The Post Master Professional Training
By Dr E.H.M. Eurelings-Bontekoe, head-trainer PDO GGZ Leiden-Rotterdam August 26, 2011
Table of Contents
The Post Master Professional Training _________________________________________ 1
Introduction___________________________________________________________________ 2 The training structure __________________________________________________________ 2 The various professions and training programs _____________________________________ 3 The GZ Psychologist ____________________________________________________________________ 3 The Specialist in Clinical Psychology. ______________________________________________________ 3 The Specialist in Clinical Neuro Psychology._________________________________________________ 3 The Psychotherapist. ____________________________________________________________________ 4 The prerequisites_______________________________________________________________ 4
Prerequisites pertaining to the Post Master Training leading to Health Care Psychologist _____________ 4 Preparatory training program requirements applicable to the Post Master Training Program leading to Psychotherapist. ________________________________________________________________________ 6 Applying and admittance to the training program ___________________________________ 7 In conclusion __________________________________________________________________ 8
Introduction
The profession of Health Care Psychologist (Gezondheidszorg Psycholoog= GZ-psycholoog=GZ psychologist) was listed in the law of BIG (Beroepen in de Individuele Gezondheidszorg / Professions within Individual Health Care) in 1998.This law, desribes the training requirements and the profiles of medical professions and psychological professions in Health Care. The various descriptions of the professions in Health Care were determined as a direct result from this law. Article 3 of the law deals with basic professions and article 14 deals with specialists. The Health Care psychologist, referred to as GZ psychologist, is a basic profession. The Clinical psychologist is a specialist in GZ psychology. Nationally recognized training programs began in 1998. Basic psychologists can be registered in the BIG register, after they have obtained their Master’s in Psychology and after they have completed their post master professional training which is required by law. They will then have obtained
recognized status by the government. They are then subject to state discipline and they can be reregistered periodically. This applies to every BIG registered professional in Health Care. The implementation of BIG, has resulted in improvement in the quality of patient care. The training structure
The Minister of VWS has created a regional division in which six training regions are defined to benefit the training program for GZ psychologist. In each of these six training regions, two or three parties are responsible for developing and implementing the training program; the university within the region and the practice institutions that provide the practice internships for the training program, in most cases the third party is an organizing and coordinating office. Currently, the six locations for the training program for GZ psychologist are in the following cities /city combinations; Groningen, Utrecht, Leiden/Rotterdam, Nijmegen, Eindhoven/Maastricht and Amsterdam. Leiden/Rotterdam is by far the largest region; it reaches into the province Zeeland.
Each region contains foundations which were started up in order to take responsibility and which provide supervision for the training. The regional universities, the institutions
providing the internships and the external organizing offices are represented on the board by means of elected positions. The training program of Leiden/Rotterdam is covered by the Board of the Foundation PDO GGZ Leiden/Rotterdam.
Each training program is headed by a lead trainer. who has been selected by the regional university. He or she is responsible for the entire training program. The lead trainer works closely together with the external organization that provides the manager for the training. The manager directs the process. Finally, the practice trainers and professionals working in the practice institutions are the third important party in the training program. The practice trainers are responsible for a good training environment within the practice institution. Large practice institutions have a P-trainer, in other words, a coordinating practice trainer, who directs other practice trainers working in the institution. All parties are accountable to the Board of the Foundation Post Master Training. This training structure is applicable to all professions named below.
The various professions and training programs
The GZ Psychologist
The training program for GZ-psychologist is a two year program. The training covers a period of two years of practical work at four days a week (32 hours), while under supervision, at an appointed and recognized institution by the lead trainer. A contractual agreement of
employment will be made between the institution and the trainee. The training/employment position will be determined at the CAO pay scale of 59-60, equivalent to the pay scale of a starting psychologist. In addition to these practice duties, the training will involve six hours of course work a week. In the region Leiden/Rotterdam, the lessons will be given by the RINO group in Utrecht, the coordinating organization of this training program. About half of the course work of the training program will be spent on Psychological Assessment (200 hours) and the remaining half (about 200 hours) will be spent on Treatment. This does not apply to Psycho therapy as a whole, but it pertains to the application of varying, specifically complaint directed, intervention techniques and treatment guidelines. In addition, attention will be paid to other subjects such as Ethics, Pharmacology, Sexology, etc.
There are two options; a training program focusing on Adults and Elderly and a training program focusing on Children and Youth. The last one mentioned, is offered in Leiden in cooperation with the training program for General Orthopedagogy, organized by the PDBO-Randstad.
During the next two years, the training program will receive 45 hours of supervision
pertaining to Psychological Assessment and 45 hours of supervision pertaining to Treatment within the practice institutions. This will involve a so called dual learning trajectory, which emphasizes the integration of technical theoretical instruction with practical activities. A fulltime training program is preferred by both candidates and the institutions; however, a part-time training program is possible with course work taken over a two year period and the practice hours over a period of four years.
The Specialist in Clinical Psychology.
Upon completion of the two year program leading to Health Psychologist, a four year training trajectory can be taken which leads to Clinical Psychologist. Although the program takes three years, an agreement has been made with the practice institutions to extend the actual period over four years in order to create time to meet the demands of the various duties. The placement will be for three days a week; in addition, once a month a block of fifteen hours of course work will have to be taken at the RINO Groep in Utrecht. The Clinical Psychology program contains three major components; specialized psycho-diagnostics (diagnostics pertaining to complex pathology, including comorbidity by which specialized diagnostic instruments are used), an in depth study of treatment skills pertaining to psychotherapy and, training in scientific research. Finally, an important component in the training program is learning how to carry out scientific research and management duties. The Clinical
Psychologist acquires a combination of important professional skills, diagnostics including complex ones, psychotherapy and scientific research / management.
The Specialist in Clinical Neuro Psychology.
The Psychotherapist.
In order to secure the clarity concerning the structure of professions, the Minister decided to eventually close the existing article 3 register for Psychotherapist, as the program for Clinical Psychology was being developed, since it also contained the program leading to
Psychotherapist. The field, however, has raised major objections which led to the reopening of the (BIG) register for Psychotherapists. Eventually, it all resulted in that, nation wide, trainingprograms leading to Psychotherapist were started up again after having initially been shut down. Therefore, there is again a possibility to follow the training program
Psychotherapist upon completion of the study of Psychology. The view held by both head trainers as well as the practice institutions however is, that it is foremost desired that the psychotherapist has first been trained as a Health Psychologist. The program of Health
Psychology places great emphasis on Psycho Diagnostics in contrast to the program leading to Psychotherapist. At present, in a cooperative effort of both Chamber of Health Psychology and the Chamber of Psychotherapy a shortened program of two years has been developed leading to Psychotherapist, which can be taken after having already completed the two year program leading to Health Psychologist. In addition, it is possible for psychotherapists to follow a shortened training program leading to GZ-psychologist. Finally, a shortened program has been developed for psychotherapists who are already GZ-psychologists leading to Clinical Psychologist In this manner, the reintroduction of the registration of the Psychotherapist has been incorporated in the existing professional structure, as clearly as possible.
The prerequisites
Prerequisites pertaining to the Post Master Trainingleading to Health CarePsychologist
The training program leading to Health Care Psychologist is open to graduates in Psychology, Orthopedagogy, and “Geestelijke Gezondheidskunde” (a program available at the University of Maastricht). In addition, requirements need to have been met pertaining to prerequisites of certain value. The subjects / course work that are part of the prerequisite requirements and their value are listed below. Next to that is indicated what subjects/courses in the bachelor’s or master’s programs of Psychology at the University of Leiden correspond to the prerequisite requirements.
1. Clinical Psychology/Orthopediology: 6 ECTS
2. Personality Theory: 6 points. Total: 12 ECTS
Will be obtained through a Propedeuse (first year of Bachelor study): Introduction Clinical, Health and Personality Theory: 5 ECTS and Introduction to Psychology: 5 ECTS and 2 ECTS from the second year course Stress
3. Developmental Psychology: 6 points
Will be obtained through a Propedeuse in Developmental Psychology: 5 ECTS plus 1 ECTS from the course developmental psychopathology during the second year.
4. Psychopathology: 9 points
Will be obtained through Bachelor 3 specialisation specific course: Psychopatholog, Diagnostics and Treatment, 10 ECTS OR through Bachelor 3, common courses Biological aspects of psychopathology (5 ECTS) AND Psychopathology (5 ECTS for all tracks, exluding CAP students. The extra point will be added to 7, listed below. OR (for CAP students) through the door specialisation specific course Social emotional development (10 ECTS; CAP). Also here, the extra point will be added to 7, listed below.
5. Neuro Psychology: 6 points
Will be obtained through a second year block Psychometrics en Psychodiagnostics: 10 ECTS PLUS 1 ECTS of the 5-ECTS Mastercourse: Clinical interviewing (track Clinical
Psychology(CP)) OR plus 1 ECTS of the van 5-ECTS Master course Assessment and interventions in chronic disease (track Health Psychology (HP)) OR plus 1 ECTS of the 5 ECTS Bachelor course Advanced psychodiagnostics I OR PLUS 1 ECTS of the Master course Advanced psycho-diagnostics II (track CAP) OR plus 1 ECTS of the Master course Adult and Old Age clinical neuropsychology, theory and assessment (5 ECTS) (track Clinical Neuropsychology (CNP)) OR plus 1 ECTS of the Master course Child Neuropsychology: theory and assessment of neurodevelopmental disorders (5 ECTS) from the track CNP.
7. Treatment models and strategies: 11 points.
Will be obtained through the Master courses Basic Therapeutic Skills (tracks CP en HP; 5 ECTS) PLUS Cognitive Behavioural Interventions (tracks CP en HP; 5 ECTS) OR through Behaviour training with children (5 ECTS) PLUS CBT with young people (track CAP; 5 ECTS) OR through Intervention strategies in Clinical Neuropsychology:theory (5 ECTS) PLUS Intervention strategies in Clinical Neuropsychology: practical training (5 ECTS). PLUS
1 point from Bachelor specialisation specific course (CP/CNP/HP) third year:
Psychopathology, Diagnostics and Treatment OR PLUS 1 point from BA-3 specialisation specific course Social-emotional development (CAP).
8. Interviewing, observation, reporting: 11 points
Will be obtained through First Year Course Academic Skills (Tutorial) of 5 points and the Second Year Bachelor’s Course: Interpersonal Professional Skills: 5 points PLUS 1 ECTS from the 5-ECTS Master course: Clinical interviewing (track Clinical Psychology(CP) OR plus 1 point from the 5-ECTS Master course Assessment and interventions in chronic disease (track Health Psychology (HP)) OR plus 1 ECTS from the Master course Advanced psycho-diagnostics II (track CAP) OR plus 1 ECTS from the Master course Adult and Old Age clinical neuropsychology practice (5 ECTS) (track Clinical Neuropsychology (CN)) OR plus 1 ECTS from the Master course Child Neuropsychology practice of neurodevelopmental disorders (5 ECTS) van de track CN.
9. Scientific Research: 23 ECTS
Will be obtained through completing a Master’s Thesis (20 points), plus 3 points from the Bachelor’s project (All tracks).
10. Internship of at least 520 hours, consisting of PsychoDiagnostics and Treatment , 19 ECTS
Will be completed through an internship during the Master’s phase. Various tracks
(depending on the content). This internship will predominantly take place in institutions that are connected to the Post Master Training Program leading to Health Psychologist. An extensive manual concerning internships is available on the website of the Department of Clinical and Health Psychology.
11. In addition, there are the requirements Organization and Legal aspects of the Dutch Health Care System (2 points).
This requirement can be fulfilled during the internship. The book written by J.M.D. Boot “Organisatie van de Gezondheidzorg” needs to be studied and discussed during the meetings of internschip students with their university supervisor, including those legal and ethical
12. Finally, three diagnostic cases will have to be completed. These will have to include variety in diagnostic questions and choice of instruments which can be constructed during the internship. This must be done under supervision of a recognized supervisor at the internship location (Clinical Psychologist NIP, or a NIP Cie. BAPD recognized supervisor) or an instructor supervisor connected to the University.
It is advised to obtain the Basis Aantekening Psychodiagnostiek (BAPD), in order to meet basic Psycho Diagnostics requirements. The BAPD will be awarded at the time of the Master Examination or at the latest six months later in Leiden.
Requirements are as follows:
The Bachelor’s and in the Master’s programs of various tracks contain the theoretical components that are required for obtaining the BAPD. In addition, one needs to carry out psychological assessment with several patients under qualified supervision. Three of these casereports will be evaluated to obtain the BAPD. This can be done by a recognized
supervisor within the institution who is a Clinical Psychologist NIP, a, NVO supervisor or a supervisor qualified by the NIP Cie BAPD. Finally university lecturers can supervise the cases. However, supervision will be delegated if a qualified supervisor is present at the practice location. The student will always have to submit three reports to the university instructor that pertain to reflection. In the reflection report the following points will have to be addressed; the question posed, the choice of instruments will have to be explained in light of the question posed, how data is integrated, points of controversy, learning points, relevant theories, etc. A statement of supervision is sufficient for signing off the clinical activities. If such a supervisor is not present, then the three cases will have to be evaluated by a diagnostics instructor connected to the university. Such an instructor is in principle a supervisor for the BAPD, but she/he can not claim this authority once he/she has left the university. Cases do not have to be sent to NIP, the Cie BAPD of the NIP evaluates the applications of those who did not obtain the BAPD through the university. Diagnostic reports, whether anonymous or not, will never be part of the internship report.
Preparatory training program requirements applicable to the Post Master Training Program leading to Psychotherapist.
Students who wish to enter the post master training program leading to Psychotherapist, will have to have completed the following preparatory training program requirements (prerequisite subjects/courses AMvB Psychotherapist 1998):
1. Personality Theory
2. Psychophysiology or Psychosomatics 3. Psychopathology
4. Developmental Psychology 5. Psychopharmacology
6. Culture-Bound Psychological Problems 7. Sexology
8. Interviewing 9. Interaction Training
10.Internship of 30 work days in a GGZ institution
All student can take the Sexology course offered during the second Bachelor year. (5 ECTS). Likewise all student can fulfil the Psychopharmacology requirements by taking the second
Finally, requirements concerning cultural aspects of healthcare can be fulfilled by taking the common course Cultural Aspects of Health (5 ECTS) during the second bachelor year.
To avoid misunderstandings: The course Organization and Legal Aspects of the Dutch Health Care System is only required for admission to the postmaster training to “Gezondheidszorg Psycholoog”(Health Care Psychologist), the courses
Psychopharmacology, Sexology and Culture-bound Psychological Problems are required for admission to the post master training to Psychotherapist.
Applying and admittance to the training program
When all the pre-training requirements have been met, the student has to apply to SPON in Nijmegen. The proof of completion of the required program can be obtained at `de onderwijsdienst` Students can apply during the entire year; however, there are only two official application periods. Application will need to be accepted before the 1st of March for those programs that start up in September of that same year. Furthermore, applications will need to be accepted before July 1st for programs that start in January of the following year. SPON is the training institution that is also responsible for the central application process and the written selection process. SPON checks if all pre-training requirements have been met. Once approved, the student will receive the so called SPON statement. Without this statement, admission to the GZ training program is not possible. Once the SPON statement has been obtained, it is possible to apply at one or more training institutions (RINO). The student then receives a list of available openings and will be able to apply for a position in one of the participating health care institutions. The student will first have to be accepted in a training position by the health care institute, before being presented to the head-trainer as a candidate for the training program. He or she makes the final decision if the student will be admitted to the program. It is clear that the practice institutions carry the most weight when it comes to the final selection; they search for candidates who fit best within their institutions. It is not easy to enter the training program. Initially, this was due to the fact that at the time, in 1998, a limited number of places within the training programs were only available, to be exact, 84 places, 14 per region. This number was determined by the Coordinating Organ of Post Graduate Education and Training (CONO). These places were also subsidized, or rather, the practice institutions received financial compensation to partly provide for the training costs such as costs incurred for supervision and compensation for loss of productivity. At the time the training programs were held exclusively at mental health institutions. A year later places were added that were not part of the GGZ. These places did not receive any
subsidizing. Slowly the numbers of places have increased, but the number of subsidized places has remained at 14. Currently GZ Psychologists are being trained in GGZ institutions, hospitals, rehabilitation centers, institutions for the mentally handicapped, institutions in the area of youth care, forensic care, addiction rehabilitation care and private practices. All the institutions meet the requirements, although some institutions may have to be required to form a cooperative alliance with another institution in order to meet all quality requirements . Training places have increased dramatically since 1998, up to 395 places in 2005 after with the largest increase taking place in 2004. The increase leveled off in 2005. The number of
unknown number of them may not have anymore interest in placement and therefore the number may have been inflated. The chances of obtaining placement in 2005 were smaller than in previous years. The cause for this was that more institutions started working with so called presented candidates. These institutions hire basic psychologists and observe their overall functioning over a period of time after which they make the decision whether or not to present them to a training program. In fact, in this manner the application process has been pushed forward. Only in Utrecht is open placement still an option instead of solely accepting internal candidates.Groningen, however, accepts only internal candidates.
In conclusion
The training program leading to GZ Psychologist and the profession of Health Psychologist, in the meantime has acquired a solid position in the field of health Care. The result of the various instated quality laws/requirements of financiers and the ambitions of the institutions for Health Care have led to the fact that institutions offer permanent jobs exclusively to those who are registered as Health Care Psychologist. In just about all job listings, the requirement of the registration of GZ Psychologist will be named. Most all graduated GZ Psychologists have a job.
At the moment Profiles of the GZ Psychologist are being developed. The training program leading to GZ Psychologist, in particular the component containing the course work, is general in content and, therefore, rather broad; a great deal of topics will be covered. Not all components are of relevance to the practice in which the training program takes place. Therefore, the need has arisen for additional schooling which is applicable to the work in specific fields. However, it is not the intention to create a new profession. The Profile is also not meant as a specialization. It is a complement to the GZ training program of, for example, a year in which the general principles learned in the GZ training program will be applied to a specific work setting such as primary health care, addiction care, forensic care, the elderly care or sexology. In this manner an already existing situation will be formalized. Many GZ Psychologists continue to take additional specific training in order to perform adequately in certain health care settings. The initiative for implementing a Profile is the responsibility of the specific area within the profession. The role of the Chamber of GZ Psychologist is limited to the testing of proposals pertaining to the implementing of a Profile. The criteria for this will be established in cooperation with the professional foundations that could be placed in charge of certification.
Information about the postmaster trainings provided by the “Stichting PDO GGZ
Leiden/Rotterdam” may be obtained at the RINOgroep, St. Jacobsstraat 12-14, 3511 BS, Utrecht, tel. 030-2308400
