1 Romania s National Report An overview of the regulatory framework and national system to protect the psychologist profession with free practice objective in the health services sector 1. Definition In Romania, the title of qualification for the profession of psychologist with right of free practice is regulated in the previsions of National Law no. 213/2004. The psychologist with right of free practice conducts the following activities: a) the study of human behaviour and mental processes; b) investigating and recommending ways to solve psychological problem; c) the development and application of tests for measuring intelligence, abilities, skills and other human characteristics; d) psychological testing, prevention and psychotherapy emotional and personality disorders and maladjustment phenomena of social and professional environment; e) interpretation of data and drafting recommendations it deems necessary. The activities mentioned above are conducted in accordance with the principles stipulated in the Shared values of the liberal professions in the European Union, approved by the European Council of the Liberal Professions - CEPLIS, in the following areas: health (specialties: clinical psychology, counselling and psychotherapy), market labour, industry and business (specialties: work and organizational psychology, transport psychology and applied psychology services), education (specialties: educational psychology, school and vocational counselling, special psycho-pedagogy) and defence, public order and national security (specialties: applied psychology in national security and judicial psychology - evaluation of simulated behaviour using polygraph technique). 2. Historical background The evolution of Romanian society towards accession to the European Union imposed development of services that ensure all citizens access to health services. Psychological services are an integrated part of health services. In this context, psychological services were provided prior to 1 July 2004 by psychologists that worked just as staff in institutions, generally public ones, in an insufficient number that didn't cover the existing needs of the psychological services market. So, the access for Romanian citizens, for patients, to psychological health services was hampered by the lack of a professional body such as group of specialized professionals, that should ensure uniform conditions for the exercise of the profession of psychologist in Romania.
2 Thus, by Law no. 213/2004 the profession of psychologist in Romania has been regulated, and it was established a professional organization, the Romanian College of Psychologists, as a regulator for the profession of psychologist in Romania, guaranteeing the right of free association of all psychologists in specific professional associations without any fencing. It was created a strategic organization, which can achieve the objectives in the development of psychological services. Thus, access to the profession of psychologist is done on the basis of uniform conditions, transparency, measured in a common reference without discrimination and privileges. Also, the main objectives were met: a) free access to the profession, on the basis of common criteria, transparency, evaluated in a coherent and unitary (conditions: undergraduate degree in psychology or similar specialty, medical evidence of fitness for the profession of psychologist, inexistence of incompatibilities or prohibitions laws, lack of criminal convictions to ban the practice of the profession); b) regulating a quality standard in psychological services, unique nationwide, presented in a transparent manner to ensure the protection of consumers / beneficiaries of the psychological services and eliminate anticompetitive practices; c) regulating a single standard training in order to provide a similar level of quality psychological services provided, to ensure the consumer protection for the beneficiaries of the psychological services; d) approval of a Code of ethics for the profession of psychologist with tight of free practice, unique nationwide (which claims privacy principles, scientific and professional responsibility with the purpose of avoiding conflict of interest, independence and impartiality, honesty, reporting cases of abuse, the obtaining of expert second opinion, etc.) accessible by electronic means, by both psychologists and beneficiaries of psychological services; e) removing or illegal or anticompetitive practices, by requiring a professional recording system based on ensuring the confidentiality and security services provided professional acts in order to avoid fraud / forgery; f) representation of psychologists interests, in order to enforce and defend their professional rights; g) development of new fields, useful beneficiaries of psychological services. 3. Economic data In Romania, before regulating the profession of psychologist (on 1st of July 2004), there were approximately 500 psychologists in practice, even though the number of psychology graduates and people who practiced related occupations was somewhere around 1,000 people. After regulating the profession of psychologist, the number of people interested in this profession has increased considerably, because there were created conditions for practicing
3 with a right of free practice, that can be organized either in individual offices, in associated offices or in professional civil societies of psychology. In Romania currently operate approximately 16,000 psychologists with right of free practice, of which nearly 7,000 psychologists permanently practice psychology as a primary profession and approximately 9,000 practice psychology as a secondary occupation. This was possible because the Romanian College of Psychologists has promoted the psychologist's role in society, and the advantages of using psychological services by the population. Through dialogue and negotiations with governmental authorities, this professional organization managed, first time in Romania, in 2013, the regulation of the reimbursement of expenses of absolutely necessary psychological services through public health insurance. In 2014, the Romanian College of Psychologists managed, unprecedentedly, the expansion of these psychological services, from 4 to 10 different types of psychological services reimbursed. Developing the profession of psychologist has created the possibility of hiring new staff, only in 2014, a total of 350 psychologists. Currently there are approximately 5,500 independent forms of practice (private forms). 4. Internal screening and recent reforms With the regulation of the profession of psychologist in Romania (since 1st of July 2004), the newly founded institution, the Romanian College of Psychologists, was able to identify several issues in the profession, mainly due to the lack of regulation, lack of knowledge regarding the professional rights and obligations, confusion between psychological services and psychiatric / medical services, psychologists lack of independence, lack of authority in regulating the profession of psychologists in an unitary manner and deficiencies in initial and continuing vocational training 1 as follows: a) the training at Higher education level which seems to be inadequate to the needs of beneficiaries of psychological services; b) lack of uniform quality standards for psychological services, in order to protect beneficiaries of psychological services; c) lack of uniform and transparent procedures for access to the profession of psychologist; d) lack of uniform professional standards in the training of psychologists; e) lack of a uniform system of a professional evidence, secured in order to combat fraud, illegal practices and anti-competitive practices; f) lack of evaluation methods, techniques and psychological assistance adapted and validation on specific populations; 1 Mainly determined by the difference between psychological needs of service users and the quality of Higher education, maladjusted a profession
4 g) lack of a single code of ethics for all practitioners, in order to protect beneficiaries of psychological services. The Romanian College of Psychologists took the measures implying sociological analysis of the situation in the market, started a process involving consultation and debate with higher education institutions, public institutions, psychologists and their local leaders, and subsequently adopted many measures to eliminate these shortcomings. Thus, it have been approved The Unique Standards of Quality for Psychological Services, The Unique Rules on Access to the Profession of Psychologist with a free practice (which enshrined free access to the profession), The Uniform Rules on Professional Training of Psychologists with a free practice, The Single Standard regarding Professional Evidence and Securing Professional Documents, Unique Rules regarding Endorsement of Methods and Evaluation Techniques and Psychological Assistance and last but not least, a Code of Ethics for the Profession of Psychologist with a free practice. All these documents were adopted and published in the Romanian Official Journal/Gazette, so as to ensure their transparency and accessibility for both psychologists and beneficiaries of psychological services. The objectives of the regulations were aimed at removing chaos, creation of simple, transparent and accessible proceedings, in order to meet the needs of consumer protection, to prevent anticompetitive practices, to ensure freedom access to the psychological profession and increasing service quality. 5. System in place to protect general interest objective The profession of psychologist is a regulated profession, but it is not a privileged profession so as to interfere with the general interest. The profession of psychologist is protected only in the sense of ensuring the independence regarding organizing the exercise of the profession, a fundamental and inalienable condition, meant to ensure the quality of psychological services, otherwise it is under the direct control of the state and the general interest of society. The public authorities, through the Romanian Parliament, have retained absolute control over the law on organizing the exercise of the profession, so can always modify, supplement or even repeal any statutory provision concerning the profession of psychologist. Romanian Government approves rules for the application of specific legislation, with similar powers of Parliament. Moreover, the Romanian College of Psychologists has adopted measures to ensure quality standards in psychological services, to ensure the confidentiality, to impose fiscal control of economic activities carried out by psychologists, to ensure a competitive market for beneficiaries of psychological services, professional liability insurance, evidence and security documents issued by professional psychologists (for example, to protect the public interest, the
5 Stamp Factory issue professional stamps, which applies to all psychological reports, to secure beneficiaries and combat illegal practice, Code of Ethics ensures the protection of beneficiaries against possible abuses of psychologists, Quality Standards facilitate the exact knowledge of the beneficiaries of the professional competence of psychologists, etc.). Moreover, the Romanian College of Psychologists signed many agreements and protocols with state institutions, to ensure transparent procedures and the protection of beneficiaries psychological services. 6. Institutional organisation The profession of psychologist is organized in a uniform manner, but without imposing restrictions on free association to the profession, on free access to the forms of exercise of the profession, on the number of staff, on their location, on their choice on organization and management at the local level. College of Psychologists of Romania is a private professional organization, apolitical, independent, with its own organization and budget. The profession of psychologist is coordinated by a national body, the Romanian College of Psychologists, consisting of representatives of all psychologists, organized in regional branches, with functional autonomy on territorial level, but without the possibility of regulating different standards of professional practice, in order to ensure unitary quality and non-discriminatory standard in relation to the beneficiaries of psychological services. Territorial branches have leaders chosen from psychologists in the territory, without any interference from the national coordinator. Moreover, in the governing bodies of the Romanian College of Psychologists, majority votes are owned by the representatives of regional branches, which virtually adopt measures democratically. Thus, functional measures are adopted in local branches, following the autonomy principle, while normative acts are adopted only centrally, by all representatives of regional branches. Basically, this type of corporate form of organization ensure independence of the leadership and unit measures adopted. 7. Certification systems Professional certification is done voluntarily, without any fencing, with the possibility of exercising the profession of psychologist or a similar profession, in other occupations / professions related fields (academic, public servant, etc.). Regarding the exercise of their profession with a free practice in offices or private companies, it must be certified in specialized and unified manner, to ensure the same quality standards for beneficiaries psychological services.
6 The Romanian College of Psychologists ensures certification under the law approved by the Romanian Parliament, with no deviation from the legal conditions set by it. Professional Certification ensures the protection of the general interest by checking the competence level of professional psychologists specialized, by analysing the level of skills and professional competences, steps of specialization and competence. In parallel, public institutions of education, health and other areas, perform an activity of selection for framing professionals in public offices, educational, or other salaried positions, in accordance with their specific legislation. 8. Additional information It is obvious that there is a tendency today, attribute to statistical concepts, to assimilate professional acts with acts of commerce or even with work. In these circumstances, especially in the intellectual professions, we appreciate that a liberal profession is and must remain the prerogative of intellectual value, therefore a regulated profession that is exercised independently by a professionally qualified person without talking about a traders. The assimilation of a liberal professionals with traders could represent a legal and social error, having first effect in harming the quality of services, legal and disciplinary liability, beneficiaries being deprived of quality professional services. At the same time, creating the possibility of existence in the same system of the two occupations, which have similar content or imply same professional skills, it will certainly affect the quality of services provided. In any coherent legal system, intellectual professions are protected to ensure an elite group of professionals, so that there are no more jobs with the same content of specific skills. Otherwise intellectual quality competition will be replaced with commercial/ economical competition and it will unduly decrease in quality of service, as a direct consequence of lower fees and removal competent professionals. Also, the removal of common quality standards, unitary training standards and the development of several specialized professional organizations in the same profession or the same system of law, could create a chaotic situation in the professional services market, difficult to quantify in terms of public confidence and consumer protection. In conclusion, the Romanian College of Psychologists considers that a possible deregulation of this profession will create inevitable social, economic and legal problems, the public interest being affected. The Romanian College of Psychologists Romanian competent authority