Teaching psychodynamic formulation to psychiatric trainees Part 2: Teaching methods

Many changes are occurring in the practice of medicine for the 21st century, one of the more positive being the emphasis on treating patients in a holistic way and involving them in their treatment 1� 2� 3� 4� planning. Most doctors agree with this aim, but in practice it can be a daunting prospect, adding a new dimension to the skills required of a practitioner. At its root is the need to be able to understand patients’ reactions to their circumstances. Although a consultation with a doctor may seem commonplace to us, for a patient it is often associated with fear, pain and anxiety. Little wonder, then, that they do not always respond in what we consider a ‘rational’ way. Most modern medical school curricula place emphasis on seeing the patient as a whole person existing in their own social and psychological environment rather than as a specimen under a microscope. This is a widely accepted educational philosophy (e.g. General Medical Council, 2003), but not always evident in practice. Beyond familiar­ isation with mental disorders, psychiatric education has a lot to offer in encouraging students to consider psychological aspects of their patients’ problems. Knowledge of the basic level of psychodynamic formulation can be extremely helpful in recognising the personal in medicine. Within clinical psychiatry, the needs of people referred to consultant teams are rarely simple. If a diagnosis of depressive illness and the judicious use of support and medication were enough, then, given the sophistication of most primary care services, this Teaching psychodynamic formulation to psychiatric trainees Part 2: Teaching methods