Bulgaria

Situation Psychotherapy in Bulgaria

A Short Overview on Psychotherapy in Bulgaria Today—Practice, Training and Political Developments

The condition of psychotherapy in Bulgaria today is in various ways an inheritance, continuation and furthering upon the previous developments in this field—the very roots of psychotherapy in Bulgarian can be searched for in the beginning of the XXth century as well as in the developments between the two world wars—processes that have been almost completely stopped and vanished in the times of communism to be re-started and renewed again in the very end of 70s and most of all in the very beginning of 80s of the XXth century.

This article does not have a task to make a full and comprehensive research on the entire sphere of psychotherapy in Bulgaria. It gives short outlines of the current situation through looking upon some concrete parameters of it.

The Bulgarian Association for Psychotherapy (BAP) exists legally since 23 November 1993, registered as an NGO in public benefit under the Law for Non-for-Profit Legal Bodies. Currently there are 111 individual members and 10 group members of BAP. The BAP also has declared and plays the role of an umbrella organisation to the psychotherapy sphere in Bulgaria in general.

The number of the individual members of BAP—being fully trained psychotherapists, psychotherapy practitioners or people in earlier stages of their professional training–does not exhaust the total number of practicing psychotherapists in Bulgaria. Some other psychotherapists are members only of their own modalities’ associations and societies. (There is also another phenomenon to be also mentioned here, in brackets. This is that some other professions—mostly psychologists but also people from other professional spheres—unduly name their consultative practice with clients psychotherapy without having any specialised training in psychotherapy. This is a big professional issue that BAP has not found and come with a proper resolution of so far.) Otherwise the estimation of numbers would be that through the group members of BAP as well as through other professional associations and societies outside BAP–there may be are more than 500 people professionally involved in psychotherapy sphere. In other words a number lower to the real social impact and needs of psychotherapy that is there currently in Bulgaria.

Since 2008 BAP established and has been running National Register of Psychotherapists in Bulgaria. This is the only legitimate register existing and to be referred to. Currently there are 50 registered psychotherapists in the National Register where the grant parenting procedure has been applied in certain cases. Since almost most of the existing psychotherapeutic schools in Bulgaria nowadays have established and organized the training and formation of their followers. The trend is that most of the people who apply and become nowadays registered psychotherapists are fully trained in at least one psychotherapeutic modality.

The group members of BAP in a way also represent most of the psychotherapeutic schools existing in Bulgaria. Those members are (in alphabetical order) Bulgarian Association of Art Therapy, Bulgarian Association for Cognitive-Behaviour Psychotherapy, Bulgarian Association for Family Therapy, Bulgarian Association for Music Therapy, Association of Short-Term Psychotherapists, Bulgarian Neoreichian Psychoterapeutic Association, Bulgarian Society for Psychodrama and Group Psychotherapy, Bulgarian Society of Analytical Psychology of K.G.Jung, Study Group for Development of Psychoanalysis in Bulgaria, The Society for Positive Psychotherapy in Bulgaria.

In addition there are two alternative schools in Lacanican psychoanalysis. These are Bulgarian Society for Lacanian Psychoanalysis in Bulgaria and Bulgarian Psychoanalytic Space Society. Although they are not members of BAP some of their key figures and psychotherapists are individual members.

A crucial recent development in the field is the establishment of the Bulgarian Society of Group Analysis and Group Processes which marked the end of the training of the first group of group analysts in Bulgaria—a joint endeavour of local and foreign psychotherapists affiliated to SFU.
Training in Gestalt Therapy as well as in Transactional Analysis has been recently started.

The training of psychotherapists varies from modality to another according to the specificity of the school, its roots and history, founders, etc. The professional associations that are members of BAP share and apply in their training standards and requirements of BAP/EAP. These are 3200 total hours of training, of those 1800 of basic training and 1400 of specialized training, etc. The specialized level of psychotherapy training takes place outside universities, in private institutes. Some schools/modalities are eager and do recognize the basic training in psychotherapy being possible and given at universities—which is the case of Bulgaria is mostly applied about university training and degrees in psychology. There is still not shared understanding that, although there might be some similarities, the training in psychotherapy is something different than what the basic training in psychology is, for example. Although the Strasbourg declaration is officially accepted by BAP and agreed upon among professional community people from other professional backgrounds–explained like broader humanities and/or social sciences–are still rarely accepted and let to training in psychotherapy only by certain psychotherapeutic schools. University people in general with very little exceptions are pretty hesitant, sceptical and even actively opposing the idea of psychotherapy training taking place in university realm. That is often a result of simple envy and fear. Sometimes it also shows misunderstanding between the psychotherapy science and education and therapy as a process of (self-)healing that universities seem to be frenetically afraid of. That all immediately brings to the surface another important issue to be mentioned here. It is that thus at the moment scientific research in psychotherapy in my country is fated to remain artificially distracted from universities and researchers.

Having the above said there are 16 psychotherapeutic modalities represented in Bulgaria currently—being members or outside BAP. These are (in alphabetical order) Analytical Psychology of K.G.Jung; Art-Therapy; Cognitive-Behavioural Psychotherapy; Family Therapy; Gestalt Therapy; Group Analysis; Hypnosis; Lacanian Psychoanalysis; Music Therapy; Neoreichian Analytic Psychotherapy; Positive Psychotherapy; Psychoanalysis; Psychodrama, Sociomentry and Group Psychotherapy; Short-Term Psychotherapy; Transactional Analysis; Transpersonal Psychotherapy. Many in numbers those psychotherapeutic modalities are on different stages of their own histories and development. They vary in professional reputation, social application of their activities and practices, efficiency, effectiveness, popularity, number of their trainees and followers, etc.

There is no legislation in psychotherapy. Psychotherapy is neither officially recognized nor among listed professions in Bulgaria. The BAP has been putting efforts in improving the situation and developing a law project to be introduced and adopted by the Parliament for quite some year now. In the previous mandate of BAP (2009-2012)—thanks to the dedication and voluntary work of just few colleagues, incl. a lawyer, and the support of the Managing Board—a first draft of the Law in Psychotherapy was accomplished and introduced before the professional community. In the current mandate (2012-2015) the Managing Board of BAP has declared their desire to continue further on with the already achieved stage of development of the law project as one of their priorities.

The government does not participate in regulation and governing the psychotherapy in Bulgaria in no way. Psychotherapy is not covered and/or paid by health insurance or any other public funds. Psychotherapeutic practice is most of all organized privately, outside clinics and hospitals, in private cabinets, etc. There is no referring system or any other official form of connecting the two realities—the one of the state health system and the private one of psychotherapy practice—besides the word of mouth practiced between individuals. Thus psychotherapy in Bulgaria stays quite much in isolation to this and other important social, public and political processes. Some psychotherapeutic schools though—trying to be better connected at least to the social reality–apply their approaches in public health centres, community centres, etc. Others—especially group methods–are successfully working in even more marginalized contexts like social houses for children deprived from parental care, homeless people living on the streets with no public or any other support, etc. This all brings again to the surface the old-new question about if psychotherapy belongs to the social or to the health realm, to both or to many more realms that we have to be pro-active about…

Vienna, 14 February 2014

Tzvetelina Iossifova
Registered Psychotherapist; Psychodrama-Therapist; Group Analyst
Elected National Delegate of BAP to EAP