The Shifting Landscape of Psychotherapy in Residency: Stable Framework of Change

This paper explores the impact of change on a psychiatry trainee’s development through a case presentation. During training psychiatry residents are exposed to constant transitions with frequent shifts in training sites and supervisors. Change is perhaps the most consistent characteristic of residency training. And yet, the maintenance of a changeless, stable frame is considered the gold standard for psychotherapy. The effect of a constantly shifting framework on the training therapist, the patient, and the therapy itself is considered. Reflecting on the multiple and varied themes elucidated by the case, it is evident that there are rich opportunities for growth for both the patient and the trainee who embark on a course of therapy together. Contrary to widely held beliefs, rather than diluting the psychotherapy and diminishing the learning experience, change can be a stimulating and enriching force.