Shifting Gears: The Challenge to Teach Students to think Psychodynamically and Psychopharmacologically at the Same Time

Learning to formulate a case is one of the most important skills that students of psychotherapy and psychoanalysis must master. Culling information from the history, the symptomatology, and the transference, students gradually learn to construct a comprehensive picture of the patient's mental life that attends to etiology, as well as to treatment recommendations. This crucial skill has always been difficult to teach, as well as to learn, but today this difficulty is amplified by the fact that students no longer have the luxury of basing their formulations on a single psychological model. On the contrary, students are now bombarded with many different models of the mind. Trainees, such as psychiatry residents, psychology interns, and social work students, learn psychodynamic models, cognitive models, behavioral models, and psychopharmacologic models, just to name a few. Generally, supervisors are experts in one of the above fields. For example, a psychiatry resident may have a psychoanalyst supervising a psychotherapy case and a psychopharmacologist supervising several medication cases. This enables the resident to learn from the experts in each field. However, in the real world, patients do not segregate into such neat categories. Rather, each patient must be evaluated using