A growing number of training programs fall into the second category. These programs rely on manual-based approaches where trainees are expected to learn the specific techniques, attitudes, and skills associated with a certain approach, for example, cognitive therapy for depression (Beck, Rush, Shaw, & Emery, 1979), or exposure and response prevention for obsessive compulsive disorder, or interpersonal psychotherapy for depression (Klerman, Weissman, Rounsaville, & Chevron, 1984), or psychodynamic psychotherapy for disturbed interpersonal relationships (Strupp & Binder, 1984). There is much merit in such manual-guided training programs, including the relatively easy provision of outcome criteria and the confidence trainees acquire in their knowledge base. However, reasonable questions arise about the generalizability to clinical practice of manual based therapies that have been shown to be effective in controlled experimental trials.

Controlled studies screen out diverse patients in order to adhere to the uniformity demanded of research protocols (Goldfried & Wolfe, 1996). A manual-focused training program limits understanding of other possible approaches for those patients who have more complicated presentations than those addressed by protocol-prescribed approaches. In addition, trainees are not shown what is fundamental to all these approaches-the basics of psychotherapy that draw them together, making each school with a variation on a basic theme. These disadvantages have given rise to a third category of training programs, those in psychotherapy integration, where the techniques shared among the major schools of psychotherapy are emphasized. This program falls into the third category.

What are the goals of an effective residency training program? The designers of an effective training program must select a limited number of skills that, if effectively taught, will lead to effective psychotherapy. This objective requires careful selection from a wide variety of potential alternatives based on research and clinical experience. The selected alternatives should include what are generally considered to common factors in or pantheoretical element of the psychotherapies. After all, if we apply the term psychotherapy to an entity, there must be certain elements that define across the various orientations subsumed under it.

It is toward this aim that this training program is developed. In addition, this training program strives to help trainees master multiple treatment combinations and to adjust their therapeutic approaches to fit the needs of their patients. An additional goal is to educate trainees to think and perhaps behave integratively-openly and synthetically, but critically-in their clinical pursuits (Andrews, Norcross, & Halgin, 1992). Trainees are encouraged to examine their own thinking to apply critical research attitudes to what they do and how they do it. They learn to measure their effectiveness and respond to these evaluations with a sharpening behavior and thinking. Trainees should be informed consumers of research findings and should respect research evidence that can contribute to clinical effectiveness.