From Training to Practice: The Influence of Education and Training on Attitudes Towards Psychotherapy Among Psychiatry Residents and Early-Career Psychiatrists

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OBJECTIVE: Despite guideline recommendations and growing evidence for psychotherapies across mental disorders, in recent years, an underutilization of psychotherapy was observed in the field of psychiatry. The authors conducted a nationwide survey investigating how education and training shape attitudes toward psychotherapy among Italian psychiatry residents and early-career psychiatrists. METHODS: An anonymous online questionnaire (April-September 2023) investigated sociodemographics, psychotherapy training (psychiatric residency and private schools), supervision and personal therapy, self-assessed competencies, disorder-specific effectiveness beliefs, and etiopathogenetic views. Mixed-effects and cumulative link models evaluated correlates of perceived effectiveness and propensity to provide psychotherapy. RESULTS: The sample included 453 participants (56.3% female; median age 31), representing 22% of Italian psychiatry residents; 45.5% reported only theoretical training, over one-third lacked supervision, and satisfaction with residency psychotherapy training was modest. Private training was common (39.3%), while two-thirds had undertaken personal therapy. Psychotherapy was considered highly effective for anxiety, eating, and personality disorders, and for most diagnoses when combined with medication. In mixed models, stronger beliefs in traumatic or stress-related etiologies were associated with greater perceived psychotherapy effectiveness, whereas bio-environmental attributions correlated with lower perceived effectiveness. Younger age and later training stage were also associated with higher perceived effectiveness. Finally, inclination towards psychotherapy was linked to the number of patients treated during residency and overall training satisfaction. CONCLUSIONS: Findings highlighted the importance of education and training in psychotherapy during residency, as these factors significantly influence the propensity of young psychiatrists to utilize psychotherapy. Structured, supervised, evidence-based psychotherapy curricula are needed to promote integrated psychiatric practice.

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