European guidelines for training in consultation-liaison psychiatry and psychosomatics: report of the EACLPP Workgroup on Training in Consultation-Liaison Psychiatry and Psychosomatics

Abstract

Objective: The European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) has organized a workgroup to establish consensus on the contents and organization of training in consultation-liaison (C-L) for psychiatric and psychosomatic residents.

Methods: Initially, a survey among experts has been conducted to assess the status quo of training in C-L in different European countries. In several consensus meetings, the workgroup discussed aims, core contents, and organizational issues of standards of training in C-L. Twenty C-L specialists in 14 European countries participated in a Delphi procedure answering a detailed consensus checklist, which included different topics under discussion.

Results: Consensus on the following issues has been obtained: (1) all residents in psychiatry or psychosomatics should be exposed to C-L work as part of their clinical experience; (2) a minimum of 6 months of full-time (or equivalent part-time) rotation to a C-L department should take place on the second part of residency; (3) advanced training should last for at least 12 months; (4) supervision of trainees should be clearly defined and organized; and (5) trainees should acquire knowledge and skills on the following: (a) assessment and management of psychiatric and psychosomatic disorders or situations (e.g., suicide/self-harm, somatization, chronic pain and psychiatric disorders, and abnormal illness behavior in somatically ill patients); (b) crisis intervention and psychotherapy methods appropriate for medically ill patients; (c) psychopharmacology in physically ill patients; (d) communication with severely ill patients and dying patients, as well as with medical staff; (e) promotion of coordination of care for complex patients across several disciplines; and (f) organization of C-L service in relation to general hospital and/or primary care. In addition, the workgroup elaborated recommendations on the form of training and on assessment of competency.

Conclusion: This document is a first step towards establishing recognized training in C-L psychiatry and psychosomatics across the European Union.