The delegates made pioneering decision to reform the psychotherapeutic training : After university degree in psychotherapy, the license to practice medicine should take place in the future. In the subsequent training, priorities should be set.
Federal Health Minister Gröhe is waiting for clear vote from Profession - please decide so that we can enter into discussions with politicians. ”The appeal from the Federal Chamber of Psychotherapists - / (BPtK) President Prof. Dr. Rainer Richter to the delegates of the 25th German Psychotherapist Day (DPT) on November 15th in Munich was urgent. The reform of psychotherapist training has been topic at the Psychotherapist Days for ten years, and concepts have been discussed for three years. The time for changes is good: In the coalition agreement, the federal government has agreed to revise the Psychotherapists Act and the entry requirements for training in this legislative period.
After long and factual discussion, the delegates finally came out in favor of proposal from the board of directors and some chamber presidents for reform: training aimed at obtaining license to practice medicine after completing scientific university degree in psychotherapy at the master’s level. In subsequent training course, priorities should be set in the treatment of adults, children and adolescents as well as scientifically recognized procedures (box) .
Status quo is postgraduate education. The reason for reform is, on the one hand, the increasing “bachelorisation” of training as child and adolescent psychotherapist due to the Bologna reform: ten out of 16 federal states now recognize the bachelor’s degree as an access. It is feared that future child and adolescent psychotherapists will be less qualified. On the other hand, psychotherapists in training (PiA) have been demonstrating for years that they are adequately rewarded for their mandatory practical work in psychiatric and psychosomatic clinics and departments. This one-year “year of practice” is often not remunerated at all, often slightly and only appropriately remunerated by few clinics. “Psychotherapists under exploitation” can therefore often be read on the demonstrators' banners.
The delegates made pioneering decision to reform the psychotherapeutic training : After university degree in psychotherapy, the license to practice medicine should take place in the future. In the subsequent training, priorities should be set.
Federal Health Minister Gröhe is waiting for clear vote from Profession - please decide so that we can enter into discussions with politicians. ”The appeal from the Federal Chamber of Psychotherapists - / (BPtK) President Prof. Dr. Rainer Richter to the delegates of the 25th German Psychotherapist Day (DPT) on November 15th in Munich was urgent. The reform of psychotherapist training has been topic at the Psychotherapist Days for ten years, and concepts have been discussed for three years. The time for changes is good: In the coalition agreement, the federal government has agreed to revise the Psychotherapists Act and the entry requirements for training in this legislative period.
After long and factual discussion, the delegates finally came out in favor of proposal from the board of directors and some chamber presidents for reform: training aimed at obtaining license to practice medicine after completing scientific university degree in psychotherapy at the master’s level. In subsequent training course, priorities should be set in the treatment of adults, children and adolescents as well as scientifically recognized procedures (box) .
Status quo is postgraduate education. The reason for reform is, on the one hand, the increasing “bachelorisation” of training as child and adolescent psychotherapist due to the Bologna reform: ten out of 16 federal states now recognize the bachelor’s degree as an access. It is feared that future child and adolescent psychotherapists will be less qualified. On the other hand, psychotherapists in training (PiA) have been demonstrating for years that they are adequately rewarded for their mandatory practical work in psychiatric and psychosomatic clinics and departments. This one-year “year of practice” is often not remunerated at all, often slightly and only appropriately remunerated by few clinics. “Psychotherapists under exploitation” can therefore often be read on the demonstrators' banners.
"As long as the practical work is legally assessed as an internship, nothing will change that," emphasized President Richter at the 25th DPT. On the other hand, qualification at master's level for KJP can only be secured through comprehensive reform of psychotherapist training, he said in the direction of an initiative by university teachers who had approached the Federal Ministry of Health (BMG) in advance of the DPT with the demand that the entry requirements be met to be legally stipulated for KJP training at the master’s level. The initiators are the professors who in 2009 prepared the research report for the BMG on the reform of psychotherapeutic training. In short time, more than 4,700 psychotherapists have accepted the demand.
It was not easy for the delegates to decide in favor of the so-called basic direct training, but ultimately 86 delegates from the regional chambers voted in favor, 38 against with four abstentions. In the run-up to the decisive DPT, in addition to maintaining postgraduate training, the model of "dual direct training" was also discussed: after studying psychotherapy, 1st state examination was planned, but the license to practice medicine would only be possible after second qualification phase and 2nd State examination takes place.
Entitlement to remuneration
"The crucial point is the time of the license to practice medicine, because it is only possible to finance further training as with specialist doctors if you have license to practice medicine after your university studies." , explained Walter Ströhm, delegate of the Chamber of Psychotherapists North Rhine-Westphalia. In order to be able to solve the regulatory problems of training, "equality with the doctors, that is, the same training structures" is needed, stressed the President. In addition, this is the only way psychotherapists in institutions and clinics could obtain specialist status.
"In further training, colleagues would not only be entitled to remuneration at specialist level, but also protection under collective bargaining law and the right to continued wages," explained Dieter Best, Rhineland-Palatinate. Hans Bauer, Hessen, also spoke out in favor of basic direct training: “If we don't make decision, others will. And the BMG has made it very clear that only direct training can be considered. ”“ I prefer to be on the side of those who design, ”added Wilfried Schaeben, Hesse. "The responsibility for further development remains with us if we opt for direct training," said Alfred Kappaus, President of the Rhineland-Palatinate Chamber of Psychotherapists. "The construction of license to practice medicine after studying psychotherapy with subsequent further training ensures the independence and quality of our profession", explained Barbara Lubisch, North Rhine-Westphalia.
"As long as the practical work is legally assessed as an internship, nothing will change that," emphasized President Richter at the 25th DPT. On the other hand, qualification at master's level for KJP can only be secured through comprehensive reform of psychotherapist training, he said in the direction of an initiative by university teachers who had approached the Federal Ministry of Health (BMG) in advance of the DPT with the demand that the entry requirements be met to be legally stipulated for KJP training at the master’s level. The initiators are the professors who in 2009 prepared the research report for the BMG on the reform of psychotherapeutic training. In short time, more than 4,700 psychotherapists have accepted the demand.
It was not easy for the delegates to decide in favor of the so-called basic direct training, but ultimately 86 delegates from the regional chambers voted in favor, 38 against with four abstentions. In the run-up to the decisive DPT, in addition to maintaining postgraduate training, the model of "dual direct training" was also discussed: after studying psychotherapy, 1st state examination was planned, but the license to practice medicine would only be possible after second qualification phase and 2nd State examination takes place.
Entitlement to remuneration
"The crucial point is the time of the license to practice medicine, because it is only possible to finance further training as with specialist doctors if you have license to practice medicine after your university studies." , explained Walter Ströhm, delegate of the Chamber of Psychotherapists North Rhine-Westphalia. In order to be able to solve the regulatory problems of training, "equality with the doctors, that is, the same training structures" is needed, stressed the President. In addition, this is the only way psychotherapists in institutions and clinics could obtain specialist status.
"In further training, colleagues would not only be entitled to remuneration at specialist level, but also protection under collective bargaining law and the right to continued wages," explained Dieter Best, Rhineland-Palatinate. Hans Bauer, Hessen, also spoke out in favor of basic direct training: “If we don't make decision, others will. And the BMG has made it very clear that only direct training can be considered. ”“ I prefer to be on the side of those who design, ”added Wilfried Schaeben, Hesse. "The responsibility for further development remains with us if we opt for direct training," said Alfred Kappaus, President of the Rhineland-Palatinate Chamber of Psychotherapists. "The construction of license to practice medicine after studying psychotherapy with subsequent further training ensures the independence and quality of our profession", explained Barbara Lubisch, North Rhine-Westphalia.The further training, the design of which would in future be the responsibility of the psychotherapists' chambers, must be regulated.
But there were also some critical voices: "I find it difficult to say goodbye to the highly qualified postgraduate training," said Susanne Walz-Pawlita, Hesse. She found the discussion "very shortened": Many concerns fell by the wayside. "To say that there is only one model that solves all problems in training - I cannot understand that," explained Dr. Josef Könning, Lower Saxony. He reported on statements from medical colleagues who warned against orienting themselves towards the further training of medical psychotherapists: there are no quality standards, and these are often not remunerated in the outpatient area. For Manfred Thielen, Berlin, central questions have not been resolved: "After obtaining their license to practice medicine, some go straight to the clinics and others do their specialist training and go to the branch - that creates two classes of psychotherapists." Benjamin Lemke from the PiA federal conference sees them too Danger of split: "Then there will be 'auxiliary psychotherapists' in future without any procedural reference."
Until such reform comes into force, it must be ensured in any case that only university graduates who have completed their studies with diploma or master's level are admitted to today's postgraduate psychotherapist training , the DPT finally decided. To this end, uniform federal administrative practice is to be ensured in the federal states for the transition period. President Richter emphasized that the debate did not end with the decision of the 25th DPT, and many discussions still had to be held. But: "The course has been set, we are sending clear signal to politics."
You could read about the possible effects of the Statutory Health Insurance Care Strengthening Act on psychotherapeutic care in the report of the board of directors, which the Delegates of the 25th German Psychotherapist Conference. The BPtK Board of Directors is following the planned new regulation with great interest, according to which the Federal Joint Committee is to make more detailed provisions on psychotherapeutic consultation hours in order to reduce waiting times. During these consultation hours, an initial discussion and individual advice about various care options should take place. In particular, this new legal regulation is intended to enable short-term clarification of the need for treatment.
The Board of Directors welcomes the establishment of such consultation hours and in this context strives for gradual lifting of the restrictions on the powers of psychotherapists.The further training, the design of which would in future be the responsibility of the psychotherapists' chambers, must be regulated.
But there were also some critical voices: "I find it difficult to say goodbye to the highly qualified postgraduate training," said Susanne Walz-Pawlita, Hesse. She found the discussion "very shortened": Many concerns fell by the wayside. "To say that there is only one model that solves all problems in training - I cannot understand that," explained Dr. Josef Könning, Lower Saxony. He reported on statements from medical colleagues who warned against orienting themselves towards the further training of medical psychotherapists: there are no quality standards, and these are often not remunerated in the outpatient area. For Manfred Thielen, Berlin, central questions have not been resolved: "After obtaining their license to practice medicine, some go straight to the clinics and others do their specialist training and go to the branch - that creates two classes of psychotherapists." Benjamin Lemke from the PiA federal conference sees them too Danger of split: "Then there will be 'auxiliary psychotherapists' in future without any procedural reference."
Until such reform comes into force, it must be ensured in any case that only university graduates who have completed their studies with diploma or master's level are admitted to today's postgraduate psychotherapist training , the DPT finally decided. To this end, uniform federal administrative practice is to be ensured in the federal states for the transition period. President Richter emphasized that the debate did not end with the decision of the 25th DPT, and many discussions still had to be held. But: "The course has been set, we are sending clear signal to politics."
You could read about the possible effects of the Statutory Health Insurance Care Strengthening Act on psychotherapeutic care in the report of the board of directors, which the Delegates of the 25th German Psychotherapist Conference. The BPtK Board of Directors is following the planned new regulation with great interest, according to which the Federal Joint Committee is to make more detailed provisions on psychotherapeutic consultation hours in order to reduce waiting times. During these consultation hours, an initial discussion and individual advice about various care options should take place. In particular, this new legal regulation is intended to enable short-term clarification of the need for treatment.
The Board of Directors welcomes the establishment of such consultation hours and in this context strives for gradual lifting of the restrictions on the powers of psychotherapists.He currently sees little support at the health policy level for the requirement that psychotherapists should be authorized to certify incapacity for work. According to the board, it seems more realistic that psychotherapists will be able to refer to the hospital in the context of consultation hour. The authorization to prescribe sociotherapy and remedies for certain indications is also sought. In order to provide evidence that such an extension of powers is accompanied by an improvement in care without causing cost explosion, the Federal Chamber of Psychotherapists suggests having the care process scientifically evaluated.
The board of directors is very critical of the provision in the draft bill of the Supply Strengthening Act, according to which in future the admissions committees should ensure that from With coverage rate of over 110 percent, practice takeovers should only be permitted in exceptional cases. If this were strictly implemented, around third of all psychotherapeutic practices would have to be dismantled. In numbers, this would be 7,444 of the 23,546 branches. In concerted action with the state chambers of psychotherapists, the members of the Bundestag are to be made aware of the consequences in their constituency.
Criticism of the needs planning
In the resolution with which the Psychotherapists Day feared against them If the new regulation applies, it is emphasized once again that the current demand planning is based on data that are not suitable for correctly mapping the demand. The basis is still the number of psychotherapeutic practices that were approved for the first time between January 1 and August 31, 1999. The psychotherapists who were admitted late at the time - around 5,000 after all - were not taken into account in this requirement planning. The number of practices that was determined in the 1999 requirements plan was actually never enough. "The planned reduction of an oversupply of psychotherapeutic practices, which actually does not exist, would be absurd," says the resolution.
The BPtK board also criticized the draft prevention law that is now available. It is noticeable that psychotherapeutic expertise is only insufficiently addressed here. “The specific competence of psychotherapists should be made more useful for prevention and health promotion.He currently sees little support at the health policy level for the requirement that psychotherapists should be authorized to certify incapacity for work. According to the board, it seems more realistic that psychotherapists will be able to refer to the hospital in the context of consultation hour. The authorization to prescribe sociotherapy and remedies for certain indications is also sought. In order to provide evidence that such an extension of powers is accompanied by an improvement in care without causing cost explosion, the Federal Chamber of Psychotherapists suggests having the care process scientifically evaluated.
The board of directors is very critical of the provision in the draft bill of the Supply Strengthening Act, according to which in future the admissions committees should ensure that from With coverage rate of over 110 percent, practice takeovers should only be permitted in exceptional cases. If this were strictly implemented, around third of all psychotherapeutic practices would have to be dismantled. In numbers, this would be 7,444 of the 23,546 branches. In concerted action with the state chambers of psychotherapists, the members of the Bundestag are to be made aware of the consequences in their constituency.
Criticism of the needs planning
In the resolution with which the Psychotherapists Day feared against them If the new regulation applies, it is emphasized once again that the current demand planning is based on data that are not suitable for correctly mapping the demand. The basis is still the number of psychotherapeutic practices that were approved for the first time between January 1 and August 31, 1999. The psychotherapists who were admitted late at the time - around 5,000 after all - were not taken into account in this requirement planning. The number of practices that was determined in the 1999 requirements plan was actually never enough. "The planned reduction of an oversupply of psychotherapeutic practices, which actually does not exist, would be absurd," says the resolution.
The BPtK board also criticized the draft prevention law that is now available. It is noticeable that psychotherapeutic expertise is only insufficiently addressed here. “The specific competence of psychotherapists should be made more useful for prevention and health promotion.“The realization of healthy lifestyle depends on number of emotional, motivational and social factors, which the psychotherapeutic profession is ideally suited to taking into account and influencing. In view of the importance of mental illnesses, the BPtK will work to ensure that appropriate counseling services can also be provided by psychotherapists.
The 26th German Psychotherapist Day will take place on April 26, 2015 in Berlin.
Petra Bühring, Thomas Gerst
Resolutions of the 25th DPT
Two resolutions criticize the inadequate psychotherapeutic care for refugees and migrants in Germany.
Refugees - based on the regulations of the Asylum Seekers Benefits Act - very often did not receive guideline-compliant treatment for severe mental illnesses, according to resolution. Although they are entitled to the treatment of acute illnesses and painful conditions, the granting of psychotherapy is often the individual decision of not appropriately qualified medical officers and clerks. Often, mentally ill refugees are treated exclusively with psychotropic drugs. Refugees should be able to claim treatment for chronic and mental illnesses as rule. The Federal Government is called upon to create uniform rule in the Asylum Seekers Benefits Act on the manner in which qualified decisions are to be made about the need for treatment for mentally ill refugees. These should correspond to the existing approval procedures for those with regular health insurance.
In further resolution, the Psychotherapeutentag complains about the inadequate psychotherapeutic care for people with migration background. Around fifth of them do not speak enough German to clearly communicate their symptoms to psychotherapist. Statutory health insurance must therefore cover the costs of an interpreter if there is no therapist available who can speak the insured's native language. In places where particularly large number of people with migration background lived, more native-speaking psychotherapists should be allowed - as special requirement within the framework of the requirements planning directive to “suspend the planned dismantling of practice seats in so-called oversupplied regions with psychotherapists and beforehand to determine the actual need for psychotherapeutic treatment places.“The realization of healthy lifestyle depends on number of emotional, motivational and social factors, which the psychotherapeutic profession is ideally suited to taking into account and influencing. In view of the importance of mental illnesses, the BPtK will work to ensure that appropriate counseling services can also be provided by psychotherapists.
The 26th German Psychotherapist Day will take place on April 26, 2015 in Berlin.
Petra Bühring, Thomas Gerst
Resolutions of the 25th DPT
Two resolutions criticize the inadequate psychotherapeutic care for refugees and migrants in Germany.
Refugees - based on the regulations of the Asylum Seekers Benefits Act - very often did not receive guideline-compliant treatment for severe mental illnesses, according to resolution. Although they are entitled to the treatment of acute illnesses and painful conditions, the granting of psychotherapy is often the individual decision of not appropriately qualified medical officers and clerks. Often, mentally ill refugees are treated exclusively with psychotropic drugs. Refugees should be able to claim treatment for chronic and mental illnesses as rule. The Federal Government is called upon to create uniform rule in the Asylum Seekers Benefits Act on the manner in which qualified decisions are to be made about the need for treatment for mentally ill refugees. These should correspond to the existing approval procedures for those with regular health insurance.
In further resolution, the Psychotherapeutentag complains about the inadequate psychotherapeutic care for people with migration background. Around fifth of them do not speak enough German to clearly communicate their symptoms to psychotherapist. Statutory health insurance must therefore cover the costs of an interpreter if there is no therapist available who can speak the insured's native language. In places where particularly large number of people with migration background lived, more native-speaking psychotherapists should be allowed - as special requirement within the framework of the requirements planning directive to “suspend the planned dismantling of practice seats in so-called oversupplied regions with psychotherapists and beforehand to determine the actual need for psychotherapeutic treatment places.
Cornerstones of the reform *
- The aim is the two-phase scientific and practical professional qualification of psychotherapists through the acquisition of professional competencies, such as those in the competence profile for professional practice in the outpatient and inpatient sector as well in institutions.
- In academic university studies, the qualification extends over the entire age range (children, adolescents, adults) and all scientifically recognized procedures.
- In the subsequent further training, specializations in Establish scientific psychotherapy procedures and methods as well as priorities with in-depth qualifications for the treatment of children and adolescents as well as adults.
- University studies and further education must be related to one another. After graduation, state examination with license to practice medicine is to be provided, which entitles to further training, which is prerequisite for the independent treatment of statutory health insurance in the outpatient and inpatient area.
- The further training courses are organized by further training institutions including theoretical parts, supervision and teaching therapies. The current state-recognized training centers will be transferred to training centers.
- The training must be designed in such way that work and family are compatible.
- Appropriate financial framework conditions are created for the remuneration of the pension benefits of Further training participants as well as for the supply and qualification services provided by further training institutions.
- Appropriate transition periods are to be provided for those who have started studies or training according to the current regulations.
* shortened Version of the decision of the 25th DPT
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