All Professional Bodies, National Associations (e.g. Mental Health, School, Guidance, Addiction, Faith-based etc.) and Accrediting Organisations.
Jungiaanse Vereniging voor Analytisch Therapeuten Nederland, , Association for Analytical Therapists Netherlands (JVATN)
- Website: https://www.jvatn.nl/pg-25546-7-51962/pagina/home.html
- Organisation Size: N/A
Universities and Other Education and Training Institutes
Counselling Agencies, Services, Group Practices, Counselling Centres
Background & Context
In the Netherlands, the first approaches to treating patients psychologically already existed at the end of the 19th century. General practitioners such as Frederik van Eeden and Albert Willem van Renterghem relied on conversations, hypnosis, directive approaches and cathartic methods, not just medical measures, and are thus considered the first psychotherapists in the Netherlands. At the beginning of the 20th century, the treatment offered was limited to psychoanalysis and was practiced exclusively by psychiatrists in private practices. A small elite of well-heeled individuals was treated by them. This was criticized by other psychiatrists, who wanted to make psychotherapy accessible to all. Therefore, the Nederlandse Vereniging voor Psychotherapie – NVP (Dutch Society of Psychotherapy) was founded and in 1940 the first Institute for Medical Psychotherapy (IMP) was founded (cf. Hutschemaekers & Van Dijk 2013, p. 316). In addition to psychoanalysis, additional procedures were established in the following years, which were largely conducted on an outpatient basis. After the Second World War, a process of differentiation between psychotherapists and psychiatrists began, as psychotherapy increasingly distanced itself from biomedical models of disorders (so-called anti-psychiatry movement) (cf. Hutschemaekers, Van Dijk 2013, p. 316).
In 1961, five years before the NVP admitted psychologists*, “the Netherlands Institute for Practicing Psychologists (NIP)” introduced a formal distinction between psychological help (counselling) and psychotherapy. “Whereas counselling was part of the university program, psychotherapy had to be learned in a distinctive professional schooling program. This distinction was, however, never accepted among psychologists; accepting this viewpoint would imply the end of the unity of psychology” (Hutschemaekers, Van Dijk 2013, p. 316). Counselling consequently became a basic component of psychotherapy.
“In the early 1970s entrance to the profession widened further through opening membership of the NVP to academics from outside the medical and psychological disciplines. For instance, in 1973 social workers with advanced studies were also allowed into the NVP. Further between 1970 and 1986, psychiatrists, doctors, psychologists, pedagogics, philosophers and even social workers could become psychotherapists. The psychotherapist became the professional par excellence who used systematic psychological interventions and counselling in mental healthcare. Counselling was considered as a special form of psychotherapy; those professionals who wanted to learn and use counselling had to become psychotherapists” (Hutschemaekers, Van Dijk 2013, p. 317).
Current Regulatory Status / Level of Recognition:
The profession of psychotherapist has been legally recognized since 1986. The entrance level as well as the modality-training is defined by governmental bodies” (EAP- Netherland 2020). The training as well as the professional activity are regulated by Beroepen in de Individuele Gezondheidszorg (BIG). Only those who have been trained according to the BIG requirements may call themselves psychotherapists. After completing the training (duration approximately 4 years), psychotherapists are included in the BIG register. A master’s degree in medicine, clinical psychology, education, and health sciences gives access to professions in the health sector and to the training program in health psychology and psychotherapy (cf. Hutschemaekers, Van Dijk 2013, p. 318). There are only five institutes in the Netherlands from which a degree entitles the holder to an entry in the BIG register. In addition, there are several other schools and institutes whose graduates are not included in the BIG register and who are not allowed to use the professional title of psychotherapist. The demand for psychotherapeutic services is growing steadily and a wide range of schools and procedures exists, such as couple and family therapy, interpersonal therapy, client-centered therapy, problem-solving training, cognitive-behavioral therapy, short-term therapies and psychodynamic procedures (cf. Ibid. p. 218). The treatment is financed by statutory and private health insurance companies, but also by the clients themselves. Therapists must fulfill 3 requirements in order to be able to invoice services via the health insurance:
- The basic psychosocial knowledge (level 6) is required, which is obligatory for the health insurance companies.
- Training by a facility recognized by the EAP.
- Completion of CPD requirements every two years. These ensure that knowledge and skills needed for professional work are maintained and improved (cf. EAP Netherland 2020).
If, on the other hand, a psychologist is consulted in outpatient primary care (PA psychologist), treatment is free of charge for clients for up to eight sessions (and up to twelve if supplementary insurance is in place), as it is financed by the state. Psychological-psychotherapeutic treatment is offered by the Dutch health care system on three levels:
- The first level includes minor psychological and psychosomatic complaints that can be treated on an outpatient basis. PA psychologists and general practitioners are responsible for this.
- The treatment of moderately severe complaints and disorders belong to the second level. Treatment can take place on an outpatient or inpatient basis.
- The third level includes severe mental and psychiatric disorders, the treatment of which, as an outpatient or inpatient, is reserved for specialists such as psychiatrists and psychotherapists (see Sonnenmoser 2011).
Psychotherapists can treat patients of all levels, in contrast to PA psychologists. These are a special case that can be found almost only in the Netherlands. PA psychologists complete two years of additional training after graduating in psychology, and must become certified and enter a register. “They are allowed to diagnose and treat the entire spectrum of behavioral and mental disorders – but only the mild cases. Psychotherapists and psychiatrists are responsible for more severe cases. PA psychologists are therefore considered generalists, while psychotherapists and psychiatrists are specialists” (Sonnenmoser 2011).
The profession of PA psychologist* has been around for more than 30 years.
“It was created after tough wrangling with professional associations, legislators, and the health care system in order to make psychological-psychotherapeutic primary care available to the general population quickly and free of charge. It was also created to make it easier to reach hard-to-reach patient groups, to facilitate contact with professional help, and to reduce inhibitions and prejudices.” (Sonnenmoser 2011).
This relieves the burden on general practitioners, who were previously involved in the treatment of mild mental and psychosomatic disorders. On the other hand, psychotherapists and psychiatrists can concentrate more on serious cases. For problems such as nicotine addiction, pain without physical findings, anxiety, complicated grief or sleep disorders, PA psychologists are the first port of call. They only accept patients from their district. If they belong to another, they are referred to colleagues. This reduces competition and promotes even distribution (see Sonnenmoser 2011).
Psychotherapy and counselling are forms of treatment for people with psychological or mental health problems. The therapist structures the process, provides feedback and advice, offers insight, and implements interventions to strengthen the client*s self-direction, healing power, and self-responsibility. The therapist* works in the past, the present, as well as the future. Psychotherapy focuses on the treatment of complex problems in patients* of different ages and backgrounds (cf. Hutschemaekers, Van Dijk 2013, p. 318). Reasons for psychotherapeutic interventions may include: psychological distress, anxiety, loss of control, anger outbursts, stress, exhaustion, burnout, chronic pain, loneliness, depression, relationship problems, loss & grief, psychotic states, eating disorders, and many more. (idea psychological bureau – therapy ed./Over therapy 2020).
In many countries, counselling is fully integrated into mental health care. In the Netherlands, counselling will also be used to support regular health programs. In order to increase the professionalism of the counselling profession, the Association for Counselling (ABvC) was founded already in late 1997. Counselling is suitable for those who suffer from stress, feel that everything is too much or have encountered problems within the family, work or relationship. Reasons to go to a counselling center are: Burnout, emotional problems, chronic fatigue, problems at work, communication problems and conflicts, relationship problems, learning difficulties, grief and loss, sleep disorders and loss of concentration, depressive complaints, physical complaints, questions of meaning and life. (see Algemene Beroepsvereniging voor Counselling ABvC 2020).
Challenges & Trends
The profession of psychotherapy has seen tremendous growth and psychotherapy has become one of the most important treatment options in mental health care in the Netherlands.
“It is also probable that the success of psychotherapy (an interdisciplinary profession of doctors and of psychologists) opened the doors of the BIG law to non-strictly medical professions such as clinical and healthcare-psychologists. Formal settlement of these psychological disciplines reduced rivalries and disputes between professions, provided transparency in a number of professionals and what they do, and offered excellent opportunities for improvement of healthcare quality and professional schooling” (Hutschemaekers, Van Dijk 2013, p. 322).
At the same time, however, it must be said that the success of psychotherapy also has its downsides. Due to the interdisciplinary nature of psychotherapy, it does not fully belong to either medicine or psychology and therefore is not part of their academic schooling and research programs. Consequently, it grew distant from the academic world, where psychotherapy does not have its own department or is not recognized as a distinct academic profession. “With the rise of empirically supported therapies (EST) and their translation into evidence-based guidelines, the gap between the psychotherapists and the academic world became even more aggravated.” (Ibid. p. 322).
With the complexity of the psychological professions comes a blending. However, if the various disciplines were more clearly divided, this could lead to a clearer delineation between psychiatric and psychological help as well as psychotherapy and counselling (see Ibid. p. 322). In addition to interdisciplinary challenges, there may also be financial challenges for the client. Treatment is only fully reimbursed if the chosen psychotherapist is under contract with the client’s respective health insurance and the 3 necessary requirements are met (see p. 44 above). If there is no contract with the respective health insurance, usually only between 50% to 80% of the money is reimbursed. The costs of psychotherapy by a psychotherapist who is not under contract can therefore be considerable (see Zorgwijzer – Overige vergoedingsvoorwaarden 2020).
Additional Information & References
For a more in-depth examination of the counselling profession in the Netherlands, interested readers are advised to read the following articles as well as books:
- Algemene Beroepsvereniging voor Counselling ABvC (2020). Abgerufen von https://www.abvc.nl
- EAP European Association of Psychotherapy – Netherland (2020). Abgerufen von https://www.europsyche.org/situation-of-psychotherapy-in-various-countries/netherlands/
- Hutschemaekers, G. J. M., & Van Dijk, F. E. (2013). Psychotherapy and clinical psychology in the Netherlands. In: Moodley, R., Gielen, U. P., & Wu, R. (Eds.). Handbook of counseling and psychotherapy in an international context, S. 315- 325. Routledge
- Idee psychologisch bureau – Therapie ed./Over therapie (2020). Abgerufen von https://www.idee-pmc.nl/psychotherapie/therapie_over.html
- Sonnenmoser, M. (2011). Psychotherapie in Europa – Niederlande: Schnelle und niederschwellige Erstversorgung. Deutsches Ärzteblatt PP.
- Zorgwijzer – Overige vergoedingsvoorwaarden (2020). Abgerufen von