Project IMPART Description

The Harvard South Shore Psychiatry Residency Training Program is dedicated to training psychiatrists in state of the art evidence based psychotherapies. Psychotherapy training is delivered through a developmentally-based learning model that spans the four years of the residency program. Didactic courses include an introduction to psychotherapy and alliance building, training in evidence-based psychotherapy, and a course on advanced psychotherapy topics. Psychotherapy supervision is provided through the various clinical experiences.

IMPART focuses on training residents in modern psychotherapies with a proven evidence base, using state-of-the-art guidance in the form of explicit, published manuals. Project IMPART is recognized by the Accreditation Council for Graduate Medical Education (ACGME) as a Notable Practice and is currently the only recognized Notable Practice in Graduate Psychiatry Education.

What is “Manual-Guided Psychotherapy?”

Manual-guided psychotherapy is the current state-of-the-art in providing psychotherapy to individuals with a variety of conditions and mental health challenges. A wide variety of types of psychotherapies are supported by explicit manuals, including cognitive therapy, behavioral therapy, several family therapies, psychoeducation, supportive psychotherapy, interpersonal psychotherapy, and various types of psychodynamic therapies including both short- and long-term treatments.

Which Psychotherapies are the Focus of Project IMPART?

The main psychotherapies addressed in Project IMPART are:

Supportive Psychotherapy

The fundamental skills necessary for enhancing illness management skills and dealing with life stresses.

Psychodynamic Psychotherapy

Modern, practical, manual-guided versions of the therapeutic approaches first developed by Freud and subsequent psychoanalysts.

Cognitive-Behavioral Psychotherapy (CBT)

The combination of both cognitive and behavioral techniques to address mood, anxiety, and personality disorders with application to other serious mental illnesses as well.

Cognitive Processing Therapy (CPT)

A cognitive-behavioral therapy focused on trauma and recovery.

Motivational Interviewing (MI)

Initially developed for substance dependence, techniques and approach that specifically address ambivalence and enhance motivation for change for a wide variety of conditions, enhancing adherence to treatment.

How Does Manual-Guided Psychotherapy Supervision Work?

Supervision is an integral part of training in manual-based psychotherapies, as it is in all clinical skills (the old medical dictum of “See one, do one, teach one” doesn’t typically work in psychotherapy training!). Supportive psychotherapy training and supervision is incorporated into weekly sessions in Continuity Clinic for PGY-IIs, and into weekly clinic meetings in the General Mental Health Clinic for PGY-IIIs.

Psychodynamic psychotherapy, CBT, CPT, and MI are the focus of weekly seminars and supervision sessions in PGY-III, with three hours of the Wednesday seminar day dedicated to these modalities. The basic approach that is taken is to first understand the basic psychological and behavioral principles that underlie the therapy, then to develop the basic technical and attitudinal skills, and subsequently to utilize and improve these skills with patients, under supervision of expert clinicians:

Basic Principles -> Technical and Attitudinal Skills -> Ongoing Case-Based Supervision

Residents initiate treatment with a small number of intensively treated outpatients in PGY-III, receiving weekly supervision in these Project IMPART psychotherapies as part of the Wednesday seminar schedule. Residents are encouraged to video/audiotape sessions for review in supervision. They have the option to continue treatment and supervision into the PGY-IV year as well.

The training experience is enhanced by related activities as well. For instance, case conferences during Grand Rounds provide an opportunity for residents to present a case to a visiting psychotherapist. Many residents also take advantage of programs at the Boston Psychoanalytic Institute.

Fundamentals of additional psychotherapies, including group and couples work, are also provided in the course of required rotations, case conferences, and seminars. These can be augmented with PGY-IV electives as well.