Implementing a Mind-Body Skills Group in Psychiatric Residency Training

Objective The burnout crisis in healthcare has led to interventions promoting resiliency and wellness among residents. One such intervention is a 10-week Mind-Body Skills Group including didactics and experiential exercises, self-expression, and small-group support. A Mind-Body Skills Group for residents and fellows in the University of Arizona-Tucson Department of Psychiatry aimed to teach skills for self-care and patient care. Methods In 2018–2020, 50 University of Arizona-Tucson psychiatric residents and fellows participated in Mind-Body Skills Groups. After finishing the course, 44 participants completed a survey about satisfaction with the course and its content, comfort sharing experiences with the group, use of mind-body skills for participants’ own self-care and wellness, use of these skills with patients, and likelihood of recommending the Mind-Body Skills Group to colleagues. Results Eighty-four percent of survey respondents were satisfied or very satisfied with the Mind-Body Skills Group. Eighty percent used skills learned in the course for their own self-care and 61% used the skills with patients on at least a weekly basis. Eighty-nine percent indicated they were likely or very likely to use mind-body skills with patients in the future. Ninety-five percent of respondents felt safe sharing personal feelings and experiences in the group, and 95% would strongly recommend or likely recommend the course to colleagues. Results for in-person and online groups were not significantly different. Conclusions A 10-week Mind-Body Skills Group during psychiatric residency was well received by participants. The course influenced personal health behaviors, which may bolster resiliency and reduce risk for burnout.

Unnecessarily prolonged suffering: a case of missed diagnosis of post-traumatic stress disorder in a teaching hospital

ABSTRACT We described a case in which a heavily-traumatized patient had been under psychiatric treatment for seven years (five of them in a university mental health clinic) but was never diagnosed with PTSD and, therefore, did not receive the proper treatment for a very long period. After the correct diagnosis was made and personalized treatment instituted, the patient has shown marked improvement in functionality and wellbeing. The key element in this case, was the adequacy of psychiatric training. Our report suggests that psychiatrists are not being adequately trained to identify traumatic events and to diagnose atypical cases of PTSD. With that in mind, we emphasize that theoretical modules on trauma and trauma-related disorders and practical training in specialized PTSD clinics should be incorporated into the psychiatric residency training programs wherever they may be missing, particularly in countries most impacted by violence. Furthermore, continuing medical education on trauma and PTSD should be provided by medical associations and journals to keep physicians updated on recent progress in the field.

Training in Neurology: Feedback from graduates about the psychiatry component of residency training

Objective:To obtain feedback from early career adult and child neurologists about the psychiatry component of residency training.Methods:A survey was developed and administered electronically to four cohorts of recently certified American Board of Psychiatry and Neurology diplomates.Results:The response rate was 16% (431/2,677) and included 330 adult neurologists and 101 child neurologists. Less than half of the respondents described themselves as extremely or quite satisfied with their psychiatry training while 26% of the adult neurologists and 33% of the child neurologists felt slightly or not at all prepared for this component of practice. Four themes were identified in the respondents’ suggestions for improving psychiatry training: provide more outpatient experience; provide more time/teaching in psychiatry; provide more experience with both pharmacological and non-pharmacological psychiatric treatments; and provide more exposure to patients with conditions likely to be encountered in neurology/child neurology practice.Conclusion:These recent graduates of adult and child neurology residency programs felt under prepared for the psychiatric issues they encountered in their patients. They suggested a number of strategies for better alignment of psychiatry training with the likely demands of practice, and a model curriculum recently developed by the American Academy of Neurology’s Consortium of Neurology Program Directors and the American Association of Directors of Psychiatric Residency Training also provides guidance for both neurology and psychiatry program directors.

Future Directions

In this book, the authors have focused on three challenges to the human aspect of work—technology, globalization, and litigation—and have provided tools for managing the types of challenges these forces present. The workplace is an ever-changing scene, and we can only hypothesize how the relationships among globalization, litigation, and technology may change in the future. Nonetheless, maintaining emotional health in work and workplace relationships will remain ever-important for the success of employees, managers, employers, and the company as a whole. Increasing challenges to the integrity of culture and relationships in the workplace demand greater involvement from mental health professionals. Because of the substantial potential benefit both to the 21st-century business world and the field of psychiatry, the development of formal training in workplace issues, including courses, mentorship, and fellowships, would present an important opportunity for future psychiatric residency training.