The Relationship between Psychiatrists' Couple and Family Therapy Training Experience and Their Subsequent Practice Profile

By Guttman, Herta A.; Feldman, Ronald B. et al. | Journal of Marital and Family Therapy, January 1999 | Go to article overview

The Relationship between Psychiatrists' Couple and Family Therapy Training Experience and Their Subsequent Practice Profile


Guttman, Herta A., Feldman, Ronald B., Engelsmann, Frank, Spector, Liliane, Buonvino, Michael, Journal of Marital and Family Therapy


A 28-item questionnaire was returned by 291 psychiatrists who had completed training between 1962 and 1992. There were positive correlations between the amount of couple and family therapy training (CF) they received and the following: the extent to which graduate psychiatrists practice CFT; their involvement as supervisors, teachers, teaching program directors or researchers; the extent to which they seek continuing education in CFT; their positive attitude toward CFT and the extent to which they feel that their attitude to and interest in CFT has had a positive effect on the milieu in which they practice and on their personal lives.

Although the concepts of systems theory espoused in family therapy have become more widely valued and recognized within psychiatry (Marmor, 1983), there are concerns that family therapy itself is becoming marginalized as a treatment modality (Shields, Wynne, McDaniel, & Gawinski, 1994). Rodenhauser (1992) reports that although supervision in couple and family therapy is generally provided in child and adolescent psychiatry training and in the third-year outpatient adult psychiatry residency rotation, the amount of training varies in different centers.

With the ascendance of biological psychiatry, the place of all psychotherapy training in psychiatric residency teaching has been questioned (Feigelson & Friedman, 1984; Yager, Langsley, Peele, McKegney, & Fink, 1987), and there is the risk that it will become increasingly perfunctory in the future (Simons, 1987; Tucker, 1987). It is important to ascertain whether practicing psychiatrists consider their training in psychotherapy in general to have been useful and relevant, and it is particularly important to substantiate the idea that couple and family therapy training (CFTI) enhances clinicians' effectiveness (Kniskern & Gurman, 1988).

Carter has systematically evaluated the effects of family therapy training on residents' attitudes toward seminars on couple and family therapy (CFT) and on the relationship between residency training and the subsequent practice of CFT (Carter, 1986, 1989, 1990). He first developed a 27-item questionnaire that was answered by 20 psychiatrists and 10 residents (77% response rate) in one residency program. He found that most of the respondents practiced and/or referred cases for CFT, and that their training seemed to have influenced their preference for individual treatment or CFT. In 1989, Carter used a 37-item questionnaire to compare 24 different residency programs. The extent of cooperation was poor: Only five programs responded, and of those, only two offered CFTT. Because all 87 respondents claimed to have received at least some training, he divided them into a high-exposure and a low-exposure group. The amount of couple therapy that was subsequently practiced was significantly proportional to the amount of training received. Carter (1990) concluded that CFIT had long-lasting effects on subsequent practice, but it was not entirely clear that more exposure as opposed to any exposure was responsible for the difference. Moreover, in the second study there was a low response rate of 30% from psychiatrists and 25% from residents.

Schmidt and Bonjean (1995) described the impact of a family therapy training program for residents. In their study of second-year residents, they demonstrated that therapeutic skills significantly improved after completion of a 10-month family therapy training program.

Slovik, Griffith, Forsythe, and Polles (1997) interviewed graduates of two residency training programs in child and adolescent psychiatry, obtaining a response rate of 31/38 (81.6%) for one program and 21/21 (100%) for the other. They conducted comparable, semistructured face-to-face or telephone interviews with each respondent and provide some quantified data. Their overall conclusion was that "graduates from both programs were utilizing family therapy theory and skills . …

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