Education and Training in Europe 13and practice ”owing out of this interdisciplinary “eld. At the
same time, changes in health policy in many countries are
generating new roles for psychologists. With a growing
awareness of the importance of psychosocial factors in the
promotion and maintenance of well-being, the demands for
professional health psychology services within European
health care systems are expected to increase. As Garcia-
Barbero (1994) stated, •Health professionals clearly need
more appropriate training to meet the challenges of the health
for all policy, to meet the health needs of the population, to re-
duce health costs, to assure quality, and to permit the free
movement of suf“ciently quali“ed health professionals.Ž
Under the national ethical codes of the psychology pro-
fession, there is an absolute responsibility to ensure that
psychologists only practice in areas of competence. This prin-
ciple requires that health psychologists be trained and assessed
for their competence before they enter into unsupervised prac-
tice. Psychologists wishing to practice in new areas therefore
have a responsibility to become appropriately trained and
experienced.
Complementing Other Fields of Applied Psychology
As noted earlier, there are overlapping competencies between
health psychologists and other applied psychologists work-
ing in health “elds and it is likely that there will be shared,
generic components of training. All psychologists working in
health “elds have a common foundation of basic education
in psychology. Psychologists with experience and/or training
in “elds of applied psychology wishing to have a professional
quali“cation in health psychology should be permitted to re-
ceive accreditation of their prior experience and/or training.
The proposed training should be speci“cally designed to ful-
“ll this objective of complementarity.
Professional Autonomy and
Complementary Independence
The ultimate objective of training should be professional
autonomy and complementary independence. The latter re-
quires mutual respect of experience and training, without in-
trusions, infringements, or subordination across health care
professions.
Stages of Competency
It is recognized that practitioner-training passes through stages
in which a person will, at “rst, practice under supervision of
another fully experienced practitioner. Following an appropri-
ate level of supervised, placement experience with a range of
settings and client groups, the psychologist will be competent
to practice in his or her own right. However, training is never
“nal and practitioners require continuous professional devel-
opment through the acquisition of new skills and with the de-
velopment of new technologies and the updating of knowledge
following the advancement of research.Training Guidelines for Professional
Health PsychologistsDifferent educational systems and traditions affect the struc-
ture of curricula for training professional psychologists in dif-
ferent European countries. In several meetings, the Task Force
deliberated on the idea of formulating a “xed set of minimal
standards for the whole of Europe. Three case studies of train-
ing at different levels of development were analyzed in depth
(training in Denmark, Germany, and Holland). Symposia and
workshops were held at international conferences at which
training models for different countries were compared and
contrasted (Donker, 1994; Marks et al., 1995a; Rodriguez-
Marin, 1994; Rumsey et al., 1994a; Sidot, 1994; Wallin,
1994). Large, possibly irreconcilable, variations are evident in
the models and methods of training and in the amount of ex-
perience deemed necessary for nationally accredited recogni-
tion as professional psychologists across different countries.
One country (Austria) has a law specifying the tasks to be per-
formed by professional health psychologists. In the remain-
der, the tasks and responsibilities of professional health psy-
chologists (and, for most countries, other applied
psychologists as well) are dependent on a complex array of na-
tional, regional, and local agreements. Training practices are
equally diverse. In a few countries, training programs are well
advanced and have been implemented by national associations
(e.g., Berufsverband Osterreichischer Psychologen, 1995;
Dansk Psykologforening, 1996). Other associations are making
progress in formulating and implementing training guidelines
(e.g., British Psychological Society: Edelmann et al., 1996;
Rumsey et al., 1994b; Berufsverband Deutscher Psychologen:
Rielander, 1995). However, many European countries still do
not yet train health psychologists in any speci“c and specialized
manner.
If health psychology is to achieve its full potential in
European health care systems, training will need to be imple-
mented much more widely than is presently the case. This will
only be possible within the particular legal and professional
conditions that determine the organization of psychology and
health care in different countries. A principle of subsidiarity
must therefore operate. However, it will be necessary to at
least have a framework for training in each country and these
guidelines provide that framework.