Master’s Graduates as State-Licensed Psychotherapists, Both a Challenge and an Opportunity: Practical University Teaching Concepts in Clinical Psychology

Psychotherapeutic training in Germany is about to be changed soon: master’s graduates in clinical psychology will be able to become state-licensed psychotherapists. It is therefore mandatory to teach basic psychotherapeutic skills at the universities. This article presents examples of application-oriented courses in clinical psychology, which have been tried and tested at the Philipps University of Marburg for years. During the practical exercises “Interventions in practice 1 and 2“, students gain initial experiences with psychotherapeutic techniques on personally relevant problems. In the case seminar, the students apply their acquired skills to treat an actual outpatient case, while translating basic psychological knowledge into an individualized treatment plan. The seminar “Different approaches to psychotherapy in practice“ offers the opportunity to explore 6 different patients coming from a variety of treatment settings. The courses are evaluated regularly. An overview of cumulated evaluations shows a high degree of student satisfaction with the course concepts. The described courses meet several requirements of the new licensing regulations, especially regarding job-qualifying and self-reflection. Necessary adjustments and additional requirements are discussed, and possible solutions are presented accordingly. If the licensing regulations are implemented as demanded, receiving a state license after the master’s degree seems justified.

Neurologist and Psychoanalyst, 40 years’ experience, Germany

This chapter details the experience of a Neurologist who had only just started to train as a Psychotherapist and Psychoanalyst. At this time, there was no established knowledge, let alone evidence-based guidelines, for the treatment of patients with Non-Epileptic Seizures or for their psychotherapeutic treatment. The Neurologist’s psychotherapeutic training familiarized him with a way of perceiving conversations not commonly encountered in Neurology. The Neurologist further realized that, apart from serving to transmit information, conversations can also be a stage on which established ways of relating to others are re-enacted (transference), and that the clinician can learn to access his own resonant or dissonant affective reaction to this through introspection (countertransference), thereby gaining personal insights into relationships patients have previously experienced themselves. These processes allow a person engaged in conversation to absorb potentially challenging affects, detoxify them, and present them, in a processed form, to the patient by offering so-called interpretations.

Theoretical Considerations on the Way to Becoming a Psychotherapist

This paper aims to recount a shared experience of some psychology students – an intellectual adventure of exploring one’s own approach towards human relations and nature on the way to becoming a psychotherapist. To become practitioners, the students need to choose a certain psychotherapeutic training based on one of the main psychotherapeutic theoretical approaches. The following are mentioned in this paper: psychoanalysis, cognitivebehavioral therapy, humanistic/existential and the postmodern narrative approach. Exploring the assumptions underlying different modalities and practices is also considered here to be an ethical challenge. It is reckoned that the choice of a specific psychotherapeutical practice bound to a theory shapes the identity of the therapist and the patients, forms the language and behaviour through which the future therapist will express his own Self and influence the Other. Referring to postmodern inspirations, the author speaks in favour of making an endless effort of recognizing the assumptions underlying different practices – as the only way for not taking a potentially violent and impervious attitude in the relationship between the therapist and the patient.

Theory and Characteristics of IPT. IPT in Spain

Gerald Klerman, Myrna Weissman and colleagues (Basic Books, New York, 1984) created IPT as a psychotherapeutical agent, analogous to a psychopharmacological one, antidepressants. With psychodynamic roots, IPT shows cognitive behavioral aspects: therapeutic stance, problem-solving attitude and the encouraging role of the therapist; he/she does not give homework to the patient. IPT overlaps with family therapy, but is mainly individual, although other formats (couple, groups) exist. As an eclectic formalization of procedures often used by psychiatrists, IPT is a semistructured way to guide the patient over a few months. It is user-friendly, confortable and well-accepted. IPT shows a solid ground based more on empiric knowledge and less on belief systems. So, school faithes should not obstacle IPT to improve with research and even be a model for it in the field. Psychotherapeutic training should include at least the psychodynamic, the cognitiv-behavioral and the interpersonal approach.I translated the original manual's Part II included in “Psicoterapia Interpersonal” (Elsevier, Barcelona, 1998), the only Spanish IPT textbook in use. In the Comprehensive Guide to IPT (Weissman, Markowitz & Klerman, 2000) I am quoted as its introducer in Spain. Members of the Sociedad Española de Terapia Interpersonal -psychiatrists and psychologists, mainly- have given presentations and imparted courses in Spain and abroad (Portugal, Latin America). Since my seminal 1995 paper “Qué es y donde está la psicoterapia interpersonal” (Revista de Psiquiatría, 6:141-159), a number of Spanish papers have been produced. Spanish research programmes on IPT are still lacking, although promising initiatives have been published in local journals.

Can Biological and Psychological Intervention Be Integrated Into the Treatment of Psychosis? Probably Not

Clinical experience leads to the conclusion that schizophrenics and other psychotics can best be treated by psychoanalytic therapy without medication. So do research studies using competent therapists and control groups, such as Deikman and Whitaker (1979) and Karon and VandenBos (1981). The supposed necessity for biological treatments is based on the lack of appropriate psychotherapeutic training and the belief that medications are extremely effective. But current medications seem to interfere with full recovery. Medication can sometimes be used as a temporary adjunct, but should be withdrawn as quickly as the patients can tolerate. In the end, all we have to offer is understanding, but that is a great deal.