John Libbey Eurotext




Psychiatrists and psychotherapists? Perceptions and practices of psychiatric residents
l'Information Psychiatrique. Volume 88, Number 4, 305-13, Avril 2012, Question en formation
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Author(s) : Aude Van Effenterre, Marion Azoulay, Xavier Briffault, Françoise Champion
Summary : This article presents the main results and interpretations within the framework of analysis of the sociology of professions, a qualitative survey by semi-structured interviews conducted with psychiatric residents on their perceptions and practices of psychotherapy and the place that is given in psychiatry. The practice of psychotherapy, since its extensive definition, without being limited to structured psychotherapies, is linked to the identity of (future) psychiatrists while taking into consideration the commitments of varying degrees of intensity. Psychotherapeutic orientation of residents is diverse with a range of methods being advocated. This is considered not only a source of wealth and good practice of psychiatry but also because the residents consider it essential to their training. Psychoanalysis is no longer in a hegemonic position and the demand by residents for genuine psychotherapy training within a psychiatric curriculum appears along with a parallel movement showing the end of intellectual jurisdiction of psychoanalysis over psychotherapy and willingness to replace it with basic psychiatry. Residents do not want to abandon the practice of effective psychotherapy (Law court practice) for the benefit of only a few psychologists – their refusal to be only “prescribers of psychotherapy” creates a dilemma – because history is made of “unintended effects” by the actors, which is limiting the psychotherapy market in favour of psychiatrists. Medical residents want to become doctors in psychiatry and are recognized as such, but generally feel poorly accepted by their fellow doctors and residents in somatic medicine. The medicalization of psychotherapy is likely not only to transform the perspective of physicians towards psychotherapy in a positive sense, but it also demands that the residents acquire a solid competence in psychotherapy and receive real training, of a high practical and theoretical level in this field. This would only be a possibility offered to residents and not an obligation, while at the same time being careful to avoid the risk of a division between “psychiatrists-psychiatrists” and “ psychiatrists-psychotherapists”. The plan to introduce psychotherapy training in psychiatry for residents involves issues that go beyond the mere desire to respond to the lack of competence of psychiatrists. It is without question necessary to anticipate the possible “unintended consequences” of such a project, but it should be done without any delay, provided its implementation is not a hindrance.
Keywords : psychiatrist, hospital resident, psychotherapy, psychotherapist, professional training, practice analysis, sociology, profession, investigation, professional counselling

Psychiatrists and psychotherapists? Perceptions and practices of psychiatric residents