For many years now, a debate has been ongoing in Italy regarding the establishment of the Primary Care Psychologist within the National Health Service.
The demand for mental health services has been steadily increasing, and following the COVID-19 pandemic, this need has more than doubled. At the same time, the way mental health and psychological well-being are perceived has changed, and people now express less fear of stigma and less discomfort in seeking help from a psychologist.
Where can people find support for these needs?
In Italy, there are currently two main channels through which individuals can access psychological support and psychotherapy services: the private sector and the public healthcare system.
Both present certain challenges. Private psychotherapy services, for example, often provide prompt and effective support, but they are not always accessible to everyone due to high costs, often combined with the prospect of lengthy treatment pathways.
Public healthcare services, on the other hand, while generally more affordable, are often characterized by slow bureaucratic procedures and long waiting lists. These delays are also influenced by the predominance of traditional approaches that rely on long-term treatments, which are frequently incompatible with both people’s needs and lifestyles and the operational demands of the services themselves. As a result, public services often struggle to provide rapid and effective support to a large population.
How can access to mental health and psychological well-being services be improved and made more accessible?
Since Italy still does not have a national law regulating the role of the Primary Care Psychologist, but only the adoption by the Chamber of Deputies’ Social Affairs Committee of the draft legislation entitled “Establishment of Primary Psychological Care Services within the National Health Service,” we can draw inspiration from the model of Intermittent Brief Psychotherapy Throughout the Life Cycle proposed by Nicholas Cummings (Cummings, 1990; Cummings & Sayama, 1995).
Cummings was a psychologist and Chief of Mental Health at Kaiser Permanente Health Maintenance Organization, as well as the founding president of the California School of Professional Psychology, where he trained numerous psychologists and therapists in this approach.
What does Nicholas Cummings’ model of Intermittent Brief Psychotherapy Throughout the Life Cycle involve?
Drawing on the healthcare model provided by primary care medicine—where patients consult their physician only when needed—Cummings argued that people should consult a psychologist or psychotherapist when they encounter a problem and discontinue therapy once that problem has been resolved.
Rather than engaging in lengthy and time-consuming psychotherapy, clients retain the option of returning to therapy whenever a new issue arises. According to Cummings, this process can continue throughout the individual’s lifetime.
How does this differ from the medical context?
The main difference between the medical and therapeutic contexts is that, within therapy, individuals can learn to become their own therapists. They can apply what they have learned during previous therapeutic experiences to future challenges and seek professional support again only when their self-help efforts prove insufficient.
Conclusion
The model of Intermittent Brief Psychotherapy Throughout the Life Cycle proposed by Cummings can be integrated with the Single-Session Therapy approach. This integration can support the development of professionals and services capable of providing targeted interventions focused on achieving specific goals, while also promoting services designed to help individuals maintain psychological well-being throughout the entire lifespan.
Angelica Giannetti
Psychologist, Psychotherapist
Member of the Italian Center
for Single Session Therapy Team
References
Cannistrà, F. & Piccirilli, F. (2018). Terapia a seduta singola. Principi e pratiche. Giunti.
Cummings, N. (1990). The Credentialing of Professional Psychologists and Its Implication for the Other Mental Health Disciplines. Journal of Counseling & Development, Vol. 68, Issue 5.
Cummings, N. & Sayama, M. (1995). Focused Psychotherapy. A Casebook Of Brief Intermittent Psychotherapy Throughout The Life Cycle. Routledge.