Sweden

IAC Member Associations & Organizations

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Additional Counselling Associations & Organizations

Sveriges Psykologförbund (Swedish Psychological Association)

Register över Auktoriserade Counsellors i Sverige (RAS) 

IAC Education Institute Members

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Additional Education Institutes

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The field of psychology has existed in Sweden for over 100 years. The word psychology has often been used in this country as a generic term for psychological treatment orientations, the clientele and the duration of treatment. There is no Swedish translation for the terms counselling psychology, counselling and counsellors, which is why counselling is not considered an established psychological field.  (cf. Nilsson/Lindgren 2009 p. 322).

Similarly, as in many other European countries, mental health treatments in Sweden were influenced by psychoanalysis. From the middle of the 20th century, other treatment orientations, such as cognitive therapy and behavioral therapy, began to gain acceptance. (cf. ibid.)

Until World War II, psychology in Sweden was the academic responsibility of the faculties of philosophy. In 1943, the first psychotechnical institute was established at the ‘Högskola of Stockholm’, (Stockholm University Institute). Towards the end of the 1950s, more formal training for psychologists* was introduced at the universities. Currently, this training consists of a five-year, degree program, with a focus on applied psychology, and is offered at a total of eight universities in Sweden. (Gothenburg, Linköping, Lund, Stockholm, Umea, Uppsala and Örebro) The program concludes with a Master of Science in Psychology. Admission is highly competitive, however, as the program is one of the most popular in all of Sweden.  (cf. ibid. p.322f.)

In recent years, psychology programs, along with all other university programs, have been revised to meet the standards of the Bologna Reform. In Sweden, the main focus has been on adapting and revising the degree levels, the grading system, and the admission procedure. (cf. ibid. p.323).

Counselling is not regulated by law because it is not an established specialty. In 1985, the Psychotherapists Act was introduced in Sweden. It states that only those who can prove that they have undergone appropriate further training in psychotherapy can obtain psychotherapy recognition. (cf. Cohen 2002, p.12) Despite the Psychotherapists Act, there is a confusing situation with regard to training offers and providers of psychotherapy. The quality and seriousness is hardly checked. Universities and professional societies, however, follow European and worldwide training standards and offer a five-year training. (cf. Sonnenmoser 2011) As a rule, this psychotherapeutic training is divided into three stages. First, a basic training of about three years must be completed. After successfully completing the training, one receives a bachelor’s degree. With this degree, psychotherapeutic interventions can be carried out under supervision. In the second stage, training in psychotherapy takes place and in the third stage, psychotherapists are finally prepared to be able to work as supervisors. (cf. Van Broeck/Lietaer 2008 p. 58).

In 1995 a national law was passed in which the right to treatment was guaranteed. This law gives society a right to health care, including psychotherapy, and was enacted to enforce equal treatment in health care in all parts of Sweden. As a result, the regional governments were required to comply with this guarantee of treatment. There is one restriction for psychotherapy. It is only guaranteed and subsidized if it is considered medically necessary. (cf. Nilsson/Lindgren 2009 p.325).

The “Swedish National Board of Health and Welfare” grants psychologists the authorization that allows them to work as licensed psychologists. The license is issued only after a five-year course of study in psychology (master’s degree), supplemented by one year of supervised training. Furthermore, the Swedish National Board of Health and Welfare sets guidelines on licensing for title and practice as a psychotherapist and accreditations for training institutions. (cf. Van Broeck/Lietaer 2008 p. 58).

• In Private Practice
• In community Services
• In school
• Care for the elderly
• Social Services
• Behavioural Therapy (CBT)
• Interpersonal Psychotherapy (IBT)
• Family Therapy
• Systemic Therapy 

There are continuing education programs in psychotherapy offered primarily at universities, but also at some accredited training institutions. The programs offer psychologists in-depth training in psychoanalytic, psychodynamic, behavioral or cognitive group or family therapy. Swedish psychologists take advantage of these programs and continue their education to a greater extent than any other professional group in their country.  (cf. Nilsson/Lindgren 2009 p.323).

Currently, psychologists* complete five years of academic training in applied psychology, followed by one year of supervised internship. Of note is the desire to advance training and develop specialization in the field. This desire may be a reflection of responsible and dedicated professionals who want to expand their skills and meet the diverse psychological needs of the Swedish population. However, it may also be an indication that students find the training too general and does not adequately prepare them to work with specific people and problems. (cf. ibid. p.325)

Furthermore, it should be pointed out that not only the primary health care system employs a low number of psychologists. The same problem arises in the school system. In Sweden, the number of school psychologists is lower than in many other countries in Western Europe. The low number of psychologists in primary health care as well as in the school system can ultimately contribute to a lack of awareness of the profession and to the feeling that psychological services can only be used by the seriously mentally ill. (cf. ibid.)

In Sweden, mentally ill patients are initially treated with medication. Primary care does not include therapy. Only in exceptional cases is it used as a supplement to medication. However, especially in the areas of anxiety disorders and depression, therapy is a very good, if not the better alternative.(Cf. Sonnenmoser 2011) Studies from 2004 showed that over two-thirds of respondents would prefer therapy to medication. Furthermore, 60% felt that individuals with mental health problems do not receive the treatment they would want from available subsidized mental health services. (cf. Nilsson/Lindgren 2009 p.325)

Many patients have to pay co-payments for their psychological treatments, if not pay for them entirely. For example, a therapy carried out by a psychologist in her private practice costs between 600 and 1000 kronor and is usually not subsidized. Swedes with a medium income often cannot afford such a treatment in the long run. So the question arises what people in Sweden do when they feel the need to talk to a psychologist due to depression or a crisis. (cf. ibid.)

There is an overall problem with the availability of affordable treatment options, as most psychologists are self-employed and work in private practices. (cf. Sonnenmoser 2011) The Swedish health care system does not seem to be able to meet the treatment needs of people with milder forms of mental illness. Here, the country could learn a lot from the field of counselling psychology. By developing such a psychological specialty, the availability of psychological resources would increase. (cf. Nilsson/Lindgren 2009 p.326).

In summary, there is still much need for action. The need for psychotherapeutic interventions is steadily increasing in Sweden. The number of existing psychotherapists, trainers, institutions, supervisors is not sufficient, the counselling area is not yet sufficiently covered. However, the awareness of the need for psychological health care in the form of therapy is growing and the Swedish Psychological Association seems determined to further develop these specialties. (cf. ibid.)

Interested readers are advised to read the following books and articles for a more in-depth discussion of the counselling profession:

• Nilsson, J.E. & Lindgren, T. (2009) Applied Psychology in Sweden: A Brief Report on Its Role, Ambitions, and Limitations In: L.H. Gerstein, P.P. Heppner, S. Ægisdóttir, S-M. A. Leung, K. L. Norsworthy (Hrsg) International Handbook of Cross-Cultural Counseling – Cultural Assumptions and Practices Worldwide.(321-328) Los Angeles: Sage Publications
• Sonnenmoser, M. (2011). Psychotherapie in Europa – Schweden: Psychotherapie wird kaum genutzt. Deutsches Ärzteblatt PP.
• Van Broeck, N. & Lietaer, G. (2008). Psychology and Psychotherapy in Health Care: A Review of Legal Regulations in 17 European Countries. European Psychologist, Vol.13 (1) (53-63)