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Psychiatry residents offer quality therapy at low cost Third-year psychiatry resident Katherine St. Germain says it's a great opportunity for people who need help with anxiety, depression, social phobias or any of the other mental and emotional illnesses that step between themselves and a content, productive life. It’s MUSC's psychiatry residents’ clinic. Clinic patients have ready access to trained, objective therapists at a cost based on their ability to pay. The residents’ four-year program includes two years of inpatient training and a third year of outpatient clinic training. Specialty training in the fourth year could also include seeing patients in the clinic. “And we're well supervised with several attending psychiatrists reviewing our cases with us,” St. Germain said. “We have two tools at our disposal. We have therapy and medication.” Explaining the benefits of therapy, St. Germain said that psychiatry residents are physicians in four years of additional training in psychiatry and able to prescribe medications as well.  Their aim is to recreate patterns in the brain, she said. Patterns that give rise to panic attacks, to conflicts in relationships, or the depression that may come from the loss of a loved one or divorce can be changed. It's the therapist's role to guide or coach a patient into thinking and acting differently.  “It's the patient who does the work,” St. Germain said, explaining that the therapist helps find the appropriate way to achieve the desired goal. “Sometimes a person can get stuck at one point in life due to conflict or other stressors like a job or family. Others suffer from addictions and require therapies and medications designed for their particular needs.” Each resident sees about 12 patients a week at the clinic. The rest of the resident’s patient load is then divided among the other clinics at the VA Medical Center, Child Clinic in West Ashley, and Counseling and Psychological Services (CAPS) clinic. The remainder of the resident’s schedule is then filled with supervision time and lectures. Patient therapies range from 10 to 12 weekly sessions to six months or even as long as a year or more. Residents diagnose mental and emotional illnesses based on patients’ complaints and symptoms and design appropriate therapies.  Patients, usually without adequate insurance or on Medicaid, are assigned as much as possible to residents according to their areas of interest and their need for certain cases, said Institute of Psychiatry adult outpatient referral coordinator Langdon Ellington. “I try to get to know the residents and their areas of interest, but outside of that the patients are randomly distributed. Our priority is to get our patients seen as soon as possible.” Ellington said that patients seen at the clinic offer a wide range of mental and emotional illnesses. St. Germain said that patient privacy is protected and residents maintain strict confidentiality about individual cases, keeping patient information within the confines of resident and faculty adviser.