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      Clinical Psychology in Spain: History, Regulation and Future Challenges


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          The heterogeneity of national regulations in clinical psychology and psychological treatment across Europe requires a detailed description of every regulation to start a shared discussion. In the current paper, we describe the history, legal regulations, a specialized training program, the current status and some future challenges for clinical psychology in Spain. The evolution of clinical psychology in the Spanish National Health System (NHS) towards a health specialty regulated by law, exemplifies a balanced process of expansion, social recognition and professional settlement. Overall, the growth of clinical psychology in Spain may depend on access to leadership and management positions in the NHS that would allow a better organization of care resources to improve citizens’ access to psychological treatment.


          • Spanish regulation of clinical psychology is mediated by socio-cultural and political changes that occurred in the late 70's and 80’s in the country.

          • Recognition as a licensed clinical psychologist is obtained through a 4-year training system as an intern resident psychologist (PIR).

          • PIR is a training system of supervised internships, with increasing autonomy in various healthcare departments in the National Health System (NHS).

          • Achieving independent Clinical Psychology Services within the NHS in order to organize, implement and deliver evidence-based practices is currently one of our biggest challenges in the near future.

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          Most cited references26

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          Evidence-based practice in psychology.

          The evidence-based practice movement has become an important feature of health care systems and health care policy. Within this context, the APA 2005 Presidential Task Force on Evidence-Based Practice defines and discusses evidence-based practice in psychology (EBPP). In an integration of science and practice, the Task Force's report describes psychology's fundamental commitment to sophisticated EBPP and takes into account the full range of evidence psychologists and policymakers must consider. Research, clinical expertise, and patient characteristics are all supported as relevant to good outcomes. EBPP promotes effective psychological practice and enhances public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship, and intervention. The report provides a rationale for and expanded discussion of the EBPP policy statement that was developed by the Task Force and adopted as association policy by the APA Council of Representatives in August 2005. Copyright 2006 APA, all rights reserved.
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            Realizing the Mass Public Benefit of Evidence-Based Psychological Therapies: The IAPT Program

            Empirically supported psychological therapies have been developed for many mental health conditions. However, in most countries only a small proportion of the public benefit from these advances. The English Improving Access to Psychological Therapies (IAPT) program aims to bridge the gap between research and practice by training over 10,500 new psychological therapists in empirically supported treatments and deploying them in new services for the treatment of depression and anxiety disorders. Currently IAPT treats over 560,000 patients per year, obtains clinical outcome data on 98.5% of these individuals, and places this information in the public domain. Around 50% of patients treated in IAPT services recover, and two-thirds show worthwhile benefits. The clinical and economic arguments on which IAPT is based are presented, along with details of the service model, how the program was implemented, and recent findings about service organization. Limitations and future directions are outlined.
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              A new therapy for each patient: Evidence-based relationships and responsiveness: NORCROSS and WAMPOLD

              In this study, we introduce the journal issue devoted to evidence-based responsiveness and frame it within the work of the third interdivisional APA Task Force on Evidence-Based Relationships and Responsiveness. We summarize the meta-analytic results and clinical practices on the adaptations of psychotherapy to multiple transdiagnostic characteristics of the patient, including attachment style, culture (race/ethnicity), gender identity, coping style, therapy preferences, reactance level, religion and spirituality, sexual orientation, and stages of change. We then discuss the clinical and research process of determining what works, and what does not work, for whom. The limitations of the Task Force's work are outlined and frequently asked questions are addressed. The article closes with the Task Force's formal conclusions and 28 recommendations and with some reflections on fitting psychotherapy to the individual client.

                Author and article information

                Clin Psychol Eur
                Clinical Psychology in Europe
                Clin. Psychol. Eur.
                17 December 2019
                : 1
                : 4
                : e38158
                [a ]Department of Mental Health, Aragón Healthcare Service (Spanish National Health System) , Zaragoza, Spain
                [b ]Department of Mental Health, Murcia Healthcare Service (Spanish National Health System) , Murcia, Spain
                [c ]Department of Mental Health, Principality of Asturias Healthcare Service (Spanish National Health System) , Gijón, Spain
                [4]University of Vienna, Vienna, Austria
                Author notes
                [* ]Aragón Healthcare Service, Plaza de la Convivencia, 2, 50017 Zaragoza, Spain. jpradoabril@ 123456gmail.com
                Copyright @ 2019

                This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) 4.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 10 July 2019
                : 25 September 2019
                Politics and Education

                training,clinical psychology,psychological treatment,Spain,education,national regulation
                training, clinical psychology, psychological treatment, Spain, education, national regulation


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