Apprenticeship Model of Psychotherapy Training and Supervision: Utilizing Six Tools of Experiential Learning (original) (raw)

2015, Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry

Apprenticeship experiences have existed for centuries as ways to gradually introduce individuals to professional trades, skills, and roles. Cobblers, blacksmiths, attorneys, artists, healers, and surgeons have all learned as apprentices. Traditional apprenticeships focus on specific methods for carrying out physical skills instrumental to accomplishing meaningful practical tasks (e.g., building a house). Apprenticeship learning occurs through a combination of observing, coaching, and practice. The cognitive apprenticeship model, initially described by Collins [1] and elaborated by Stalmeijer et al. [2, 3], shares the traditional apprenticeship's focus on learning complex tasks from experts, but further emphasizes cognitive skills of the teachers and learners, not as readily observable [1, 2]. Cognitive psychotherapy skills refer to clinical reasoning, the development of a differential diagnosis, and case formulation. Cognitive skills also include the ability to use emotions, behaviors, precise therapeutic language, and the strategies, tactics, and interventions needed to conduct psychotherapy. Developing psychotherapeutic cognitive skills requires that both supervisor and resident externalize or think out loud, sharing their thoughts, emotional process, and the rationales for their therapeutic choices. The problems and tasks that supervisors address are chosen to illustrate the effectiveness of a psychotherapeutic task, discuss mistakes, or demonstrate psychotherapeutic interventions so that psychiatric residents can practice and improve their reflective psychological and emotion-focused skills.