7. What are my rights in psychotherapy?

Whether you receive psychotherapy as a patient (in public health care) or as a client (in private practice), you have your rights. The mental health expert must inform you about them and respect them.


Psychological care in public health system

Clinical psychologists are primarily bound by Ethical Codex of Association of Clinical Psychologists of Czech Republic and by the Act on Health Services (372/2011 Coll.) A complete list of patient's rights including comments can be found on the website of the Ministry of Health of the Czech Republic. The most important ones are (certain limitations apply):

  • the right to choose a medical facility, an insurance company and a doctor

  • the right to refuse a medical intervention

  • the right to information (and the right not to be informed)

  • the right to privacy

Mental health services provided by state institutions are mostly of high quality. Unfortunately, there are only 8 clinical psychologists per 100,000 people in the Czech Republic, although the World Health Organization recommends 26 (as a matter of interest, in USA it is about 30, in Austria 80, and the far highest number is in Argentina). This results in situation, where you have to wait about 3 to 6 months for first appointment, and then hope for the interval between sessions not to be excessive.

 

Psychological care in private sector

Most of psychological care in EU and the Czech Republic happens in private sector. Czech Ministry of Health acknowledges this and has officially allowed for providing psychotherapy in private practice. Unfortunately, since we still lack a unified Czech law on psychotherapy, ensuring the highest EU standards in private psychotherapy providers became a challenge. 

​For this purpose, Czech Association for Psychotherapy (ČAP) has been established. It maintains a list of therapists who fulfil all of the required criteria. However, the request for registration is voluntary, therefore also professionals who are not on the list, may fulfil the criteria. These are:

 

  1. University degree relevant for psychotherapy (psychology, medicine etc.)

  2. Long-term psychotherapeutic training (of minimum 5 years duration, including: theory, practise, supervision, self-experience, own individual therapy, altogether 700 hours at minimum, mostly about 1500)

  3. Supervision (regular consultation of one's practice aimed to develop psychotherapeutic skills)

  4. Continuing education (besides self-study, namely conferences, lectures etc., 30+ hours per year)

  5. Respecting The Ethical Codex of ČAP, respectively The Ethical Codex of Psychological profession. In total, the Codes run to 25 pages; below is a short selection from their contents:

    • psychologist only carries out activities in the scope of his/her competencies and authorization

    • He/she avoids multi-relationships (for example, reciprocal services or examination of his friends. Of course, any sexual contact between the therapist and the client is forbidden).

    • He adheres to confidentiality, also after finishing the cooperation with the client.

      • The confidentiality of psychotherapist in private sector is not defined by law, but by the ethical codex of his profession and membership in a professional organization. This is why private therapists offer their client a contract under the terms of the Civil Code, which defines the conditions for the sessions. Such a contract including GDPR information can run to several pages, therefore, an agreement in electronic form is most often used.

    • A psychologist only uses high-quality psychodiagnostic methods, with known and acceptable psychometric parameters, and he protects them from deterioration (e.g. he does not disclose them to public)

He follows principles of evidence-based practice, and evidence based on practice.

  • In his private life the psychologist can, for example, be a scientologist, practice holotropic breathing or voodoo. However, he is not allowed to popularize these phenomena in his professional role as therapeutic methods. Even if studies would exist that claim “Voodoo improves your mood” or “Scientology will help you to know yourself better and reduce the death anxiety”. Thas is because couple of isolated, narrow-focused studies do not guarantee the safety and efficiency of a particular method, and do not replace common sense or scientific consensus.

​​Submitting complains

 

If you feel that a psychologist has acted in violation of a law or ethical code, you can file a complaint with his supervisor, or to any of the following organizations (of which s/he is the member):

  • Czech Association for Psychotherapy (ČAP), see more here

  • Association of Clinical Psychologists (AKP), see more here

  • Czech-Moravian Psychological Society (ČMPS), see more here

I offer my psychological services as a self-employed therapist in the sense of the law no. 89/2012 Sb., Civil Code, § 2636 and following. I don’t provide healthcare in the sense of law no. 372/2011 Sb., about healtcare services. For more info click here.

© 2019 by Vladimír Marček, Ph.D

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