A survey of psychotherapy written case barriers in NSW: An unequal opportunity

Objective To assess systemic barriers to trainee completion of the Royal Australian and New Zealand College of Psychiatrists Psychotherapy Written Case (PWC) assessment in New South Wales (NSW). Methods The NSW Association of Psychiatry Trainees (NAPT) distributed a survey to NSW trainees. Data were collected via Google Forms over 2 weeks and analysed descriptively (quantitative) and thematically (open-ended responses). Results 96 trainees responded (17.2% of all stages; 21.7% of Stages 2–3). Of 68 unable to commence the PWC due to supervision or cost barriers, 42.6% ( n = 29) reported a Fellowship delay of 6 months or more. Overall, 70.8% ( n = 68) lacked formal psychotherapy education and 57.3% ( n = 55) had no network-driven patient selection process. Of 43 who completed 40 sessions, 34.9% ( n = 15) experienced supervisor feedback delays causing submission setbacks. Despite access to no-cost supervision at their hospital (59.4%, n = 57) or network (69.8%, n = 67), 54.2% ( n = 52) could not commence the PWC imminently. Conclusion Barriers include limited access to formal education, no-cost supervision, patient selection support, and timely feedback. Unequal access risks entrenching disparities in trainee development and delaying fellowship, consistent with broader literature and highlighting areas for targeted systemic intervention.