Clinical Psychology in Israel
Lecture held in Samara
I would like to express my thanks for inviting me to carry this lecture. I am highly excited to meet colleagues from the Russian Republic, and this is for me a unique experience to meet you and talk to you. I thought that I would commence by introducing myself, thereby acquainting you to my profession and its status in my country.
I am clinical psychologist. That means, in Israel, first, that I am registered as a psychologist, according to the Psychologist Law, which was legislated in 1977. According to this law, A person is allowed to be called psychologist only if he or she holds a Master’s, or equal degree, in psychology. In Israel’s academic system a person is ought first to study for a Bachelor’s degree in at least one or two majors; but a Bachelor’s degree does not grant him or her the privilege to be registered as a psychologist. After finishing the first degree (BA) with high grade the student has to be accepted to a second degree (MA) in psychology, and only after finishing that degree – including a thesis – that person is allowed to be registered as a psychologist.
After being registered as such, the psychologist may specialize in one of six specialties which are acknowledged by the Israeli law. Four of these specialties had been listed in the original version of the Psychologist law which was legislated, as I have mentioned before, in 1977, and additional two had been added later. The original four specialties were: Educational, Clinical, Rehabilitational, and Social. The last one was subdivided to Organizational Psychology and Vocational Psychology. The two added later were Developmental Psychology and Medical Psychology.
In order to specialize in one of those specialties one has to undergo a specialization or, as I would like to call it, borrowing from medicine – a residency. Hereinafter I would describe the Clinical residency, which I naturally more acquainted to. This residency’s specifications and requirements are defined rigorously in the law. They include two years full-time employment in an institution which is recognized officially for that residency (namely, Clinical). Most psychologists perform this residency in a period of four year part time employment. During this period the clinical resident is expected to run individual therapies. Family or group therapies are welcome but not mandatory. At least one year has to be executed in an ambulatory clinic; another year has to be done in a psychiatric ward. During this period of residency the clinical resident has to be given at least 160 hours of a supervision on psychotherapy, 30 hours supervision on interviewing, and 160 hours on psychodiagnostics. After fulfilling all of those duties the resident has to undergo a final exam, in which he or she present a case of psychotherapy and a case of psychodiagnostics. It is noteworthy to mention here that the residency regulations allow the resident to choose his or approach – psychodynamic, cognitive-behavioral, or system-familial. However, the evolution of the profession of clinical psychology in Israel, until recently, was apparently predisposed toward the psychodynamic school. Only very few had chosen a direction other than psychodynamic. Recent forces in the field try to reverse this situation, and a very acute and bitter struggle is going on at the present between traditional, psychodynamic-oriented psychologist, on the one hand, and another group which is more CBT and research oriented ones, about the way clinical psychology will be taught and practiced in the state.
It is also worth mentioning here that all residents, regardless of their theoretical approach, should practice what we tend calling the ‘classical battery’ of psychodiagnostic instruments, namely – the Wechsler Intelligence scale, The Bender Gestalt Visual-Motor Test, The Rorschach Inkblot Test (Exner system), The Thematic Apperception Test (the TAT), and the picture (House-Tree-Person) Test. The group that opposes the traditional, psychodynamic establishment criticizes the use of that battery, which is apparently psychodynamic in its nature, and strives to replace them by other diagnostic tools, like the MMPI (Minesota Multiphasic Personality Inventory), or other tools, more suitable to therapeutic approaches other than psychodynamic.
After reviewing so briefly the clinical training in Israel, I would like to make another brief review of the history of the profession in Israel, and I would try to follow two lines. The first one is the development of academic psychology. Studies of Psychology as an academic discipline had began in the Hebrew University of Jerusalem in 1940, conducted by Enzo Bonaventura (1891, Pizza, Italy – 1948, Jerusalem, Israel), a distinguished professor of psychology in the University of Florence, who immigrated to Israel, where he founded the first laboratory of psychology and the department of psychology in Jerusalem. Prof. Bonaventura was killed by Palestinians in the 1948 war. After this distressing event the department of psychology in the Hebrew University in Jerusalem had been continued being carried by various specialists, until it was re-founded by another immigrant, that time from the USA, Shlomo (Sunny) Kugelmass, who left a position in Columbia University. I had the privilege of studying with Prof. Kugelmass, who is now retired, and even being tutored by him in my master’s thesis. Since the fifties of the twentieth century departments of psychology had been founded in all the other universities in Israel.
The second line in my so brief review is pointing to the foundation of the psychoanalytic institute in Jerusalem by Max Eitingon, M. D. (1881, Могилёвm Belarus – 1943, Jerusalem). Eitingon was one of Freud’s distinguished followers. He immigrated to Israel (at that time – Palestine, under the British Mandate) in 1933, after the Nazis started ruling Germany. This institute exists until today, and accumulated much prestige for its profound and serious clinical excellence. Not so long time ago a second institute, of a more contemporary character, had been founded in Tel-Aviv. Both institutes are proud of having a long list of candidates. Academic departments of psychology are irresolute in their attitude toward the discipline of psychoanalysis; only in 1977 a chair under the name of Freud had been erected in the Hebrew University, and was first appointed the British famous psychoanalyst Joseph Sandler (1927, Cape town, South-Africa, – 1998, London). I had the privilege of hearing lectures held by Prof. Sandler in Jerusalem.
At the present there are about 9000 psychologists in Israel, a number which, when divided by the country’s total population, yields on of the worlds greatest psychologist per persons ratio. However, not all of them are active in their profession. As was describes above, they practice the various fields of psychology. The specialties that were described do not embrace academic psychology – those psychologists who are engaged in research only, without any specialty. The two largest specialties within the field of psychology are Educational and Clinical. It is worth mentioning that there are other professions, adjacent to psychology, which are engaged in similar practice. These are mainly psychiatry and clinical social work, but also creative therapists (bibliotherapists, art therapists, drama therapists, and the like;) cbt therapists, and more. The latter are not recognized by an explicit law.
I would come to termination of my abridged review by pointing to some of the more intriguing issues that occupy at the present the psychological community in Israel, as I see it:
Psychotherapy: Is psychotherapy exclusive to clinical psychologists? If not, who should be allowed to practice psychotherapy? What should be the requirements for a person to be allowed to practice psychotherapy? And, as a matter of fact, what is psychotherapy?
And still with psychotherapy – what should be the relations between the various schoold pf psychotherapy