Psychoanalytically oriented therapies in the UK the current position. There are two main routes to getting psychotherapy in the UK.

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1 European Psychotherapy/Vol. 10 No european Jan McGregor Hepburn, London Psychoanalytically oriented therapies in the UK the current position A BSTRACT The paper is about the current situation in the UK for psychoanalytically oriented therapies from the perspective of the British Psychoanalytic Council. It describes how treatment is accessed in the UK, and looks at the history of the British psychoanalytic movement generally. It outlines the latest information on statutory regulation, and gives a description of the British Psychoanalytic Council and how it works. Key words: Psychoanalytic,, British, National Health Service, private system. Background & Context As we still do not have statutory regulation, the situation in the UK is rather complex. There are several voluntary registering bodies, of which the British Psychoanalytic Council [BPC] is one. We had been advised that will be regulated by the Health Professions Council, which is essentially a government body which operates independently of the relevant government department [Department of Health]. However, this has very recently changed. There are two main routes to getting in the UK. The National Health Service [NHS] aims to provide whatever treatment is necessary for both physical and psychological ill health, and every region in the UK is covered by a department of. As this is locally organized, treatment options and waiting lists vary considerably. In the past there have been many psychoanalytically trained staff employed in the NHS; in the last 40 years or so there have been other treatment options available, and most recently there have been cuts in NHS provision. However, there is still new financial input into short term treatments. 143

2 european European Psychotherapy/Vol. 10 No For those who can afford to pay, there is a thriving private system. Fees are relatively modest in order to make treatment more widely available, and about 50% of BPC registrants work independently. A few people have private health insurance, and these insurers maintain lists of those registers which they approve as suitable to provide therapists for the insured patient. However, they very rarely, if ever, fund long term work. Statutory Regulation Until February 2011, we had been told both by government and opposition that all the recognized psychotherapies would be statutorily registered with the Health Professions Council [HPC]. However, the new coalition government has now decided that assured voluntary registration will replace this. At present therefore we have little real idea of how this will work in practice; it seems that voluntary registration may still be through the HPC, or could be through the CHRE [Council for Healthcare Regulatory Excellence]. The British Psychoanalytic Council has always supported the principle of statutory regulation, and in this new situation have taken the view that we should encourage all practitioners to be part of any voluntary register. British Psychoanalytic Council The British Psychoanalytic Council have around 1300 registrants who work psychoanalytically, and think that we have most of the intensively [3 x weekly plus] trained psychoanalytic practitioners, and increasing numbers of psychodynamically trained practitioners. We currently register psychoanalysts, Jungian analysts, psychoanalytic and psychodynamic psychotherapists and couples psychoanalytic psychotherapists, and are expanding the categories of registrants further. What follows is the situation with the BPC, and from our perspective. History When Freud came to the UK, there was already a small but thriving psychoanalytic community, and the member institutions which formed the BPC mostly have their roots in this movement. [For further information, see JONES 1957, & RAYNER 1991] In Jungian Analysis the Society of Analytical Psychology (SAP) was set up in 1946 by Michael Fordham and this was followed by the development of the Jungian Analytic Section of the British Association of Psychotherapists (BAP). [For further information see CASEMENT 1995, and SAMUELS 1985] 144

3 European Psychotherapy/Vol. 10 No european Once British Psychoanalysis became established, a particular group formed which was neither wholly Freudian nor wholly Kleinian- the British Independents. [For a thorough exposition of this movement, see KOHON For an overview of Kleinian theory and development in the UK, see HINSHELWOOD 1989]. Historically these institutions never felt that their particular preoccupations and interests had a place in the more general regulators, and left the psychoanalytic and psychodynamic section of the United Kingdom Council for Psychotherapy [UKCP] in 1993 to form the British Confederation of Psychotherapy, later the BPC. Obviously, this was a difficult and divisive process which left some very bad feelings. However, co-operation between all the voluntary registering bodies has been much improved in recent years as we get ready for statutory regulation. BPC Structure The BPC is an umbrella organisation; our members are the training and postgraduate institutions our MIs [Member institutions]. The psychotherapists are our registrants, and they have access to registration through their MI. Each MI has 2 places on BPC council, which elects an Executive. We also have trainee representation on council, and some observer members. The executive includes the officers- Chair, vice chair, registrar, continuing professional development [CPD] chair, treasurer, secretary, chair of ethics and 2 representatives from Council. In addition we have a Chief Executive and 3 other staff in the headquarters. BPC Training Requirements For acceptance on to our trainings we usually require a degree [or equivalent], previous basic training in psychoanalytic theory, and experience of working with patients. The minimum length of the psychoanalytic trainings is 4 years, and 2 years for the psychodynamic trainings, maximum part time. [This means 100 hours per year theory and 100 hours per year clinical.] Most trainings are longer, in practice. The psychoanalytic trainings require 2 cases treated in depth [minimum 3 x weekly] for 2 years and one or one and a half years, and the psychodynamic trainings have 2 cases [minimum 1 x weekly] for 1 year each. The couples trainings have 6 cases. All these cases are intensively supervised weekly. 145

4 european European Psychotherapy/Vol. 10 No All our trainings require personal psychoanalysis/ Jungian analysis/ psychoanalytic which starts before the training, continues for the duration of the training and can only be concluded after graduation. The frequency is at least as often as the training cases are seen. The trainings cover all the major psychoanalytic theorists, and teaching in psychoanalytic practice in the relevant category. In addition there are seminars on cross cultural issues, gender and sexuality, philosophy, religion, and of course psychiatry. For trainees without sufficient psychiatric experience a psychiatric placement is required. Most trainings include a one year infant observation module. Training therapists and supervisors have at least 5 years post qualification experience, and other teachers are senior members of the profession, with expertise in teaching and in the specific topic. All are assessed and appointed by the training organisation. Trainees write about their cases, usually every 6 months, and these reports, together with reports from the supervisors, are considered by the training committee as part of the ongoing assessments of the trainees work. Trainings usually require a longer clinical paper as part of the qualifying process. In order to qualify, trainees have to have completed the course requirements, and be judged by the trainers to be a suitable person to practice independently as a psychotherapist and to have achieved a sufficient standard of competence. Governance and Accreditation All our trainings adhere to the basic requirements, but each has their own distinctive attributes and ways of training, which we value. Each training is run by a local training committee, and has a great deal of autonomy about how they wish to conduct their training within the parameters of the BPC requirements. There is an ongoing programme of re-accreditation undertaken by the Registration Committee of the BPC, which is a panel of senior members appointed by the Registrar in the first instance, and then by consensus of the committee itself. The Registrar is elected by the BPC council. Conclusions In reviewing the current situation in the UK, I think it can well be seen that the different schools of thought within psychoanalysis have been able to retain their individual identity, but that we are able to work together, appreciating both autonomy and co-operation. The majority of our registrants seem to be in favour of statutory regulation, and until recently those in contact with government sources understood that statutory regulation was anyway not optional. 146

5 European Psychotherapy/Vol. 10 No european In view of the changing situation we are aiming to work towards some viable regulatory system which protects the public and improves standards, but which allows for our individual and independent ways of conducting our training and our psychoanalytic work. We think this is possible, and vital. References Casement, A. (1995) A Brief History of Jungian Splits in the United Kingdom. Journal of Analytical Psychology, 40: Hinshelwood, RD (1989) A Dictionary of Kleinian Thought. Free Association Books Jones, E (1957) The Life and Works of Sigmund Freud Vol 3- The Last Phase Hogarth Press Kohon, G- Ed (1986) The British School of Psychoanalysis- the Independent Tradition. Free Association Books. Rayner, E (1991) The Independent Mind in British Psychoanalysis. Free Association Books Samuels, A (1985) Jung and the Post-Jungians. Routledge & Kegan Paul. London The British Psychoanalytic Council: Psychoanalytic Psychotherapists, Psychoanalysts, Jungian Analysts, Couples Psychoanalytic Psychotherapists, Psychodynamic Psychotherapists and Child Psychotherapists Requirements for Membership and Administrative Procedures 1 The Structure of Institutions 1.1 In order to be eligible to become a Full Member of the BPC, an organisation must have been formed for a period of not less than 5 years. 1.2 The stated aims of the organisation must be judged by the BPC to be compatible with its own aims. 1.3 Any organisation considering an application for Full Membership of the BPC should have not less than 20 members of its own who are fully qualified couples psychoanalytic psychotherapists. 1.4 All organisations must show evidence that they are governed by Rules or a Constitution that is compatible with that of the BPC. 1.5 The Council of the BPC may consider applications for Affiliate Membership from psychoanalytic institutions not yet able to fulfill the criteria for Full Member status of the BPC. (For a description of the conditions governing such applications see Article 5 of the Constitution of the BPC.) 147

6 european European Psychotherapy/Vol. 10 No No organisation shall be eligible to be a member of the BPC unless it is able to give an undertaking that it is able to select trainees free from considerations that may require the lowering of its standards for selection, training or subsequent professional association in order to meet financial or other targets. 1.7 All institutions must be able to accept and abide by the BPCs Single Member Policy (see the attached statement of the policy). 2 Standards for Training & Professional Association 2.1 Selection of trainees Whilst personal suitability is of paramount importance, a sufficient range of other conditions must be satisfied for applicants to be selected for training as couples psychoanalytic psychotherapists Applicants should hold a degree either in medicine, psychology, the social sciences or an equivalent degree or professional qualification They should have had previous clinical experience or have carried out other responsibilities for the development or welfare of individuals Trainees should have had an appropriate experience with patients in psychiatric in-patient care. If such experience does not pre-date admission to the training, it must be a required element in the candidate's subsequent course All trainees must have been in personal therapy at a frequency of not less than three times weekly, and preferably more frequently, with a BPC registered therapist approved by the organization concerned, for at least one year before being eligible to proceed to the full status of trainee psychoanalyst, psychoanalytic psychotherapist, Jungian analyst, child psychotherapist or couples psychoanalytic psychotherapist. All trainees for psychodynamic training must have been in personal therapy at a frequency of not less than the frequency of the training [once or twice weekly] and preferably three times weekly or more frequently, with a BPC registered therapist approved by the organization concerned, for at least one year before being eligible to proceed to the full status of trainee Organizations should expect that trainees shall have had a sufficient amount of experience of working in the field with other professionals prior to the start of their training as couples psychoanalytic psychotherapists. When a candidate lacks such experience, organizations must require that they gain it during their training. 2.2 Length of training No training in psychoanalysis, Jungian analysis and psychoanalytic is expected to last for less than four years, maximum-part-time. 148

7 European Psychotherapy/Vol. 10 No european Training in psychodynamic should last for a minimum of 200 hours, over not less than 2 years. 2.3 Frequency and duration of personal A candidate's personal / psychoanalysis must be conducted over the entire period of his or her training and at a frequency of not less than three times a week, and preferably at a greater frequency A trainees in psychodynamic training must be in personal therapy at a frequency of not less than the frequency of the training [once or twice weekly] and preferably three times weekly or more frequently, with a BPC registered training therapist. 2.4 Qualification of training analysts/psychotherapists and supervisors It is expected that those who conduct the personal psychotherapies of trainees in training or who provide the supervision of training cases must be experienced BPC registered psycho-analysts, Jungian analysts or psychoanalytic psychotherapists of at least five years post-qualification experience. The organization should have in place a procedure allowing it to verify that the experience of the psychoanalyst/psychotherapist concerned is of a satisfactory standard Other work which may be part of the training, e.g. couple, family or brief psychoanalytic, should be supervised by those psychoanalytic psychotherapists who are judged to be competent to carry out such supervision by the institution concerned. 2.5 Number of cases to be seen in the core component of the training The core component of all psychoanalytic trainings must comprise the treatment of no less than two cases, one of each sex, under supervision. Where appropriate, all trainings should require therapy with additional cases, sometimes at lesser frequencies and, when suitable, in differing contexts e.g. marital, family and group settings. The core component of all couples psychoanalytic trainings must comprise the treatment of no less than six couples, under supervision. The core component of all psychodynamic trainings must comprise the treatment of no 2 cases, one of either sex, for not less than one year each, under supervision. 2.6 Training in diagnosis and assessment Essential to any clinical course must be the training of trainees in diagnostic and assessment work with patients. Either an organisation has evidence that a candidate 149

8 european European Psychotherapy/Vol. 10 No is appropriately trained in this respect prior to his or her selection for training, or, the organisation must provide that component of training and make its satisfactory completion compulsory for qualification. 2.7 Frequency of sessions and duration of treatment of core component cases Individual cases seen 3 x weekly or more [psychoanalytic, Jungian analysis, psychoanalysis] Each of the two cases, one of each sex *, must be treated at a frequency of not less than three times weekly, one for a period of not less than two years, the other for not less than 18 months. [exception may be made to this for a 5 x weekly training, where the patient is also seen 5x weekly] Frequency of sessions and duration of treatment of core component couple cases. 2 couples for a minimum of 18 months, and 4 couples for a minimum of one year, seen weekly Individual cases seen once or twice weekly [psychodynamic ] Each of the 2 cases, one of either sex *, must be treated for a minimum of 1 year * Please see guidance notes Gender of Training Cases of March Training Institutions must have a system for clinical responsibility for trainees raining cases, and a written procedure which has been accepted by BPC. Please see guidance notes Clinical Responsibility of March Frequency of supervision All individual 3 x weekly therapeutic work must be supervised once weekly, individually each case with a separate supervisor. 1 x weekly or 2x weekly individual therapeutic work may be supervised in small group supervision [max 3], weekly. However, individual supervision is strongly recommended. For couples, all therapeutic work must be supervised once weekly Supervision of training cases must continue at the same frequency until the trainee graduates, or until the case is finished if this is before qualification. [see for definition of qualification] 2.9 Academic training requirements Training institutions must provide a full range of lectures and seminars covering all clinical, theoretical and technical aspects of the training. Attendance at these components of the course should be compulsory, and be of a duration of not less than three years for couples psychoanalytic psychotherapists, psy- 150

9 European Psychotherapy/Vol. 10 No european choanalytic psychotherapists, Jungian analysts and psychoanalysts, and of not less than 2 years for psychodynamic psychotherapists. Encouragement for research and publication must be given to trainees Once the formal lecture programme had been successfully completed, trainees must continue in clinical seminars weekly until qualification. [The equivalent hours to weekly clinical seminars can be used but this should be in exceptional circumstances] Training Institutions must appoint an External Examiner, and have written procedures for their appointment, and outlining their role Assessment of trainees Of progress during training All courses must monitor the progress of trainees closely. Trainees should not be permitted to proceed to a more advanced level of their training until they are judged to have completed the earlier stages satisfactorily. A formal review of a trainees progress should occur at least annually For qualification In order to become qualified, a trainee must have completed all the required components of his or her training. In order for this judgment to be made, the Training Committee of the organisation involved, meeting in formal session, must agree to it and thereafter inform the trainee in writing, which formally confers qualification Post-qualification professional life All organisations must have a post graduate organization, and must provide, or else must be formally linked to organisations which will provide, a scientific and professional association for trainees once they have qualified Opportunities for further training Training institutes must provide opportunities for further training so that qualified associates can proceed to Full Membership of the organisation concerned, or else address the need of its members for their continuing education Complaints from trainees about Training Institution All Training Institutions should have a written procedure for making any complaints, formal or informal, which should be given to the trainee Trainees should follow BPC procedure and may contact the BPC Ethics Committee formally or informally if they have concerns about their training. Please see article 7, below. 151

10 european European Psychotherapy/Vol. 10 No Application by an Institution for full Membership of the BPC 3.1 Nothing in the following description of the administrative procedure governing an application for Full Membership can take precedence over the requirements for Full Membership as set out in Article 4 of the Constitution. 3.2 Any psychoanalytic organisation having read the Constitution and the Guidelines for Membership and Administrative Procedures of the BPC may apply for Full Membership. 3.3 All applications for Full Membership must be sent to the Registrar of the BPC. 3.4 Applications for Full Membership must be accompanied by all the relevant documents from the applicant institution in support of its application. 3.5 All applications will be assessed by the Registration Committee. The Committee will ask the applicant institute for the further information required. 3.6 Having collected all the relevant information, and having formed a view as to the appropriateness of the application, the Registrar will present the application to a meeting of the Executive of the BPC. 3.7 Should the Executive decide that, in order to form a view, it needs further information, it can request it from the applicant institution. A meeting, or meetings may be arranged by the Chairman between members of the Executive and the relevant officers of the applicant institution for any further clarification of the application should that be necessary. 3.8 Once the Executive Committee is satisfied that it has the required information to form a judgment about the application, it will make a presentation of the application to a meeting of the Council of the BPC. 3.9 Should the Council not be satisfied that it has the information that will enable it to assess the application, it may instruct its Executive to continue the investigation and re-present the application As provided for in the Constitution, only the Council of the BPC has the authority to confer or deny an applicant institution membership of the BPC. Once the decision has been taken, it will be conveyed to the applicant institution in writing by the Chairman of the Council Should an applicant institution be denied Full Membership, that institution will not be able to make another application within the next six months If, within a period of seven years, an institution has been refused Full Membership on three separate occasions, no further applications can be received from it for a further five years Once accepted for Full Membership, an institution will have a place on the Council of the BPC. It will be able to play a full part in the work of the BPC and its continuing membership will thereafter be determined by its capacity to go on meeting all its obligations for membership described in the Constitution and the Guidelines for 152

11 European Psychotherapy/Vol. 10 No european Membership and Administrative Procedures of the BPC Once institutions become member organizations, they agree to fully participate and co-operate with the Registration Committee in regular re-accreditation processes at a frequency decided by the Registration Committee. 4 Registration Procedures 4.1 Admission to Full Membership of The Council of the Institutions of the BPC entitles member institutions to submit the names of all their members for inclusion under the appropriate title in the Register of the BPC. 4.2 Full, Associate, Student and Honorary Members of the Full Member Institutions of the BPC may appear in the list of an institution for the purpose of registration. 4.3 In the first instance, the lists from Full Member Institutions of those entitled to be registered must be sent to the Registrar of the BPC. Thereafter the BPC Administrator must be informed promptly of all alterations to a Member Institution s membership list that may affect the Register of the BPC. 4.4 Should the Registration Committee require further guidance concerning the registration list, or any individual on it, it can request clarification from the member institution concerned. 4.5 It will be the duty of the CEO to maintain the Register and ensure that it is up-to-date and accurate. Should difficulties arise, the CEO must take the matter to the Chairman of the CPD committee for discussion. Further clarification and discussion, if needed, should be taken with the Executive, and final decisions will be taken by Council. 4.6 Member Institutions must have a written procedure of how graduates can become registrants. Member institutions may accept registrants who have not trained with them, but must ensure that any such registrant meets the BPC standards of training and experience. Please see document Equivalence for MIs of Feb Principles Governing the Presentation of the Register 5.1 For the information that it will provide for the public, the register must represent the BPC perception of the training and qualification of the registrants so that its practitioners can be distinguished clearly from other, non-bpc, practitioners. 5.2 A further aim is to make clear to the public, by the way in which the Register is drawn up, the different distinguishing titles and the institutions that hold them, that refer to the members of the institutions of the BPC itself. 5.3 As a general rule, the titles used to distinguish practitioners should be those that appear in the titles and documents of member institutions as they will be the titles by which members of the institution concerned are known in the wider profession and by the public. 153

12 european European Psychotherapy/Vol. 10 No If there are sufficiently compelling grounds for suggesting that an institution should use a title in the Register that is not its formal title, then it should be expected that it should use the title that describes its essential character. The third choice might be that the institution use its informal title, or the title by which it may be known popularly if it has one. 5.5 Whenever possible, entries in the Register ought to be represented in a uniform way. Where that aim conflicts with the wish of a member institution to present itself and its members in an appropriate way, every reasonable attempt should be made to accommodate the institution concerned rather than to insist on uniformity under all circumstances. 5.6 The way in which an institution wishes to represent itself on the Register should not limit the manner in which another institution can present itself in an appropriate way in terms of its own title. 5.7 In addition to the distinction between practitioners trained in child, couple and adult psychoanalytic, there should be four categories of entry on the Register An Alphabetical List of the practitioner members of all Full Member Institutions An alphabetical list which classifies practitioners according to geographical location of practice(s) A list of those BPC practitioners competent to conduct clinical work in one or more of a number of foreign languages the names of those concerned to be listed in alphabetical order under the heading of each language A list of institutions and their members under their professional titles together with other appropriate formal descriptions. (In order to make the required distinction, the title: Psychoanalytic Psychotherapists of the London Centre for Psychotherapy should appear in this form as an extended title in this part of the Register.) In the Alphabetical List of Practitioner Members of all Full Member Institutions, those listed should have the right to have included a range of information. 5.8 In the Alphabetical List of Practitioner Members of all Full Member Institutions, those listed should have the right to have included a range of information Surname, followed by a first name and/or initial(s) Personal title e.g. Mr., Miss, Ms., Mrs., Dr., Dr (Ph D) Evidence of membership of a related publicly recognised professional register e.g. FRC.Psych., C. Clin.Psychol A member's professional title The name of the institution(s) through which the individual practitioner member has a right to register. If an individual member belongs to more than one Full Member Institution, the full name or abbreviated reference to those insti- 154

13 European Psychotherapy/Vol. 10 No european tutions should be recorded in is or her entry Consulting room address(es) together with telephone and fax. number(s), and addresses, if desired A public institution address together with public appointment title, telephone and fax number. 5.9 Where institutions offer particular facilities, e.g. a Reduced Fee Clinic, mention may be made at an appropriate point in the Register The BPC can levy a charge for the cost of the registration of each member appearing on the register to that member's organisation. Some members are likely to have more than one entry on the register if they are qualified to work with adults as well as children and adolescents or couples, and if they are members of more than one of the constituent institutions of the BPC. For the purpose of the BPC s charge to institutions for the registration of their members, institutions whose members belong to more than one body will be charged according to the institution that appears first on the following list thus ensuring that only one institution will be charged for each member registered. 1 The British Psychoanalytical Society 2 The Society of Analytical Psychology 3 The British Association of Psychotherapists 4 The Lincoln Clinic and Institute for Psychotherapy 5 London Centre for Psychotherapy 6 North of England Association of Psychoanalytic Psychotherapists 7 The Northern Ireland Association for the Study of Psychoanalysis 8 The Scottish Association of Psychoanalytic Psychotherapists and the Scottish Institute of Human Relations 9 The Severnside Institute for Psychotherapy 10 The Tavistock Clinic and The Tavistock Society of Psychotherapists 11 wpf Therapy / The Foundation for Psychotherapy and Counselling Psychoanalytic Psychotherapy Section 12 British Society of Couple Psychotherapists and Counsellors 6 Codes of Ethics 6.1 The minimal requirement for an organisation s Code of Ethics is set out under Article 6 of the Constitution of the BPC. 6.2 All Member Institutions must agree to the BPC investigating, and hearing if necessary, all complaints made about their registrants, and any other ethical matters involving them or any of their registrants. This agreement should be formally passed by the Member Institution at their AGM, and a copy sent to BPC. 155

14 european European Psychotherapy/Vol. 10 No All Member Institutions will agree to pass on to BPC Ethics Committee any matters of ethical concern, or any complaints received. 6.3 The BPC Ethics Committee shall put any such complaints or enquiries before any of their sub-committees which they see as congruent to conducting a proper enquiry into such matters. 6.4 Should the BPC Ethics Committee consider that a matter should be referred back to the Member Institution, the Member Institution will agree to take appropriate action. 6.5 Should the Ethics Committee decided on any sanction[s], the Member Institution will agree to put these into operation. 7 Review of the Constitution 7.1While changes to the Constitution and the Guidelines for Membership and the Administrative Procedures may occur as set out under Articles 11 and 17 of the Constitution at any time decided by the Council, the Council shall have the duty to assess the adequacy of the Constitution within four years of its adoption. Q UESTIONNAIRE Which qualification is necessary to enter training? Must show ability to study at post graduate level, and be fluent in English. Is a university degree obligatory? If so, what subject(s)? No. Is a university degree in psychology a possible or mandatory requirement for the training? Possible but not mandatory. Is a university degree in medicine a possible or mandatory requirement for the training? Possible but not mandatory. Which directions in and methods of are approved? As is an unregulated profession, it is not possible to answer this question directly. Publicly funded methods are marked P ( ) psychodynamic P ( ) psychoanalysis ( ) behavioral therapy P ( ) person-centered therapy by Carl Rogers ( ) gestalt therapy 156

15 European Psychotherapy/Vol. 10 No european ( ) systemic therapy P ( ) hypnotherapy ( ) pesso therapy PBSP How many hours of theoretical lessons are part of the training? It varies according to the method and the training. Probably not less than 200 hours, and often much more. How many hours of self-awareness or training analysis are part of the training? It varies according to the method and the training. Some methods do not require personal therapy at all. Psychoanalytic therapies require around 700 as a minimum. Psychodynamic therapies could be much less- around 150- but rarely are. How many hours of therapy (as a therapist) are part of the training? Psychoanalytic therapies require 460 as a minimum. Psychodynamic therapies require around 150. How many hours of supervision are part of the training? Psychoanalytic therapies require 150 as a minimum. Psychodynamic therapies require around 100. How many months of practice in a psychiatric clinic are part of the training? Trainees do a psychiatric placement if they do not have sufficient experience of working with patients who have psychiatric problems. The placement is usually weekly for a year. How many months of practice in a psychosomatic clinic or surgery are part of the training? None specifically How many years does the training take at least? Psychoanalytic therapies require 4 years, psychodynamic therapies require 2 years. Are the final examinations oral or written? Usually both Which certificate including which authorizations are granted with the final examinations? The training Institution awards the certificate, and informs the central council so that the graduate can be on the register Is covered by health insurance? How many hours of for each patient are covered by health insurance? 157

16 european European Psychotherapy/Vol. 10 No It can be offered in the publicly funded health service [NHS], and arrangements differ locally. Some places are still able to offer open ended treatment where indicated, others have to work to a time limited model. Most providers in practice do a mixture of both. For those patients who have private health insurance, [very few], there is a strict limit on the number of hours paid for; the exact number varies according to the insurer and what is clinically indicated. What qualification is needed to be a training instructor? I can only answer this for psychoanalytic and psychodynamic therapies. Usually teachers need to have a registered qualification in psychoanalytic, 5 years post qualification experience and expertise in the topic being taught. The training organisations all have an assessment system for appointing trainers. What qualification is needed to be a supervisor? I can only answer this for psychoanalytic and psychodynamic therapies. Usually supervisors need to have a registered qualification in psychoanalytic and 5 years post qualification experience. The training organisations all have an assessment system for appointing supervisors. What qualification is needed to be a self-awareness instructor? I can only answer this for psychoanalytic and psychodynamic therapies. Usually these people [called training therapists] need to have a registered qualification in psychoanalytic and 5 years post qualification experience. The training organisations all have an assessment system for appointing training therapists. Are there certifications for training institutes? What requirements have to be fulfilled? I can only answer this for psychoanalytic and psychodynamic therapies. Trainings apply to the British Psychoanalytic Council for accreditation, and have to fulfill our requirements. They are then assessed by the Registration Committee. Once registered, trainings undergo a regular re accreditation process. Is there a governmental curriculum for training? Would it be possible for us to get this curriculum? No. The British Psychoanalytic Council have requirements of their training organizations, which are attached. The content of any curriculum is assessed at accreditation and re accreditation, but training organisations have flexibility about exactly which psychoanalytic theorists they teach. 158

17 European Psychotherapy/Vol. 10 No european Are there any national associations? Would you be so kind to give us their addresses? British Psychoanalytic Council, Suite 7, Wedmore Street, London N19 4RU There are many other national institutions which I do not have addresses for, and may not know about. They include United Kingdom Council for Psychotherapy British Association for Counselling and Psychotherapy Which governmental department is responsible for and training? Would you be so kind to give us its address? As we do not have statutory regulation, there is no government department responsible for training. The Department of Health is responsible for the provision of all health services, which would include publicly funded. However, I should think at least 80% of is privately funded and not therefore under any government control or overview. Jan McGregor Hepburn is a psychoanalytic psychotherapist in private practice, and Registrar of the British Psychoanalytic Council. Correspondence address: Jan McGregor Hepburn Post Office Cottage, Station Bank, Mickley Northumberland NE437AU (consulting room) and Unit 7, Wedmore Street London N19 (BPC) Phone (CR) & (BPC) janhep@gmail.com 159

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