Child & Adolescent Psychiatry Residency

Child & Adolescent Psychiatry Residency Psychodynamic Psychotherapy Training

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Psychodynamic Psychotherapy Training in the Program

The MGH/McLean Program in Child and Adolescent Psychiatry has a long standing and proud commitment to making certain that our graduates are comfortable with and take great joy in practicing psychodynamic psychotherapy with ou patients. We very much believe that understanding and indeed being part of the internal life of the child is core to any therapeutic endeavor in child and adolescent psychiatry.

To this end, psychodynamic therapy informs not only a primary treatment modality with which nmany of our patients are treated, but also provides the fundamental core developmental principles with which we approach all of our patients and their families.

Moreover, a psychodynamic formulation of all child cases is critical to the provision of treatment on all of our services and, indeed, in other therapeutic modalities. We know, for example, from the evidence-based literature, that dynamically informed cognitive-behavioral therapists are more effective than those without such training. Psychodynamic theory and practice are immeasurably helpful on our Consultation Service to Pediatrics, in the Acute Psychiatric Service (the Emergency Department), on inpatient and adolescent residential services, and in the community. Thus we hope to provide a sound foundation in psychodynamic principles and practice. Our program acknowledges that psychotherapy must be tailored to the needs of the patient. In many cases psychodynamic technique is combined with other modalities, such as psychopharmacology, cognitive-behavioral therapy, family therapy, group therapy, and other treatments.

In the first year, every resident has at least two M.D. supervisors who are well known for their interest and practice of psychodynamically-based therapy. In addition, there are two core seminars that compliment these supervisory relationships in helping first year trainees to grasp the differences between adult psychodynamic treatments and caring for children. A general course in the basics of psychotherapy is taught by Suzanne Bender, MD. She and the late Ed Messner, MD, wrote a very influential guide to becoming a therapist (“Becoming a Therapist: What Do I Say and Why, 2003”), and this work is the cornerstone of her highly regarded seminar. Residents also participate in a Case Conference Seminar taught by Drs. Laura Prager and Martin Miller. Dr. Miller is a senior training child analyst at the Psycholanalytic Institute of Boston.

In the second year, residents select their own supervisors, approved by the training committee. We encourage them t have at least one or more experts in psychodynamic psychotherapy. In addition, they continue their didactic experiences by participating in Advanced Child Development Seminar which includes supervised reading of major theorists of psychodynamic therapy (Winnicott, Freud, Anna Freud, Melanie Klein) with Dr. Beresin and Dr. Skip Onesti. Dr. Onesti is also a senior child psychoanalyst. Dr. Beresin leads a seminar on the Integration of Theory and Practice that is largely based on the synthesis of psychodynamic principles in ongoing clinical cases. This seminar also involves classic psychodynamic readings. In addition, there is a required case observation seminar directed by two senior child psychiatrists and psychoanalysts, Drs. Steven Ablon and Bayard Clarkson. This seminar allows residents to watch in vivo a play therapy case conducted by one of their peers and then to discuss the case immediately after the session.

Psychodynamic Therapy, from play therapy with young children to exploratory psychodynamic psychotherapy with older children and adolescents are key aspects of caring for young people and families in the psychiatric setting. MGH and McLean are committed to preserving these aspects of treatment for all of our trainees and throughout the hospital.