Psychotherapy in Europe

Michel Meignant. International Journal of Psychotherapy. Abingdon: Jul

1999.Vol.4, Iss. 2; pg. 225, 4 pgs

Abstract (Document Summary)

The conditions for the practice of psychotherapy in Europe vary from one country to
another. There are many psychotherapists who have been adequately trained, but are
neither medical doctors nor psychologists, and do not have the right to practice their
profession legally anymore.

Full Text (1774 words)

Copyright Carfax Publishing Company Jul 1999

Psychotherapy in Europe*

The conditions for the practice of psychotherapy in Europe vary from one country to
another. There are psychotherapists who are free and happy to practise their art in certain
states, notably in Great Britain, Austria and certain countries of Northern and Eastern
Europe. However, other psychotherapists are experiencing a real existential professional
drama, for example in Italy, and it is to be feared that the situation will soon be similar in
Germany. Indeed, since the 1989 law in Italy, the situation has become catastrophic. This
law, voted by the Italian Parliament without preliminary consultation of the professionals
themselveswith the commendable intention of discouraging 'charlatans' or 'quacks'-has
had perverse side effects. It reserves the exclusive rights for the learning and practice of
psychotherapy to physicians and psychologists only. After their medical or psychology
studies, they are supposed to undergo 4 additional years of university studies.

But since the practice of psychotherapy is their exclusive right, in reality they do not
undergo any real training, considering that the 5 or 10 years of study that they have
already been through to obtain their first diploma is largely sufficient.

Furthermore, the many psychotherapists who have been adequately trained, but who are
neither medical doctors nor psychologists, do not have the right to practise their
profession legally anymore. Due to this fact the number of trained psychotherapists who
are practising has considerably diminished and the training institutes are closing down
due to a lack of candidates. One category has lost the right to receive this training, and
the other does not feel the need for it, since their field of practice is their exclusive
privilege anyway.

Exactly the opposite has happened in Austria where, ever since the status and the identity
of psychotherapists and their training have been defined, physicians and psychologists are
receiving proper training. The same has occurred in Great Britain.

In France the situation is mitigated or mixed, since in public institutions the only people
that may be hired are physicians or psychologists, without any specific training in
psychotherapy even being required from them. However, practice with a private clientele
as a liberal profession is absolutely not regulated, anyone being therefore able to set up
shop and to claim to be a psychotherapist.

To remedy this deplorable situation, the French Federation of Psychotherapy is

attempting as a first step to establish a quality certification. This work is being carried out
in collaboration with the AFNOR, the French Standardization Association.

I believe that it would be a mistake to think that this is merely a corporate body or guild
problem, where each category would be struggling to preserve its clientele. I think that
what we have here is a question affecting the liberty and human rights which must prevail
in any democracy.

A democracy is a country where one is allowed to practise freely one's own religion,
proclaim one's philosophical and political ideas, to have an autonomous sexual behaviour,
to be equal in terms of sex or gender, and where each and every citizen should have the
right to follow the form of psychotherapy they have chosen, and each professional should
have the right to choose freely his/her training and practice.

Totalitarian governments do not respect these liberties. Hitler's Nazis persecuted Jews,
homosexuals, gypsies, Free-Masons, psychoanalysts and sexologists. Stalin's communist
regime and that of satellite countries also persecuted the same people, as did Argentinian
generals or the Chilean General Pinochet.

Thus the enactment in Italy in 1989 and soon in Germany, in 1999, of corporatist laws
limiting the practice of psychotherapy solely to physicians and psychologists, seems to
me to be contrary to the Universal Declaration of the Rights of Man. These laws are far
from being unanimously acclaimed in these two countries, but they are imposed both on
to the general public-depriving them of the freedom of choice of the type of care they
desire to receiveand on to professional psychotherapists, preventing them from following
the particular training that they would like to follow, and from practising freely thereafter.

The Spanish Association of Psychotherapists has refused to join the European

Association of Psychotherapy based in Vienna, also wishing to restrict the practice of
psychotherapy to physicians and psychologists.

This reinforces the importance of the European Certificate of Psychotherapy (ECP), for
which we are about to grant the first diplomas. Its development under the leadership of
Emmy van Deurzen and Digby Tantam through the European Association for
Psychotherapy, gathering representatives from Germany, Austria, Belgium, Croatia,
Denmark, France, Ireland, Italy, the Netherlands, Poland, Russia, Serbia, Sweden and
Switzerland, has taken 4 years. The ECP was voted for in Rome one year ago by the
European Association of Psychotherapy with representatives from 29 countries. Its
creation required the definition and the recognition of scientific criteria for the evaluation
of European methods of psychotherapy. Today more than 15 European Organizations
specialized in one given method (European Wide Organizations, or EWOs) have already
been recognized, and others will also receive this accreditation of course.

The first Conference of the World Council for Psychotherapy, which gathered 4000
psychotherapists from some 100 nations in Vienna in July 1996, has proved the scientific
coherence of psychotherapy. A second World Conference will once again bring together
psychotherapists from all over the world in Vienna from the 4th to the 8th of July 1999;
the topic will be `Myth-Dream-Reality'.

Today, during this 8th European Conference, we are therefore going to deal with the
`Social and political dimension' of the practice of psychotherapy. The moment therefore
seems appropriate to solemnly proclaim the rights to psychotherapy.

Historically, the very first Declaration of the Rights of Man and Citizen of 1789, was
voted by the French Constitutive Assembly on 26 August 1789. Inspired by the doctrines
of the philosophers of the Lights (Montesquieu, Diderot, Voltaire and Rousseau), it
comprised 17 articles setting out the `natural and imprescriptible rights' of Man (liberty,
property, equality with respect to the law) and those of the Nation (national sovereignty,
separation of powers: legislative, executive and judiciary).

The Declaration of the Rights of Man and Citizen of 1793 was made up of 35 articles.
Making common happiness the purpose of society, this declaration went far beyond, in
many respects, that of 1789; it considered indeed equality as being the basic natural right,
affirmed the right to be given work, assistance and instruction.

The Declaration of the Rights of Man and Citizen, voted on 10 March 1948 by the United
Nations' General Assembly reaffirmed liberty and equality for all men, despite
abstentions by the USSR, by five `popular democracies', and by Saudi Arabia and the
Republic of South Africa.

These declarations established the principle of freedom of thought, gave permission to

practise freely the religion of one's choice (Catholic, Protestant, Jewish, Muslim, etc.). It
made sure one had the possibility to proclaim one's ideas, whether they be philosophical,
Buddhist, linked to Free-Masonry, etc.

Two centuries after the Declaration of the Rights of Man and Citizen, the Strasbourg
Declaration on 21 October 1990 already asserted:

1. Psychotherapy is an independent scientific discipline, the practice of which amounts to

an independent and free profession.

2. Training in psychotherapy takes place at an advanced, qualified and scientific level.

3. The multiplicity of the methods of psychotherapy is assured and guaranteed.

4. In a process of psychotherapy, training is carried out in full and includes theory, self-
experience and practice under supervision. Adequate knowledge is gained of further
processes of psychotherapy.

5. Access to training is through various preliminary qualifications, in particular in human

and social sciences.

Here is today the Declaration of the Rights to Psychotherapy. I first proposed the idea to
the French Federation of Psychotherapy which, after having shaped it with the help of the
Lawyer Francois Briard, presented it to the Board of the European Association for
Psychotherapy. This is the text which we are going to proclaim symbolically on
Trocadero Square, on the Esplanade of Human Rights (or: `Parvis des Droits de l'Homme'
in French). This year, since our Congress is taking place in France, homeland of the
Rights of Man, the opportunity had to be seized to give life to this new Declaration.
Declaration of rights to psychotherapy

Article 1.

Psychotherapy is a social science, which tends towards the harmonious development of

the human person, and the relief of psychological suffering.

Article 2.

The psychotherapist exercises his/her mission with strict respect for the physical and
mental dignity and integrity of the human person.

He/she lends his/her contribution to social prevention, to the protection of public health
and to the promotion of the citizen's autonomy and responsibility. He/she carries out
his/her mission with dedication, without any distinction nor influence based notably on
sex, race, colour, language, religion, political opinion, national or social origins, minority
membership, fortune, birth or any other situation.

Article 3.

Each and every person has the right to the free choice of a psychotherapist and to free
access to all recognized methods of psychotherapy.

Article 4.

The psychotherapist determines freely, with full respect for the profession's ethical
guidelines, the method of psychotherapy in which he/she intends to train and which
he/she chooses to practise.
Article 5.

The psychotherapist practises his/her art in complete independence. He/she is free of

his/her methods, considering the circumstances submitted to his/her appreciation, without
exposing his/her patient to any unjustified risk.

The freedom to practise psychotherapy cannot be the object of any other restrictions than
those provided for by the law, which are the necessary measures, in a democratic society,
for public health or the protection of the rights and liberties of others.

Article 6.

The psychotherapist must respect professional secrecy, according to the conditions set out
by the law; he/she practises his/her art with full respect for people's lives, liberty and
security.

Article 7.

The psychotherapist receives a specific training, which cannot be replaced by diplomas

from other fields such as medicine, psychology, sociology, philosophy or any other.

Article 8.

Any method of psychotherapy must be based on specific, scientifically validated Social

Science criteria. A recognized method of psychotherapy cannot claim to be superior to
another one.

Article 9.

Each psychotherapy method freely determines the conditions of training, evaluation and
control of its practitioners, in conformity with the general rules which govern the
profession.

Article 10.

When psychotherapy is taken in charge by an institution or a social system, the same

criteria must be applied in the same conditions, to all recognized methods, in order to
give access to all without distinction.

[Footnote]
* Address to the Sth Congress of the EAP, Paris, 24-28 June 1998.

[Author Affiliation]
MICHEL MEIGNANT
President of the European Association for Psychotherapy (EAP) and of the French
Federation of Psychotherapy (FFdP)