APA Adds Video Option To Online CME

Continuing medical education (CME) is moving out of the classroom and the symposium hall and into cyberspace.

And APA is moving with it, presenting its first online video CME course created specifically for Internet learning and taught by one of psychiatry's most prominent teachers and clinicians.

A three-part course titled “Principles of Psychodynamic Psychotherapy” taught by Glen O. Gabbard, M.D., will debut this month on the Internet, with a link to the site through APA's Web site. The course will provide up to two hours of CME credit.

The cost to view the program is $35 for APA members and $70 for nonmembers. However, psychiatry residents and fellows may access the lecture free. A code for logging into the lecture will be provided to residency programs across the country.

The course focuses on general principles of psychodynamic psychotherapy, transference, and countertransference. Each segment can be viewed in approximately 20 minutes. In addition to a discussion of psychotherapeutic concepts by Gabbard, the video also features vignettes drawn from real clinical experiences and portrayed by actors.

The segment on countertransference, for instance, shows a therapist who is stymied by a patient's hostility and resistance, and frustrated by the negative feelings she feels in response. Later, the therapist is depicted talking with her supervisor, who helps her to see the ways in which the patient has unconsciously elicited those negative feelings in an effort to recreate a past family situation.

Afterward, Gabbard comments on the entire interaction—patient with therapist, therapist with supervisor—to explain how an emphasis on countertransference is a reflection of the fact that, as he puts it,“ there are two persons in the consulting room, each bringing his or her respective histories and internal object worlds into the therapy process.”

Gabbard is the Brown Foundation Chair of Psychoanalysis and a professor of psychiatry at Baylor College of Medicine in Houston. He is also director of the Baylor Psychiatry Clinic and training and supervising analyst at the Houston-Galveston Psychoanalytic Institute.

Deborah Hales, M.D., director of APA's Division of Education and Career Development, told Psychiatric News that she believes video technology is remarkable for elucidating unconscious processes at work in a therapeutic setting.

“Teaching about these concepts can be really difficult because you need other eyes and ears to catch things that are going by in a heartbeat,” she said. “That's why film and video are particularly well suited for teaching about nonverbal and unconscious communication. The acting is superb, and I am deeply impressed with the content of the lecture.”

An online video of the 2001 annual meeting lecture by Eric Kandel, M.D., is also available at APA's Web site, and some annual meeting symposia have been“ repurposed” as online video CME material. But the new product is the first specifically created for Internet learning, Hales pointed out.

She added that Gabbard, one of the most prominent and knowledgeable speakers about psychoanalysis and psychodynamic psychotherapy, brings something of a “star quality” to the effort. She predicts that this will not be the last such effort and looks forward to the day when APA has an online video archive of similar CME courses.

Gabbard emphasized the value of the video to residents and residency training directors. He added that learning through online and video technology comes naturally to younger people now entering psychiatry.

“Residents today have been brought up in a generation in which they are accustomed to learning from sources on the Web and from video,” he said. “Moreover, I think psychotherapy is best learned by watching actual sessions, rather than by just reading about psychotherapy.”

Gabbard collaborated on the video with fellow psychiatrist Lucy Puryear, M.D., also of Baylor College of Medicine. “We sat down and discussed common situations that residents encounter,” he said. “We outlined the basic principles that they need to know when beginning dynamic psychotherapy.

“One video is based on what a psychodynamic psychotherapist says and how you think about optimal interventions to make,” said Gabbard.“ The videos on transference and countertransference focus on how to recognize them and use them as therapeutic tools. In writing the video, we combined didactic material with clinical vignettes that illustrate the principles or techniques being discussed. We used actors so that we did not have to worry about breaching confidentiality, but the material is drawn from actual therapy sessions.”

“Principles of Psychodynamic Psychotherapy” can be accessed online at<www.psych.org/cme/apacme/>.▪