzin G, Fontaine A, Pinto da Costa M, Szczegielniak A. Violence Against Psychiatric Trainees: Findings of a European Survey. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:233-237. [PMID: 34606076 DOI: 10.1007/s40596-021-01539-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/16/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Violence by patients against health care professionals has been widely described. Although psychiatric trainees are particularly exposed, little is known about the extent, context, and impact of violence toward them in Europe. METHODS A cross-sectional online survey was distributed between June 2018 and December 2019 among European psychiatric trainees through professional networks, using a snowball approach. The questionnaire asked about experiences of verbal abuse and physical and sexual assaults, as well as their context and impact. Descriptive analyses of the obtained data were conducted. RESULTS The survey was completed by 827 trainees from 39 countries (68.4% females). Most (83.6%) reported having been abused/assaulted at least once (of these, 92% verbally, 44.1% physically, and 9.3% sexually). Emergency rooms and inpatient units were the most frequent settings. Psychological impact of these events was commonly reported. Most respondents did not report abuses and assaults to their supervisors. They also described a lack of training for staff and aggression management plans at their institutions or of being unaware of their existence. CONCLUSIONS Violence from patients is reported by many psychiatric trainees across countries in Europe, with very frequent verbal abuse and worrisome figures of physical and sexual assaults. Particularly concerning are the low proportion of trainees reporting to authorities, the lack of staff training and management protocols, and trainees' lack of awareness about those resources. Despite the study limitation of a small response rate, these results support a call for urgent efforts to address this problem in Europe, and possibly beyond.
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Affiliation(s)
| | - Ahmet Gürcan
- Başkent University Faculty of Medicine, Ankara, Turkey
| | | | | | | | - Yugesh Rai
- Essex Partnership University NHS Trust, Colchester, UK
| | - Gamze Erzin
- Başkent University Faculty of Medicine, Ankara, Turkey
| | - Audrey Fontaine
- Hôpital Corentin-Celton, Université de Paris, Issy-les-Moulineaux, France
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Gargot T, Kisand H, Miguel A, Tanyeri S, Soron TR, Serene B, Feron G, Žaja N, Valdés-Florido MJ, Soto-Angona Ó, Frankova I. Preventing Post Traumatic Stress Disorder in the general population induced by trauma during the COVID pandemic: A simple brief intervention based on cognitive science that could be delivered digitally. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2021; 5:100193. [PMID: 38620807 PMCID: PMC7833821 DOI: 10.1016/j.ejtd.2020.100193] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/12/2020] [Accepted: 12/27/2020] [Indexed: 11/16/2022]
Abstract
Most of the recent studies indicated the prevalence of Post-Traumatic Stress Symptoms (PTSS) are increasing after the COVID pandemic around the world. Bo et al. reported PTSS prevalence of 96.2% among the COVID-19-infected people. The sociocultural and individual vulnerability and protective factors may influence onset and maintenance of the symptoms. However, there is significant lack in understanding the risk factors and preventive factors that influence the maintenance of Post-Traumatic Stress symptoms that defines Post-Traumatic Stress Disorder (PTSD). The digital technology gives us the unique opportunity to assess this risk, to monitor and track this evolution longitudinally. In this research project we aimed to design and develop a smartphone application for longitudinal data collection enabling to (1) predict and follow the evolution of PTSS toward PTSD, (2) assess the relative efficacy of several methods to prevent the evolution of PTSS right after exposure to trauma (1-24 h), (3) educate people about psychological effects that can occur during and after trauma, normalize acute distress and refer to professional help if a disorder is constituted. We hope that this research project will help to understand how to maximize the self help support during the acute phase (golden hours) after trauma to prevent the transition from PTSS to PTSD. A video abstract can be found on https://www.youtube.com/watch?v=RZJehj3J8go&feature=emb_title.
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Affiliation(s)
- Thomas Gargot
- Child and Adolescent Psychiatry, Excellence Center in Autism and neurodevelopmental disorders - Tours ExAC-T, CHRU Tours
- ISIR, Sorbonne Université, CHART Laboratory-EA 4004, Paris, France
- THIM, Paris 8 University, Saint Denis, France
| | - Helena Kisand
- University of Tatru, Estonia. EFPT Psychotherapy Working Group
| | - Ana Miguel
- Centro Hospitalar Vila Nova de Gaia/Espinho, Portugal
| | - Selin Tanyeri
- Ege University, School of Medicine, Psychiatry Department, Turkey
| | | | | | | | - Nikola Žaja
- University Psychiatric Hospital Vrapče, University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Óscar Soto-Angona
- Department of Psychiatry, Vall d'Hebron University Hospital, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Catalonia, Spain
| | - Iryna Frankova
- Bogomolets National Medical University, Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Kyiv, Ukraine
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Baessler F, Zafar A, Gargot T, da Costa MP, Biskup EM, De Picker L, Koelkebeck K, Riese F, Ryland H, Kazakova O, Birkle S, Kanellopoulos T, Grassl R, Braicu A, Schultz JH, Casanova Dias M. Psychiatry training in 42 European countries: A comparative analysis. Eur Neuropsychopharmacol 2021; 46:68-82. [PMID: 33678470 DOI: 10.1016/j.euroneuro.2021.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/15/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
Psychiatry qualifications are automatically recognized among European Union (EU) countries despite differences in national training programs. A widening gap between the number of psychiatrists, their competencies and the growing burden of mental illnesses in Europe has renewed calls for international standardization of training. Comprehensive information about training programs is missing, which limits thorough comparisons and undermines development of an actionable strategy to improve and harmonize psychiatry training. This study describes and compares the existing postgraduate psychiatry programs in 42 countries in the European region. Representatives of national psychiatry associations completed a semi-structured, 58-item questionnaire. Training structure and working conditions of each country were compared with population needs calculated by the World Health Organization to determine the European mean and contrasted among pre-2004 and post-2004 EU members and countries with unrecognized qualifications. Differences were tested with nonparametric (Wilcoxon) and parametric (Anova) tests. Median training duration was 60 months, significantly shorter in countries with unrecognized qualifications (48 months, χ²16.5, p < 0.001). In 80% of the countries, placement in a non-psychiatric specialty such as neurology or internal medicine was mandatory. Only 17 countries (40%) stipulated a one-month rotation in substance abuse and 11 (26%) in old-age psychiatry. The overall deficit of training versus population need was 22% for substance abuse and 15% for old-age psychiatry. Salaries were significantly higher in pre-2004 EU members (χ²22.9, p < 0.001) with the highest in Switzerland (€5,000). Significant variations in curricula, training structure and salaries exist in Europe. Harmonization of training standards could offer significant benefits for improving mental healthcare.
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Affiliation(s)
- Franziska Baessler
- Center for Psychosocial Medicine, Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Ali Zafar
- Center for Psychosocial Medicine, Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Thomas Gargot
- Psychiatrie de l'Enfant et de l'Adolescent, Pitié Salpêtriére - Charles Foix, Assistance Publique Hôpitaux de Paris, 47/83 boulevard de l'Hôpital, 75013, Paris, France; ISIR, Sorbonne Université, 4 Place Jussieu, 75005, Paris, France; CHART Laboratory - EA 4004, TIM, Paris 8 University, 93526, Saint Denis, France
| | - Mariana Pinto da Costa
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal; Hospital de Magalhães Lemos, Porto, Portugal
| | - Ewelina Maria Biskup
- Shanghai University of Medicine and Health Sciences Basic Medical College, Shanghai, China; Division of Internal Medicine, University of Basel, Basel, Switzerland
| | - Livia De Picker
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium; University Psychiatric Department Campus Duffel, Duffel, Belgium
| | - Katja Koelkebeck
- LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Florian Riese
- University Hospital of Psychiatry Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Howard Ryland
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Olga Kazakova
- Psychiatric Department, Psychiatric Clinic of Minsk City, Minsk, Belarus
| | - Sarah Birkle
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany
| | - Thanos Kanellopoulos
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children`s Hospital, Athens, Greece
| | - Roland Grassl
- University Clinic for Child and Adolescent Psychiatry and Psychotherapy, Vienna, Austria
| | - Alina Braicu
- National Centre for Mental Health, BSMHFT, Birmingham, UK
| | - Jobst-Hendrik Schultz
- Center for Psychosocial Medicine, Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Marisa Casanova Dias
- Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK; Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK
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Rai Y, Karki U, Pinto da Costa M. Psychotherapy training in Nepal: views of early career psychiatrists. BJPsych Int 2020; 18:E6. [PMID: 34287413 PMCID: PMC8274429 DOI: 10.1192/bji.2020.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/24/2020] [Accepted: 08/05/2020] [Indexed: 11/29/2022] Open
Abstract
Although training in psychotherapy is an integral part of psychiatry training, standards in psychotherapy training have wide variation across and within countries. Post-graduate psychiatry training has been conducted in Nepal for over two decades, but little is known about its psychotherapy training provisions. An online survey was conducted with early career psychiatrists in Nepal. The findings show that the majority recognised psychotherapy training as important and were eager to pursue further training. However, two-thirds had no access to psychotherapy training opportunities. These results highlight the need to improve access to training in different psychotherapy modalities in Nepal.
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Affiliation(s)
- Yugesh Rai
- MD, Psychiatry Trainee, Essex Partnership University NHS Trust, UK.
| | - Utkarsh Karki
- MD, DM, Consultant Child and Adolescent Psychiatrist, Child and Adolescent Psychiatry Unit, Kanti Children's Hospital, Kathmandu, Nepal
| | - Mariana Pinto da Costa
- MD, Consultant Psychiatrist, Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, East London NHS Foundation Trust, UK
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Gargot T, Arnaoutoglou NA, Costa T, Sidorova O, Liu-Thwaites N, Moorey S, Hanon C. Can we really teach cognitive behavioral therapy with a massive open online course? Eur Psychiatry 2020; 63:e38. [PMID: 32151289 PMCID: PMC7358632 DOI: 10.1192/j.eurpsy.2020.29] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A better training in psychotherapy is needed for psychiatry trainees. Online Cognitive Behavioural Therapies (CBT) could be a good solution. Free and wide audience course like Massive Open Online course (MOOCs) increase dissemination and accessibility of the training. However, the engagement needs to be improved. A hybrid approach seems relevant with the MOOC as an incentive. Beyond the promotion of the topic, a MOOC can be a promotion tool for the provider. The economic model of the MOOC needed to be taken into account to allow sustainability. To explore these elements, we take into account a survey taken during the 1st European Psychiatric Association MOOC about CBT.
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Affiliation(s)
- Thomas Gargot
- CHART Laboratory-EA 4004, THIM, Paris 8 University, Paris Lumière University, Saint Denis, France.,Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Universitaires, Pitié Salpêtrière-Charles Foix, Paris, France.,ISIR, Sorbonne Université, Paris, France.,European Federation of Psychiatric Trainees Psychotherapy Working Group, Bruxelles, Belgium.,European Psychiatric Association Psychotherapy Section, Strasbourg, France
| | - Nikitas A Arnaoutoglou
- European Federation of Psychiatric Trainees Psychotherapy Working Group, Bruxelles, Belgium.,European Psychiatric Association Psychotherapy Section, Strasbourg, France.,Windsor Research Unit, Cambridgeshire, Peterborough NHS FT, Cambridge, United Kingdom.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Memory and Cognitive Functions Clinic, 1st Department of Psychiatry, "Papageorgiou" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Tiago Costa
- Cumbria, Northumberland, Tyne and Wear, NHS Foundation Trust, Northumberland, United Kingdom.,Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Olga Sidorova
- European Federation of Psychiatric Trainees Psychotherapy Working Group, Bruxelles, Belgium.,European Psychiatric Association Psychotherapy Section, Strasbourg, France.,Riga East University Hospital, Riga, Latvia
| | | | - Stirling Moorey
- South London and Maudsley NHS Trust, Beckenham, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Cécile Hanon
- Regional Resource Center of Old Age Psychiatry West-Paris University Hospital, Corentin Celton Hospital, APHP, Paris-Descartes University, Paris, France
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