Graduate School in Clinical Psychology

Traditionally based above all on theories and clinical module which could not be empirically verified, today the training of psychotherapists must be grounded as far as possible on a scientific approach. This concept, usually defined as evidence-based, is summarised in a declaration of the American Psychological Association (2005) as “the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences” (for a full discussion of this topic, see enclosed: Report of the 2005 Presidential Task Force on Evidence-Based Practice). Reference to an evidence-based approach enables users to be guaranteed therapies with explicit, verifiable theoretical bases, with known indications, durations, results and cost-benefit ratio. These factors are a necessary guarantee, especially when psychotherapists are trained and practise within public institutions, whose mandate includes the duty to deliver services of verifiable and, it is to be hoped, high quality.

Empirical research proves that a variety of psychotherapy methods are effective, and this calls into question the traditional rigid distinctions or rivalries between different theoretical approaches, shifting the focus onto the factors underlying therapeutic action and efficacy. In other words, nowadays it is essential to move on from adherence to cultural traditions (psychodynamic, cognitive-behavioural, systemic, etc.), which however still provide general terms of reference, and to identify what works and how in psychotherapy treatment.

Although there is still a tendency to label training in psychotherapy on the basis of the traditional distinctions mentioned above, it has been amply proven that today training oscillates between the fragmentation of traditional concepts and the intermixing of concepts, strategies and techniques which used to be kept strictly separate. In other words, not only are there many ways of defining, for example, the concept of "psychodynamic" or "cognitive", but these areas also tend to overlap and the boundaries between them are increasingly blurred. This transformation, which no longer permits unquestioning adherence to traditions which are undergoing a complex transformation, with the risk of theoretical confusion and uncontrolled eclecticism in practice, is another reason for sticking as closely as possible to the evidence-based approach. (for an empirical analysis of the entire psychotherapy training system in Italy, see: C. Maffei, M.G. Strepparava, F. Del Corno, La formazione privata alla psicoterapia in Italia: problemi e prospettive, Giornale Italiano di Psicologia, 2013).

While complying with the obligation enforced by the national Didactic Regulations to ensure the provision of basic knowledge, especially during the first two years, the learning method used is based on attendance at teachers' activities in their specific sectors, minimising the number of lectures and thus the risk of merely duplicating the knowledge students have already acquired in their Psychology Degree courses.

With regard to the acquisition of diagnostic and therapeutic clinical knowledge and skills, the method adopted is again based mainly on attendance at teachers' teaching, clinical and research activities. Experience-based learning is made possible by the fact that the School's teaching location is at San Raffaele-Turro (via Stamira d’Ancona, 20), where diagnosis and therapy in psychology and psychotherapy (Clinical Psychology and Psychotherapy Service), psychiatry and neurology take place. School students therefore have access to all the facilities and resources of these areas of specialism. In particular, students are also able to witness the patient diagnostic process in a psychiatric (hospitalisation) context. However, as well as the San Raffaele-Turro facilities, the School is also able to make use of all the academic and hospital facilities of the Vita-Salute San Raffaele University and the Ospedale San Raffaele, where the School's teaching staff practise.

On the basis of the two previous points, the achievement of the ECTS-credits envisaged by the Teaching Curriculum is organised, in terms of timetables and attendance, by an agreement between teaching staff and students which enables the latter to witness each teacher at work to the highest possible extent.

Basically, the School's general educational objective is to enable students to acquire diagnostic and therapeutic skills largely through experienced-based learning (attendance at teachers' clinical work, attendance at the presentation of clinical cases, supervised diagnostic assessments and treatment of patients with supervision), with particular reference to evidence-based psychotherapies.

In practice, these refer above all to:

• Dialectical Behaviour Therapy (DBT) (Linehan, 1993) (the San Raffaele-Turro site is the headquarters of the Società Italiana per Dialectical Behaviour Therapy (SIDBT) (sidbt.it), the only Italian training institution recognised by the Linehan Institute, the international organisation which guarantees the quality level of DBT training)
• Mentalisation Based Treatment (MBT) (Bateman and Fonagy, 2004)
• Systems Training for Emotional Predictability and Problem Solving (STEPPS) (Blum et Al., 2002)
• Acceptance and Commitment Therapy (ACT) (Hayes et Al., 2012)
• Mindfulness Based Relapse Prevention for Addictive Behaviors (MBRP) (Bowen et Al., 2010)

Activities in these areas also benefit from international collaborations which provide the opportunity to attend events (congresses and seminars) and participate in research projects.