CBT in Greece

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					                                       CBT in Greece

              Thomas Kalpakoglou, PhD1 & Gregoris Simos, MD, PhD2

1. Introduction
Oscar Wilde once said “… we owe anything modern that exists in our life to the
ancient Greeks”. Could this be true for Cognitive-Behavioural Therapy (CBT)? It
becomes apparent from the ancient texts that psychotherapeutic methods used in
ancient Greece followed the cognitive-behavioural paradigm to a great extent. In fact,
it is widely accepted that the origins of CBT are found in the work of Stoic
philosophers, such as Epictetus.

In modern Greece, CBT, its applications and relevant research have a history of
almost 35 years. In 1979, the first institution that started providing a theoretical and
clinical training in CBT was the 2nd University Department of Psychiatry of the
Aristotelian University of Thessaloniki. Two years later, in 1981, the psychiatric
department of the University of Athens started a series of lectures on CBT. In 1994,
the same institution started providing a one-year theoretical course in CBT followed
by clinical practice under supervision for a limited number of trainees. In 1992, the
Institute of Behavioural Research and Therapy became the first private institution
offering a four-year course in CBT (theory and clinical practice under supervision), as
well as a wide range of workshops, seminars and lectures relating to CBT. The Greek
Association for Cognitive and Behavioural Psychotherapies, founded in 1993, started
a series of workshops as a means of continuous professional development for CBT
therapists. The clinical psychology courses of the universities of Athens and
Thessaloniki also offer training in CBT. Less structured forms of CBT training
(lectures, seminars, etc.) are found in other psychiatry and psychology university

2. Current Practice

 International Representative of the Greek Association for Behavioural Modification (GBA) – Athens.
  President of the Greek Association for Cognitive and Behavioural Psychotherapies (GACBP) –
CBT in Greece is applied at various mental health institutes and privately. The
following is a list of various institutions in Greece that provide cognitive-behavioural
training or therapy:

Institute of Behavioural Research and Therapy, Athens (www.ibrt.gr)
    Four-year Diploma in Cognitive-Behavioural Therapy (2714 hrs, theory,
       practice, supervision, self-awareness, dissertation, examinations)
    Seminars - Workshops
    Supervision
    Therapy (children, adolescents, adults, couples, family, group-therapy)

Behavioural Treatment Unit, Centre of Mental Health, Athens.
    Seminars
    Supervision
    Therapy

Dept. for Cognitive Therapy, Eginition Hosp., Psychiatry Dept., Athens.
    Theory (100hrs)
    Practice to a smaller number of trainees.
    Supervision
    Therapy

2nd University Department of Psychiatry, Aristotelian University, Thessaloniki.
    This is a 3-year CBT training course, within a comprehensive 5-year training
       program for the specialty of Psychiatry
    Theory- Seminars
    Group and Individual supervision
    Therapy

Special clinic for sexual dysfunctions with CBT, Sismanoglion Hosp., Psychiatry
Dept., Athens.
    Seminars
    Therapy
Psychiatric Clinic, University of Patra, Patra.
    Theory on CBT
    Group supervision
    Practice and supervision

3. The organisation of CBT in Greece.

3a. The Greek Association for Behavioural Modification (GBA)

Official Address          13, Papadiamantopoulou St.
                          115 28 ATHENS

                          Tel.: +30 1-72 52 227
                          Fax: +30 1-72 91 680
                          e-mail: eees@ath.forthnet.gr

President                 Mika Haritos-Fatouros

Vice President            Anastasia Kalantzi-Azizi

Secretary                 Angelika Gena

Treasurer                 Theodoros Chalimourdas

International             Thomas Kalpakoglou
Representative            e-mail: kalpakoglou@in.gr

Board members             Martha Floratou
                          Peter Liberis

Number of members         140

General info &             Founded in 1972.
Activities                 Organised the EABCT Annual Congress on two
                            occasions, on the isle of Spetse in 1978 and on the isle
                            of Corfu in 1994.
                           Established the Institute of Behavioural Research and
                            Therapy in 1992 in order to provide clinical training in
                            CBT at post-graduate level.
                           Organises seminars, workshops, presentations and
                            annual conferences.
                           Has published books and papers on CBT.
                           Formed its first branch in Thessaloniki in 2002.
3b. Greek Association for Cognitive and Behavioural Psychotherapies (GACBP)

Official Address        24 Vas. Georgiou St.
                        54640 Thessaloniki

                        Tel.: +30 31 838 755
                        Fax: +30 31 234 370

President               Gregoris Simos MD, PhD
                        24 Vas. Georgiou St.
                        54624 Thessaloniki
                        Tel.: +30 310 838755
                        Fax: +30 31 234 370
                        e-mail: simos@med.auth.gr

Vice President          Gregoris Lavrendiadis, MD, PhD
                        2nd University Department of Psychiatry
                        Aristotelian University of Thessaloniki

Secretary               Michalis Sotiriou, MD

Treasurer               Nikolas Nikolaides, MD

Board members           Lefteris Konstandinides, BA
                        Dimitris Xylas, MD
                        Chrysostomos Vaiopoulos, MD

Number of members       71

General info &           Founded in 1993.
Activities               It is affiliated with the 2nd University Department of
                          Psychiatry of the Aristotelian University of
                         Since most of its members graduated from the CBT-
                          training course of the 2nd University Department, the
                          main emphasis, for the time being, is on Continuous
                          Professional Development (CPD).
                         CPD is applied through advanced workshops
                          (approximately twice a year).
                         Future plans include the foundation of a CBT Institute
                          that will offer a training program in CBT (theory,
                          clinical practice and supervision) for interested mental
                          health professionals as well as CB therapy.
                         GACBP is organising the 2005 EABCT Annual
                          Congress in Thessaloniki.
4. Training activities, standards and quality management.
4a. Greek law for the profession of Psychologists: a brief outline.
Recently, the Greek Government has set up a new committee with the task of refining
the current law for Psychologists and setting up new guidelines for this profession,
which are going to include the necessary minimum qualifications for clinical
psychologists and psychotherapists. While this is in progress, the only law in use is
the one voted by the Parliament in 1979 (Law 991/1979), which went through some
amendments in 1998 (Law 2646/1998). This law outlines the criteria for issuing a
special practice license for psychologists (PLP) to anyone who wishes to follow this
Outline of the law regarding the PLP:
    Practice of Psychology is allowed only to those with a PLP.
    The regional Municipality of the applicant issues the PLP.
    The applicants should have a university degree in Psychology (Greek, or of an
     authorised university abroad). Exceptions: a PLP can be issued to applicants
     who, by the 31st December 1993, have (1) a „philosophy, education and
     psychology‟ university degree, majoring in psychology and a two-year post-
     graduate degree in psychology, or (2) a „philosophy, education and psychology‟
     university degree, majoring in psychology, a one-year post-graduate degree in
     psychology and three years‟ practice as psychologists, or (3) equivalent degree
     from abroad and five years‟ practice as psychologists.
    Male applicants must have finished, or undergoing their national service.
    Applicants should have no previous (major) legal charges and be in good health.
    The PLP can be recalled from the holder should any legal matters arise.
    A special committee at the Department of Education should outline the criteria
     for specialisations in Psychology.
    The according laws protect confidentiality.

4b. Provision of CBT by Psychiatrists in Greece
   Currently there is no specific law on the provision of psychotherapy (of any kind)
    by psychiatrists. Psychiatrists apply in their clinical practice whichever form of
    psychotherapy they were trained, either as part of their training in Psychiatry, or
    as a qualification they have obtained from independent psychotherapeutic
    institutions or associations.
   Greece, as part of the EU, participates at a European Committee that works on
    training standards in the specialty of Psychiatry. These training standards, when
    consolidated, will become a law of EU and each European country will have to
    adopt them by appropriate laws. After the implementation of these laws, training
    in Psychiatry will have the same structure and content in all EU countries. EU
    committee on the specialty of Psychiatry has suggested that a comprehensive
    training program must include training in psychoanalytic and also in CB therapy.
   The Greek Psychiatric Association has founded a Psychotherapy Branch in 1999.
    Aim of this Psychotherapy Branch is not only to promote the practice of
    psychotherapy, but also to define the necessary standards for training in and
    application of each form of psychotherapy. Under its guidelines and supervision,
    psychiatrists will be accredited as “ (specific) Psychotherapists” after appropriate
    (specific) training

4c. Training standards of the Greek Association for Behavioural Modification
GBA, in association with the Institute of Behavioural Modification and Research,
follows the training standards of EABCT in its training program. This program is
open to psychologists (fulfilling the requirements for PLP) and psychiatrists (qualified
or trainees). More specifically, the four-year course in CBT offers as minimum
     Theory (120 hrs)
     Extra presentations (24 hrs)
     Therapeutic techniques (60 hrs)
     Tutorials (60 hrs)
     Journal Club and homework (400 hrs)
     Practice under supervision (8 cases, 4 write-ups, adults and children)
     Practice in clinical setting (500 hrs)
     Self-awareness group (70 hrs)
     Workshops (100 hrs)
     Dissertation
    Examinations (written and oral after the 2nd year, oral after the end of practice,
       dissertation assessment).

4d. Training standards of the Greek Association for Cognitive and Behavioural
Psychotherapies (GACBP)
GACBP has adopted the training standards of EABCT. Since GACBP has not yet
established an official training program in CBT, the necessary qualifications for a
member depend on the appropriate training one has undergone in other institutions
and the degree that this training complies with the EABCT training standards. Since
the training program in CBT of the 2nd University Department of Psychiatry of the
Aristotelian University of Thessaloniki complies with the EABCT training standards,
most members of the GACBP are graduates of this program.

5. Discussion
Although CBT has a long history in Greece, it is only recently that enjoys wide
recognition and application. One of the main reasons for this was the lack of training
programs on CBT. Indeed, most of the professionals who teach or apply CBT have
received their training abroad, mainly in the USA or United Kingdom. This problem
will be overcome as new training programs are planned and the application of CBT in
various institutions is scheduled. Systematic promotion of CBT to a higher level,
either by the publication of relevant articles, journals and books, or the organisation of
conferences and congresses, has only been developed in the last decade or so. Greece
will host its third EABCT conference in 2005 in the city of Thessaloniki.

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