Curriculum for a course in C–L psychiatry, psychology, and psychosomatics in Austria

In Austria, the development of consultation–liaison (C–L) psychiatry, psychology, and psychosomatics in the last 15 years is a story of success. An increasing number of patients with psychological comorbidity has been treated by C–L psychiatrists or psychosomaticists in a variety of hospitals. There is a growing number of publications on the benefits of the “psychosomatic” cooperation in Austrian and international medical journals [1], [2], [3], [4], [5]. As a consequence, more and more departments want a C–L service too, and it is difficult to find enough qualified people doing that job.

In some European countries, no formal training of C–L psychiatrists and psychosomaticists exists. Therefore, the European Association of Consultation–Liaison Psychiatry and Psychosomatics organised a workgroup on training in C–L, which developed guidelines for training in C–L of residents (basic training) as well as for fellows (advanced training). The first author and a coauthor of this article (Angelika Riessland-Seifert) were members of this workgroup. The guidelines were published recently [6].

Most experts working in a C–L service in Austria are highly qualified psychiatrists or psychologists, who have often spent a period of professional isolation working in general medicine. Until 2005, no formal education for C–L work existed in Austria for either of the two main professions conducting this work. Psychologists are usually not trained in how to work in a C–L setting, nor have most of the psychiatrists had the opportunity to rotate to a C–L department during their formal training [7]. For these professionals, who “learned by doing,” we have tried to plan our curriculum for C–L psychiatry, psychology, and psychosomatics. To find out if we could meet the participants' needs and expectations with this training course, we started it as a pilot project in September 2005.

The curriculum was organized by the Department of Medical Psychology & Psychotherapy of the Medical University in Innsbruck and the C–L workgroup of the Austrian Society for Psychiatry & Psychotherapy.

The 19 participants of the curriculum came from all over Austria. Twelve were medical doctors (most of them psychiatrists, but also two general practitioners), six were psychologists and one was a social worker. The multidisciplinary character of the course was found to be as enriching, as multidisciplinary cooperation is also part of the daily C–L work. Moreover, this represents the situation in C–L work in Austria.

The duration of the curriculum was 34 h over 4 days. It seemed important to us to give space for exchange to professionals working in the field of C–L often in an isolated way.

In choosing the topics, we searched for a homogeneous mixture, knowing that we would never be able to cover all fields established in C–L work. These topics were somatoform disorders in C–L, economic aspects of C–L work, structural quality in C–L services, crisis-management in the general hospital, therapeutic relationship with patients and teams, psychooncology, psychopharmacology in C–L work, trauma-specific interventions in C–L work, psychopharmacotherapy of traumatised patients, psychosomatics in cardiology and quality management in C–L services.

In evaluating the course, participants reported increased competence in all fields. At the beginning of the course (T1), participants rated their competence especially on “economic aspects,” and structural quality as very low (Fig. 1). All lectures were rated to have a significant improvement on the participant's ability to act.

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Fig. 1. Significant changes on participant's ability to act.

There were some differences between medical doctors and psychologists in terms of the feedback we received. Psychologists appreciated most from learning about the economic aspect in C–L work and hearing about quality management. The economic aspects and quality management were considered less relevant by medical doctors. Experienced C–L psychiatrists or psychosomaticists (defined as those who are already experienced in C–L work for more than 1 year) particularly appreciated the topic “trauma-specific interventions.” The experienced participants were also more critical in judging the speakers.

The organizers of the course were delighted with the positive feedback from the participants We were pleased to note that all of the participants would recommend our curriculum to their colleagues. The next curriculum will be carried out in autumn 2007. The course is held in German.

For further information, contact e-mail: liaison@congressinfo.net; Web site: http://www.congressinfo.net/liaison.