Psychotherapy
What you must know
You must understand major psychotherapy modalities, their theoretical basis, indications, and the evidence supporting them. Know CBT (cognitive distortions, behavioral activation), DBT (emotion regulation, distress tolerance, mindfulness, interpersonal effectiveness-for borderline personality and self-harm), psychodynamic therapy, interpersonal therapy (IPT for depression and grief), motivational interviewing (for ambivalence and substance use), family and group therapy, and trauma-focused approaches (prolonged exposure, EMDR, TF-CBT). Understand common factors-therapeutic alliance, empathy, structure-and how to match modality to disorder, developmental stage, and patient preference. Know basic group dynamics and boundaries.
Traps
Questions often test indication rather than definition: DBT for chronic suicidality/BPD, exposure-based therapy for OCD and PTSD, IPT for depression with role transitions. A frequent trap is choosing a modality that contradicts the presenting problem (e.g., insight-oriented therapy for acute crisis). Another is confusing motivational interviewing (collaborative, evoking change talk) with confrontational approaches, or over-attributing outcomes to technique while ignoring alliance. Watch for boundary and confidentiality issues in group settings.
Rule of thumb
Match the modality to the target: skills and safety for BPD (DBT), exposure for anxiety/OCD/PTSD, change talk for ambivalence (MI), and role-transition focus for depression (IPT).
Worked example: A patient with recurrent self-harm and intense interpersonal chaos is referred for therapy. DBT is the best match because it directly targets emotion dysregulation, distress tolerance, and interpersonal effectiveness-unlike supportive therapy alone.