Treatment by clinical psychologists; Literature overview on training, methods of treatment and areas of application

Research area: Psychological & psychiatric interventions

Duration: April 2013 – September 2013
Publications:
LBI-HTA Project report No. 69a: https://eprints.aihta.at/1018
Contact: Nikolaus Patera

LBI-HTA Project report No. 69b: https://eprints.aihta.at/1019
Contact: Inanna Reinsperger

Language: German

Background:
Clinical psychology is defined as the branch of psychology that „deals with mental-health problems und psychological aspects of somatic diseases. This includes aetiology, classification, diagnostics, epidemiology, intervention.”1
In Austria, the ASVG (Allgemeines Sozialversicherungsgesetz, General Law on Social Security) currently includes clinical-psychological diagnostics, but not clinical-psychological treatment.
According to the resolution of the National Council from 8th of July 2011, the possibility of the incorporation of clinical-psychological treatment into ASVG is to be evaluated. Ahead of a decision about a possible inclusion of treatment by clinical psychologists in ASVG, the potential of such services needs to be analyzed.

Aim of the project:
Based on the research questions listed below, the project aims to provide a systematic overview on clinical-psychological treatment.

Research questions:
• What do international standards mean by “klinisch-psychologische Behandlung/ clinical-psychological treatment”?
• For which diagnoses does scientific evidence for effective clinical-psychological methods of treatment exist and to what extent are the respective diagnoses diseases (“krankheitswertige Störungen”) in a potential area of responsibility of the social health insurance?
• How could a line between the fields of work of psychotherapists and of clinical psychologists be drawn, in order to avoid inefficient service duplication?
• Is it possible to delineate specific fields for clinical-psychological treatment, such as chronic and cardiac diseases, dementia, psycho-oncology, metabolic diseases, disorders in children and adolescents, in neuropsychology and neurorehabilitation (e.g. stroke, accidents at work) etc.?
• Can specific disorders, aims of the diagnosis, diagnostic methods, aims of the clinical-psychological treatment, therapy programmes and intervention techniques, duration and frequency of treatment, related to the fields outlined above, and beyond, be described in the form of a “catalogue of services for clinical-psychological interventions”?
• Is every clinical psychologist in Austria today qualified to provide effective treatment in the areas of expertise outlined above?
• Are the current training requirements in clinical psychology sufficient to ensure adequate quality assurance for clinical-psychological treatment?
• Is there (national and international) research or are there practical activities by clinical psychologists with practical experience in the intramural field that can be used to gain insights into the above mentioned research questions?

Methods:
Systematic search and comparison of
• national and international definitions (methods of treatment, areas of responsibility, …)
• curricula (contents, methods of treatment, length, …) and educational settings (university/non-university, graduate/post-graduate)
• standards and measures of quality assurance

Perspectives of the professional associations (psychologists, psychotherapists, psychiatrists, …) as well as perspectives of reimbursing institutions will also be taken into account.

Systematic search and (unsystematic) preliminary analysis of publications/ evidence with focus on reviews and available Health Technology Assessments
• in broad indication groups
• for outcomes described
Textbooks on the field1,2 will be considered.

Systematic analysis of
• catalogues of services, if available (from Germany, Switzerland,…)
• curricula (content, methods of treatment, duration, …) with reference to diagnosis groups and indication areas
• services offered by care providers (psychologists, psychotherapists, psychiatrists)

NOT part of the project will be
• an economic evaluation of services by clinical psychologists or a budget impact analysis
• the development of a detailed evidence-based catalogue of services
• systematic evidence analyses in specific indications

Time schedule/ milestones:
April 2013: project protocol
May 2013: systematic literature search, non-systematic hand search, literature selection
June – August 2013: data extraction, drafting of report
September 2013: internal and external review, publication

References:
1 Perrez M, Baumann U. Lehrbuch Klinische Psychologie – Psychotherapie. Bern: Verlag Hans Huber; 4. aktualisierte Auflage 2011.
2 Sturmey P, Hersen M (eds.). Handbook of evidence-based practice in clinical psychology. Volume One (Child and Adolescent Disorders) & Volume Two (Adult Disorders). New Jersey: John Wiley & Sons, Inc; 2012.