Gogledd Cymru-Peer Supervision in Psychotherapy (GC-PSP): What Are Lessons Learned After Two Years?

Abstract

Aims

Core trainees in psychiatry (CT) must attain competencies in at least two psychotherapy modalities before they are allowed to sit for the final Royal College of Psychiatrists’ membership exam. The common training approaches in the United Kingdom include regional training workshops, weekly Balint groups, and access to individual supervision. Some CTs express their wish to have extra opportunities to practice psychotherapeutic skills and discuss cases in order to enrich their experience in learning psychotherapy. Therefore, the peer-led GC-PSP, i.e. Gogledd-Cymru (North Wales) Peer Supervision in Psychotherapy is conceptualised as a quality improvement project (QIP) for North Wales CTs. This article aims to illustrate the lessons learned after two years of GC-PSP.

Methods

A baseline survey was done to identify trainees’ ideas, concerns, and expectations in psychotherapy training and weekly one-hour supervision sessions were set up in May 2021. Sessions were facilitated by a speciality trainee (ST) in psychiatry with experience in psychotherapy. The agenda was determined on the day based on the specific issue or expectation brought up by trainees which could include: clarification of psychotherapeutic concepts and knowledge learned elsewhere, skill training through role-playing, case formulation of clinical encounters, discussions on suitable intervention, and any topics that were relevant to psychotherapy or combination. Subsequent written and verbal feedback was gathered.

Results

A total of 48 sessions had been conducted in two years, with 37.5% covering knowledge teaching, 45.83% skills training, and 39.58% case-based discussions. The top five modalities requested by CTs included: cognitive behavioural therapy (32.35%), psychodynamic therapy (20.59%) acceptance and commitment therapy (17.65%), motivational interview (11.76%), and behavioural activation (8.82%). The overall attendance had been inconsistent, ranging from no attendees and the highest of eight attendees comprising medical students, foundation year trainees, core psychiatry trainees, general practitioner specialist trainees, and specialist registrars.

Conclusion

Although inconsistent attendance results in the repetition of discussions and topics, all trainees feel the extra sessions support their learning in psychotherapy in a safe space as they feel the small group discussion allows more active participation and they are able to learn from others on top of their individual supervision (positive Kirkpatrick level 1 reaction). All trainees wish to have this initiative continued and prefer a semi-structured rather than totally flexible agenda so that they can plan for their attendance, which can be a consideration for future implementation.