Therapist shortage is a bubble – therapy is available

“In Finland, there’s a lot of talk of a therapist shortage and not having access to therapy. This isn’t true,” writes Katri Kanninen, PsyD, psychologist, trainer psychotherapist. Getting to PSYCHOtherapy is hard, because the number of trained psychotherapists isn’t enough to cover the current need for therapy. On 8th October 2022 Helsingin Sanomat published and article about  “Psychotherapy and how the therapy system in Finland is in chaos”. So what’s going on?

We all know the story of Goldilocks. Goldilocks finds herself in the bears’ home testing chairs, porridges and beds. One of them is too big, another too hard or too hot. Until she finally finds just the right one.

This also applies to therapy. The difficulty level of the problem or challenge is integral to choosing the right kind of help. We don’t always need the biggest and heaviest tools, when the right tool may be close and easily available.

There is a structural problem in Finland: we try to offer the heaviest tool to as many as possible

However, we have a structural problem at the moment: the therapy system in Finland is still based on psychotherapists. Psychotherapists study 3.5–4 years in addition to their appropriate basic education. This training takes time and money, and most people pay it themselves. In addition, psychotherapy is often offered as the solution to many mental health challenges in Finland. The number of psychotherapists simply isn’t enough to cover all those in need of help – nor should it. Instead, we should be trying to make the number of psychotherapists enough to cover those in need of the biggest and heaviest tool.

The number of psychotherapists simply isn’t enough to cover all those in need of help – nor should it.

Learning from other countries – the right help for each situation is crucial also in mental health services

Meta-analyses examining several studies at once have stated that…

• about 50% of people get help for their diagnosed mental health problems within ten or twenty sessions.
•         with 30 or 50 sessions, the share of those getting help is already 75%.
•         the more challenging and longer-term the problem, the more sessions are needed.
•         on the other hand, the studies have also found that around 30% of people receive the help they need already in three to five sessions.
•         Therapy isn’t the best tool for everyone. Depending on the study, 20–30% of people don’t get the help they need from it.

In other countries, the therapy systems differ by having psychologists or other mental health professionals with a shorter training providing short-term therapy. This is the future goal in Finland as well.

Now, the important thing is to broaden the understanding of individuals, decision makers and healthcare professionals on what kind of therapy is needed in each situation.

Roughly speaking, the need for short-term therapy and psychotherapy can be determined as follows:

Short-term therapy is for people who

•         seek help in time
•         seek help for somewhat limited challenges
•         are motivated to take part in therapy
•         believe in therapy
•         can open up to the therapist even on matters evoking difficult feelings
•         are interested in exploring the content and processes of their minds
•         can see the effects of their actions on themselves and other people

Psychotherapy is good for people with deeper or more complex challenges and in need of long term support and help in managing their situation.

There are plenty of people benefiting from short-term therapy in Finland. At the moment, many of them are referred or wish to be referred to heavier services like psychotherapy right away, even when it’s not needed. This creates an illusion of a therapist shortage, when in reality the issue is the masses being directed  to the wrong services.

How is the quality and effectiveness of brief therapy ensured?

Unlike the title of psychotherapist, brief therapist is not an occupational title protected by Valvira. This means that anyone in Finland can call themselves a short-term therapist. This in no way makes it easy for the customer.

It goes without saying that a person seeking help is entitled to high quality service. They need a mental health expert with a deep knowledge and experience of the human mind, mental health and therapeutic processes.

Short-term therapy requires a lot from the professional offering it. Therapy being short-term does not equal to light or shallow – quite the opposite.

Signs of a good short-term therapist:

•         The therapist has an appropriate vocational basic education (e.g. psychologist, doctor, social psychologist)
•         The therapist also has skills in brief therapy
•         Therapy is based on cooperation, so it’s important to feel a connection and be understood right from the beginning
•         The therapist can find the root of the problem and help set smart and fitting targets
•         The therapist can give good reasons for how to progress and process the problem
•         The therapist clearly has scientific know-how on the human mind and different therapies
•         The therapist doesn’t try to drag the therapy on for longer than needed by the customer
•         The progress of therapy is monitored on a regular basis
•  If the problem turns out to be more difficult than anticipated, the therapist takes it up for discussion and helps in finding a more suitable form of therapy

For more information, please contact:

Katri Kanninen, 040 7411 795, katri.kanninen@heltti.fi