Psychodynamic and supportive psychotherapy — structured clinical viva

This viva tests whether the candidate can locate treatment on the expressive–supportive continuum, assess suitability for insight-oriented work, handle idealising transference without collusion or cold rejection, use countertransference as data, cite real evidence, and hold the frame.^[1][4][6]

Modality choice. Depression with abandonment patterns may suit STPP or longer dynamic work if ego strength, motivation, and risk allow; supportive elements remain essential early and in crises. Supportive is skilled treatment (Winston/Pinsker; Markowitz), not a consolation prize. Combined antidepressant optimisation may still be needed — therapy does not replace biology review.^[1][3][7][8]

Suitability. Assess psychological mindedness, impulse control, alliance capacity, substance use, suicide risk, organic factors, supports, and prior boundary trauma. Contract: frequency, goals, contact rules, review points.^[8]

Idealisation and after-hours email. Idealisation is classic transference; explore meaning inside sessions. Do not accept dual-role intimacy or unbounded after-hours contact. Kindly restate the frame; document; supervise. Early specialness is a slippery-slope warning.^[4][6]

Countertransference. Feeling flattered, rescuing, or irritated is data. Name it in supervision; do not act it out via extra sessions for your need to be special. Gabbard's contemporary model: CT is inevitable and useful if contained.^[4][5]

Evidence anchors. Shedler 2010 efficacy synthesis; Leichsenring LTPP meta-analyses; Wienicke 2023 STPP depression IPD meta; supportive literature of Winston/Pinsker/Markowitz. For personality pathways if relevant: TFP/MBT landmark trials (state if examiner steers there).^[1][2][3][7]

Boundaries. Crossings vs violations (Gutheil–Gabbard); sexual contact with current patients is always a violation. No invented statute numbers — state College professionalism and jurisdiction-specific reporting duties in principle.^[6]