The medical field finds itself in a new landscape today. Patients do not just want to be diagnosed and prescribed for the illnesses they have. They want to be heard, understood, and engaged with as a human being. And nowhere is this paradigm shift more palpable than in Psychiatry. With this broader theme in mind, I arrived at the IToP conference held at AIIMS Bhopal on the 22nd and 23rd of November. The theme of the conference was “Teaching-Learning Practices in Indian Medical Institutions with Focus on Psychotherapy”.
In The Technique of Psychotherapy, Lewis Wolberg offers a definition of psychotherapy as the treatment, by psychological means, of problems of an emotional nature, in which a trained person deliberately establishes a professional relationship with the patient, with the object of
(1) removing, modifying, or retarding existing symptoms,
(2) mediating disturbed patterns of behaviour, and
(3) promoting positive personality growth and development.
The definition is instructive and brings clarity to an otherwise loosely used term, describing it as a deliberate conversation between two therapeutically aligned individuals. It also becomes apparent that such a skill must be a quintessential one.
The conference circled around the same question – Psychotherapy is an extremely essential skill for medical students, but is it being taught with the rigour it deserves in our medical institutes? All the sessions were informative and engaging. But a few sessions intrigued me, in my personal capacity, more than the others.
In one of the sessions, the BATHE method was discussed as a technique of paramount importance to encourage undergraduate students to learn basic psychotherapy skills. The technique involves five components – Background, Affect, Trouble, Handling, and Empathy, to allow for building up of an easy therapeutic alliance and brief intervention.
Another idea that stayed with me was of Balint groups. Founded by Enid and Michael Balint in the 1960s, the group served as a platform for clinicians to meet and emphasise the importance of doctor-patient relationships. The model has been successfully simulated across the world in various other countries and serves as a structured space where clinicians can reflect on the use of emotion and personal understanding to build successful doctor-patient relationship. Many other vibrant ideas were discussed throughout the two-day academic feast, like the qualities of a good supervisor, psychotherapy in personality disorders, the use of technology in promoting psychotherapy training, and an international perspective on psychotherapy training.
Importantly, a consensus was reached to have 60-100 hours of psychotherapy training for postgraduate students and at least 150 hours of psychotherapy training for DM students. The training should be supervised by a faculty member, and a liaison with a faculty member from another institution can be arranged in institutes lacking a faculty member.
If the conference highlighted anything, it was – psychotherapy is an indispensable skill. It is one of the foundational practices that distinguishes psychiatry from other medical disciplines. It must be given the due diligence it deserves. It is time for all the stakeholders to come together and invest their time and energy in teaching and learning psychotherapy skills.
Warm Regards,
Dr. Priyash Jain
Editor, Minds Newsletter
