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Je wordt uitgenodigd om plaats te nemen in het vliegtuig naar je favoriete bestemming.
Je wordt ook geïnformeerd dat de piloot een afgestudeerd ingenieur is maar zonder pilotenopleiding. Zou je plaats nemen?
We weten dat de ingenieur een grondige kennis heeft van het vliegtuig maar niet in staat is om het vliegtuig te besturen. Mensen vertrouwen op de piloot die een grondige opleiding heeft genoten om het vliegtuig te besturen en mensen veilig naar hun bestemming te brengen.
Zou je omgekeerd eisen dat een piloot een diploma ingenieur heeft?
Pilots have diverse backgrounds and most are not engineers.
The engineer represents knowledge and the pilot represents skills (and required knowledge). With this knowledge, the engineer is able to design and build the aircraft, however, not to fly it himself.
I further note that the pilot’s prior training is of little relevance.
Pilot training is – in itself – ample in quality to form skilled pilots who thereby take responsibility for the safety of hundreds of people.
This precisely illustrates the distinction between knowledge and skills.
What do pilots and psychotherapists have in common?
Let us compare for a moment the psychologist (engineer) and the psychotherapist (pilot).
So what about the psychologist and the psychotherapist? The government organizes consultation reimbursement for the primary care psychologist based on the diploma. A psychologist may just start a therapeutic conversation.
At no time was it verified that it had the necessary skills. The 2016 law does provide that as a psychologist, physician or psychiatrist, one must also have (4-year) therapist training, however, in practice there is often little evidence of this. Only for starting therapist training is the new criterion applied.
So what makes the government organize reimbursements for primary care psychologists and not psychotherapists?
Reimbursements for front-line psychologists
Reimbursements are made to front-line psychologists.
This, according to the 2016 law, would mean that psychologists without therapist training would only be allowed to do some sort of “intake”!?
Or is the solution a special training that prepares you to become a primary care psychologist? Where are the psychotherapeutic knowledge and skills?
Just try it with the most vulnerable in our society who come for help. This is apparently the position taken by the interest groups and our government here.
The term primary care psychologist is foreign in this.
It is as if the engineer with no flying experience, but with a special explanation of “how to fly an airplane” may just try the airplane.
Much greater cooperation between medics, psychologists and psychotherapists is very necessary and thus welcome. However, pushing everything under medicalization does not bring the appropriate help!
Wat met de opleiding?
In parallel met de piloot is het belangrijk dat de psychotherapeut een kwalitatief hoogstaande vaardigheidstraining geniet. Een opleiding die dus voorziet in de benodigde kennis én een zeer ruime focus op vaardigheden. Deze zou toegankelijk moeten zijn voor eenieder die hieraan wenst deel te nemen. Dat een psychologenopleiding een stevige aanvangsbasis is staat buiten kijf en kan alleen maar aangemoedigd worden. Echter de opleiding voor psychotherapeuten moet voldoende kwalitatief zijn om enkel de ‘bekwame’ psychotherapeuten te laten slagen.
Psychotherapeuten die bekwaam zijn en verantwoordelijkheid nemen om hun cliënten/patiënten te begeleiden.
A closer look yields interesting questions. Pilot training is not organized by a university. A university stands for “knowledge. Pilot training is organized by organizations recognized for this purpose with instructors who have knowledge and skills.
Similarly, Belgium makes another strange quip regarding psychotherapists. Organizations offering psychotherapy training must have a partnership with a university or college. People apparently see this as a kind of quality guarantee. Without detracting from the universities and colleges, this is again only knowledge-based.
One can only conclude that this is the result of biased thinking by some interest groups such as the psychologists’ association, among others.
The real sticking point is that there are no formalized criteria for psychotherapist training that are based on studies that demonstrate exactly what makes psychotherapy training effective.
So what are solid solutions that guarantee quality in psychotherapy?
On the one hand, a thorough training curriculum and evaluation criteria should be established for psychotherapist training. This based on studies that are conclusive about the effectiveness of psychotherapeutic counseling. So in addition to the necessary knowledge (not the entire psychologist training) the necessary skills, ability for self-reflection, communication, self-knowledge and other traits that are indispensable.
On the other hand, monitoring quality is an important part. A pilot in office is thoroughly evaluated on a regular basis. Failure to pass these interim evaluations will result in appropriate action and possible revocation of the pilot’s license.
Currently, quality follow-up for psychotherapists exists only in indirect ways, such as a follow-up of the number of hours of continuing education, supervisions done, membership in a professional association.
However, these are process-related issues that have a weak correlation with quality as an outcome.
Although answering “what is quality” and “how” does the psychotherapist demonstrate it, in a therapeutic setting is not evident. There should be a proper debate on this to come up with effective proposals.
Psychotherapist as a full-fledged profession
Psychotherapy must be recognized as a profession in its own right. Not as a “skill” linked to psychology or (much less) as a purely medical event.
For this, it is necessary:
- Psychotherapy to be recognized as a full profession
- Establish training and evaluation criteria for this course
- Based on success criteria for psychotherapeutic counseling
- Specializations with emphasis on current currents
- Addressing all currents
(from pre-paradigmatic to paradigmatic = integration) - Decoupling of universities and colleges
- Determining full-fledged quality criteria
- Establish admission criteria
- The more diversification regarding professional background the better
Reflectie
Als antwoord op de oorspronkelijke vraag, ‘wat hebben piloten en psychotherapeuten met elkaar gemeen?’ kunnen we enkel besluiten:
Zoals psychologen mensen mogen begeleiden in een psychotherapeutische begeleiding mogen ingenieurs zonder meer gewoon een vliegtuig besturen.
Dit is dan ook een oproep aan onze overheid om het op deze wijze te benaderen.
Er is te veel aandacht geschonken aan de hardst roepende belangenverenigingen en te weinig aan vaardigheden en kwaliteit.
Als observator stel ik in deze vast dat de vertegenwoordigers van de beroepsgroepen (psychologen, artsen, psychiaters, overheid, anderen) wel over een degelijk diploma beschikken en dus de gepaste kennis hebben vergaard.
Echter uit de beslissingen die zijn genomen met betrekking tot de psychotherapie kan men niet anders besluiten dat kennis vergaren en deze dus ook begrijpen(?) niet hetzelfde is als deze toe te kunnen passen.
Enkel het persoonlijk belang en in het beste geval de belangen van de beroepsgroepen worden vervuld. De cliënt/patiënt verliest men hierbij volledig uit het oog.
Let this healthy critical eye inspire us to do the right things. The path indicated by the professional associations of psychologists, physicians and psychiatrists can only be explained from an overly defensive and personal interest defense.
This one puts the quality of current psychotherapeutic services anything but first.
Together towards a more correct world!