Poland

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Most counselling services in Poland are practiced by psychotherapists of various theoretical orientations.

But how many psychotherapists there are in Poland is unknown, since the term “psychotherapist” is not protected and the professionals are not registered. The majority of psychotherapists with academic training are physicians (medicine) , especially psychiatrists, while psychologists are in the minority.

Intensive works have been carried out in Poland in the lawgoverning psychotherapy as a profession. The law is being prepared by the Ministry of Health in consultation with Polish psychotherapeutic associations. The law is to safeguard the patients rights and regulate the qualifications of psychotherapists. The postgraduate training courses are to be run by the Psychotherapy Association whose members are obliged to conform to codes of ethics.

Since consistent legally prescribed training standards do not yet exist, at least the specialist psychotherapeutic societies ensure a certain level of quality assurance.

They offer psychotheapy training, define the training content and award certificates that serve as proof of minimum standards. So far, each professional society follows its own rules and decides for itself who is admitted to the training. The training content, requirements and duration are also extremely heterogeneous.

Psychotherapy is covered not only by the statutory health insurance but also private health insurance. Private practice psychotherapy is becoming more and more popular when patients have to pay, but they can choose their therapist and have no limitations on the number of sessions. But for Polish patients, it is difficult to find their way around the diversity and to distinguish serious from dubious providers.

Psychotherapists in Poland do not have a secure legal status. In recent years, various draft laws, as well as a legislative amendment, have been sought. However, the project has failed. Among other things, the aim is to become a pendant to the German Psychotherapists Act.

Moreover, polish psychotherapists have currently no chambers, but form associations specific to different approaches to psychotherapy. However only three of such associations are officially recognized by the National Health Fund: The Association of psychologists, the Association of Psychiatrists (both representing integrative psychotherapy) and the Polish Association of Cognitive-Behavioral therapy.

Already organized courses involve four year studies, involving 1200 hrs. of formal education, internship, clinical work under supervision as well as own psychotherapy experience. The courses are open to any person with humanistic or scientific degree. The law is to allow a variety of recommended approaches to be practiced (not finally decided as yet). It is hoped to regulate that the most efficient methods of psychotherapy are used and evidence based practice is promoted.

Psychotherapy is recommended for adjustment-, affective-, anxiety-, eating-, sexual-, sleep-, personality-, psychotic- and somatic disorders as well as behavioral and emotional disorders in children and adolescents. Inpatient care for persons with mental disorder is offered by psychiatric hospitals and rehabilitation centers.

Challenges:

For polish patients, it is difficult to find their way around the diversity and to distinguish serious from dubious providers.

The most important task for the future is to introduce the law governing the psychotherapy. A reform of the regulation system should lead to:

• the reduction of the presence of unprofessional therapists
• replacing it with evidence-based approaches
• it would improve access to recognized psychotherapy services and
• it may result in reducing of the high amount of drugs taken.

Trends:

Psychotherapy is covered not only by the statutory health insurance but also private health insurance. Private practice psychotherapy is becoming more and more popular when patients must pay, but they can choose their therapist and have no limitations on the number of sessions.

New more proactive approaches to psychotherapy are becoming popular and recognized, such as cognitive-behavioral therapy or motivational enhancement therapy. Such approaches not only deal with patient’s weakness but build a patient’s strengths, self-esteem and self-efficacy.