Psychology and psychotherapy in health care

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Psychology and psychotherapy in health care. A review of legal regulations in 17 European countries Lisbon, november 2011 N. Van Broeck, Catholic University of Louvain Belgium Member of EFPA Standing committee on psychotherapy Member of the Working group on legal affaires - PowerPoint PPT Presentation

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  • Psychology and psychotherapy in health careA review of legal regulations in 17 European countriesLisbon, november 2011

    N. Van Broeck, Catholic University of LouvainBelgiumMember of EFPA Standing committee on psychotherapy Member of the Working group on legal affairesFormer president of the BFP/FBP

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Problem? Psychologists in health care?

    Important placeResearch shows positive effects of delivered services on mental an physical health

    Underdeveloped legal framework

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Different countries different regulationsLegal regulation or not ?Education and Training ? Licencing?Professional ethics?Quality control ?

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Consequences of poor regulation: Confusion between professionals with different qualifications insufficient quality control of trainingInsufficient quality control of servicesPoor protection of clientsPoor protection of the professionalRecognitionremunerationmobility restrictedInadequate fit needs / servicesLisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Legal regulation of Psychology and psychotherapy in health careLack / diversity

    Definitions Survey on legal regulations 2007EFPA visionProject of the EFPA Working Group on legal Affairs : Survey 2011/2012

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • DefinitionsPsychology in health care /Clinical psychology : the development and application of theories, methods and techniques of scientific psychology and related disciplines (f.i. neuro-sciences, genetics ) in the assessment, prevention and intervention of health problems that manifest themselves in psychological and/or physical symptoms in persons of all ages (Van Broeck, 2007, based on Perrez and Bauman, 1986).Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • domain of application of clinical psychologyBy means of psychological knowledge and methods:

    education on the psychological aspects of health prevention treatment of health problems rehabilitation after health problems and or traumatic life experiences

    In the domain of physical and mental healthLisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • DefinitionsPsychotherapy:

    Psychotherapy is a specific type of psychological treatment in which the professional applies a coherent whole of psychological interventions based on a scientifically validated theory on human psychological development, functioning, and dysfunctioning and on processes of change.

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • DefinitionsPsychotherapy:

    The psychologist applying psychotherapy followed a specialized training in one or more of these scientifically validated theories and in the methods of change based upon it. He applies the theory and the methods in the context of a professional helping relationship in order to alleviate the psychological complaints, problems or disorders. The client or patient can be an individual, family or group.

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • 2. Research 2006/2007 Survey of legal regulations of psychology and psychotherapy in health care

    In 17 European countries

    Van Broeck, N., & Lietaer, G. (2007). Psychologists and psychotherapists in Health care. A review of legal regulations in 17 European Countries. European Psychologist.

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Method: CountriesSelection of countries: 15 (situation EU in 2004) + 2

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    AustriaBelgiumDenmark FinlandFranceGermanyGreeceIrelandItalyLuxemburgThe NetherlandsNorwayPortugalSpainSwedenSwitserlandUnited kingdom

    Psychology and psychotherapy in health care: Legal Regulations

  • Method: ParametersLaw on psychologists in health care (clinical psychologists, health care psychologists ..)?If yes: Title protection ? If yes: Criteria ?

    Practice? Licencing ?Registers ?Ethical control ? Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Method: ParametersRegulatory bodies ?Decision ?Execution / application ?Ethical control?

    Education training?Duration ?Level ?Internship?Supervision?Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Method: Parameters

    Psychology and psychotherapy:

    If there is a law on psychotherapySpecialization of profession of psychologists and psychiatrists ? Or Multiprofessional activity= access for other professions ?

    If PT is considered a multiprofessional activity :Minimum basic level of access to trainingDuration of specialized trainingLisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Related questions : not adressedReimbursement ?Public insurancesPrivate insurances

    Consequences of different models of regulation?

    Role of professional bodies / associationsLisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • ResultsLaw on Psychology in health care?Law on psychotherapy?Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Table 1. Legal regulations of the title and the practice of psychologists in health care and the title and practice of psychotherapists in 17 European countries

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    CountryLaw on the practice of psychologists (licensing and registry) in health careLaw on the title and the practice of psychotherapist1Austria XX (M)2Belgium //3Denmark X/4Finland XX (M)5France XX (M)6Germany /X (S)7GreeceX/8Ireland //9Italy XX (S)10Luxemburg //11Netherlands XX (M + S)12NorwayX/13Portugal X/14Spain X/15SwedenXX (M)16Switserland//17United Kingdom/*/Total number of countries117

    Psychology and psychotherapy in health care: Legal Regulations

  • The majority of the countries opted for a legal regulation of clinical psychology: 11/17

    In 5/17: only clinical psychologyIn 6 / 17: both clinical psychology and psychotherapy are regulated

    In 1/17: law on psychotherapy but not on clinical psychology (Germany)

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • The majority of the countries opted for a legal regulation of clinical psychology: 11/17

    In 5/17: only clinical psychologyIn 6 / 17: both clinical psychology and psychotherapy are regulated

    In 1/17: law on psychotherapy but not on clinical psychology (Germany)

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Results:

    Vision on psychotherapy?Specialization of professions of psychologist or psychiatrist

    Multiprofessional activity?

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    Psychology and psychotherapy in health care: Legal Regulations

  • Table 2. Legal regulation of psychotherapy as a specialization of the professions of psychiatrists and clinical psychologist or as a multiprofessional activity in the 7 countries with a legal regulation of this professional activity

    Lisbon, november 2011Psychology and psychotherapy in health care: Legal Regulations

    countryPsychotherapy as a specialization of the professions of psychiatrist and clinical psychologistPsychotherapy as a multiprofessional activityAustria /XFinland /XFrance /XGermany X*/Italy X/Netherlands* XXSweden/X35

    Psychology and psychotherapy in health care: Legal Regulations

  • avril 08Psychology and psychotherapy in health careIn 7 countries with law of PT: Specialization of professions of psychologist and psychiatrist:3/7

    Multiprofessinal activity: 5/7

    In the Netherlands : both solutions

    > When there is a law: mulitprofessional activity

    Psychology and psychotherapy in health care

  • Results: Education and training of psychologists in health care in countries with legal regulationIn the 11 countries with legal regulation of psychologists in health