Postgraduate Training Courses in Treatment of Eating Disorders in Austria Günther Rathner Innsbruck Medical University Innsbruck, Austria guenther.rathner@uibk.ac.at Paper presented at ECED Innsbruck 2005, 9th General Meeting of the European Council on Eating Disorders, Innsbruck, September 7-9, 2005 Special Session: Eating Disorders Training Courses (for Professionals) in Europe www.eced-innsbruck2005.at www.netzwerk-essstoerungen.at www.oeges.or.at Background The quality and accessibility of eating disorders (ED) programs and services is not equal around the world. The same is true for professional s qualification and training. In Austria, Germany, and Switzerland (as in many other countries) no special or additional qualifications are required for mental health professionals to practice in the field of ED. Thus, each mental health professional can claim to be a specialist into ED. 1
Six basic ideas for the Course developed since 1997 In our professional life we can only treat a limited number of sufferers. Thus, supervision, consultation & training is useful to pass on ideas and expertise to colleagues. Multi-disciplinary trainer staff & multi-disciplinary trainees (all mental health professions involved in early detection, diagnosis & treatment of ED). No single trainer course : I would not give a course only by myself. Include not only German speaking trainers, but international experts into ED. Thus, it must be a bilingual course (German & English). Trainees should get to know the persons behind the publications. The training should not be a crash course, but of longer duration to enhance continuity, process & change and to foster continuous supervision & learning. Life consultations of all trainers as highlight of teaching. The first training course started in 2000. Diagnostic criteria The weight continuum in the population, weight standards for children, adolescents & adults Epidemiology Risk factors, high-risk groups Guidelines for treatment First contact with sufferers & carers Ambivalence, denial & motivation Course content (1) Which treatment is best? Treatment pyramide, stepped-care approach Somatic aspects, emergencies How to change ED symptoms? Pharmacological treatments Binge eating disorder (BED) 2
Course content (2) Specific problems in treatment Aims of treatment, how to deal with chronic cases? Denial & resistance : pro/con compulsory treatment developmental aspects Self-help & stepped-care approach Males & ED Role & impact of families, relatives & partners Family therapy & couples therapy Course, outcome & prognosis Prevention: high-risk vs. population-based approach Basics of diagnosis & treatment of obesity. Who attends? (Clinical) Psychologists (in training or certified) Psychotherapists (in training or certified) Medical doctors (GP s, registrars, consultants) Dieticians Counsellors et al. Postgraduate course: a minimum of two years of professional experience is required. The bilingual training is held in German & English (according to trainers). Open to trainees from all German speaking countries; for other countries, knowledge of German is necessary. 3
Trainer Staff Courses led by Günther Rathner (A) e.g. Gerald Russell (UK) Ulrike Schmidt (UK) Bob Palmer (UK) Walter Vandereycken (Belgium) Martina de Zwaan (A, D) Andreas Karwautz (A) Duration & group size The whole course consists of 200 training hours over 18 months. Two course days (Friday to Saturday) about once a month in Salzburg; in total 24 teaching days. Trainee group size about 20-25. Closed group from the start till the end. Attendance is obligatory (some missing hours allowed). 4
Exams Written examanination (multiple choice & open questions). Oral examination. Written thesis. Course Approval by Austrian Psychotherapy Board (ÖBVP) Austrian Medical Board (ÖÄK) Austrian Psychological Association (BÖP) Austrian Dieticians Association Austrian Society on Eating Disorders (ÖGES/ASED) Trainees from Germany & Switzerland have to apply for approval at their respective national boards. 5
Difficulties & highlights This is the first German language postgraduate training into treatment of ED, also the first focused on a specific diagnostic group of mental disorders. It runs since 2000. Thus, getting approval by the respective professional boards took plenty of time, although considered necessary for trainees. Highlights: The life-consultations done by different trainers with different styles with sufferers, couples & families showed up as the salt in the soup. Conclusions 1. Multi-disciplinary & 2. postgraduate training course 3. with international trainer staff 4. no narrow-minded focus on one or two psychotherapy methods, but oriented towards a unified psychotherapy, integrating different psychotherapy schools & methods ( trans- ) 5. process-oriented learning & training. 6