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What does not convince me in the battle for the Psychologists Bonus

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by Antonello D’Elia

12 GENDear Director,

I would like to try to clarify a little in the hope of improving the information circulating on the Psychologists Bonus. The idea is spreading that a deaf politics is opposed to psychic human suffering, absorbed as it is by the management of the arid economy, and a part of the country that claims the reasons for listening and psychology by engaging in a battle for cultural progress. and social.

It would all seem simple but it is not. On the other hand, how could it be otherwise in an Italy that shows enormous backwardness in the public and social image of speech treatment even though thousands of psychologists graduate every year to whom it does not offer work and in which the confusion between psychologist, psychiatrist, psychotherapist, Does the psychoanalyst still question too many people, even those with the tools to have clearer ideas?

And, I would add, that he promoted by law, in 1978, a capillary territorial organization for the protection of mental health, then letting it drift away, feeding the idea that it serves only to administer drugs and lock up dangerous madmen? And that, in 1989, again by law, regulated the professional training of psychotherapists who, in order to practice the profession, require a specific qualification and not a simple degree in Psychology?

The rejection of the amendment to the Budget Law which revised the Psychologists Bonus fits into this scenario. David Lazzari is right to remember the effectiveness of psychological treatments, as well as Luigi Cancrini, on Open, to claim the cultural and social necessity of psychotherapy as a fair policy choice for health in an advanced democracy and not as a prerogative of a few with the means to be able to face it. Now, one of the key points, in my opinion, is just that.

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The battle for the Bonus, that is, to be able to have access to psychological treatments for a limited, very limited number of clinical meetings, cannot overlap with that for the enhancement of listening, of speech, of the ability to reflect on oneself and on the own relational resources which is the very core of a therapeutic process.

It does not seem to me that the defense of psychological treatment is at stake as opposed to pharmacological, hasty and mechanical medical treatments. Nor is it an anthropological model of man / woman that must be repaired with suitable medicines that is compared with that of subjects who, through a care relationship, can have access to suffering parts of themselves and thus restore acceptable well-being. Many agree on these principles.

As on the fact that a model of universal and accessible care such as that of our National Health System cannot leave out this component of health without creating serious consequences for everyone, especially in the contingency triggered and amplified by the pandemic. The fact is that the Bonus proposal does not respond to the logic of the goodness of psychological treatments but to that of the labor market.

Treatments for everyone, yes, but on time, by unidentified psychologists and on deadline. At the end of the bonus, you can always continue at one of the many private studios where, together with many experienced professionals, a sea of ​​graduates looking for a job will finally be able to find a job outlet, perhaps taking advantage of the hundreds of courses offered by a huge training market. access to which is independent of the possession of those specific qualifications still necessary today to do a very delicate (and beautiful) job such as that of the psychotherapist. Deregulation was called in the Reagan era.

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Are we sure that the supporters of the Bonus are aware of this? And that it is clear to everyone that the Mental Health Departments have been desertified in recent years but, if staffed, could they once again become a garrison for psychological treatments? And that the same goes for family counseling and for school psychology? Are we all certain that psychological treatments are only those that are ‘administered’ in a private practice made accessible by a sort of ‘timed’ agreement with the State? What if we thought in terms of community, of society and not of the market?

We could, for example, think of a battle of culture and equity so that psychological treatments are widespread, of quality, accessible and those who practice them worthy of respect and professional recognition. One could think of a vast plan where Mental Health Centers are repopulated with competent, supervised professionals who work as a team and think in terms of communities. And counseling centers and schools equipped with trained and trained psychologists who know about children, families and adolescents and teachers.

Or, again, that the nursing homes, perhaps organized in apartments and not in large containers, equip themselves with personnel capable of approaching the elderly and the frightened and lonely old people who help to manage the states of greatest suffering, first of all by socializing them and not treating only the individuals. Other professionals may approach families who have lost loved ones and also doctors and nurses who work and live in daily contact with COVID death. In this case, psychotherapists hired by hospitals or RSAs would be needed to detoxify staff from prolonged exposure with death, as contagious as a virus but with even more insidious effects.

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In other words, it would be a question of thinking in terms of society and not of corporations, of civil progress and not of work at all costs. Young psychotherapists, trained, would work and how! However, we would need someone who cares about psychology as a discipline of health, reparation and relationships, both human and professional. And politicians who believe that children, adolescents and adults who are a little more aware will be and are also better citizens.

Antonello D’Elia
President of Democratic Psychiatry

January 12, 2022
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