by Swiss Society for Sports Psychiatry and Psychotherapy SSSPP
Claussen Malte Christian1, Imboden Christian2, Seifritz Erich3, Hemmeter Ulrich4,
Gonzalez Hofmann Carlos5
1 Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland, Private Clinic Wyss AG, Münchenbuchsee, Switzerland, and Psychiatric Services Grisons, Chur, Switzerland
2 Private Clinic Wyss AG, Münchenbuchsee
3 Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich
4 Psychiatry St. Gallen North, Wil, Switzerland
5 Practice for Psychiatry and Psychotherapy, Romanshorn, Switzerland
Abstract
The SSSPP established a three level curriculum for additional training in Sports Psychiatry and Psychotherapy. Level 1 “Basic Healthcare In Sports Psychiatry And Psychotherapy” is imparted. The curriculum contains a theoretical part, practical experience and supervision within 80 hours of additional training, leading to a SSSPP certificate. Basic knowledge in sports medicine, sports psychology, sports science and training theory as well as further topics of sports and exercise therapy with mental disorders, disorders related to elite sports, sport as coping and additional topics such as law, ethics, abuse, and doping are contained. Study goals are defined. Psychiatrists and psychotherapists, sports physician, and psychological psychotherapists could participate on level 1. An outlook on levels 2 and 3 is added.
Zusammenfassung
Die SGSPP hat ein dreistufiges Fortbildungs-Curriculum entwickelt für Sportpsychiatrie und -psychotherapie. Die Stufe 1 «Sportpsychiatrische und -psychotherapeutische Basisversorgung» wird hier vorgestellt. Das Curriculum umfasst einen Theorieteil, praktische Erfahrung und Supervision, mit einem Umfang von 80 Stunden Fortbildung. Es führt zu einem Zertifikat der SGSPP. Das Curriculum umfasst Grundkenntnisse in Sportmedizin, Sportpsychologie, Sportwissenschaft und Trainingstheorie. Weitere Themen sind Sport- und Bewegungstherapie bei psychischer Krankheit, psychische Störungen im Leistungssport, Sport als Coping sowie ergänzende Themen wie Recht, Ethik, Missbrauch und Doping. Die Lernziele werden beschrieben. Die Studie 1 des Curriculums kann von Psychiatern und Psychotherapeuten, Sportmedizinern sowie psychologischen Psychotherapeuten absolviert werden. Ergänzend wird ein Ausblick auf die Stufen 2 und 3 gegeben.
There has been a tremendous development within all aspects of psychiatry and psychotherapy. This applies to child and adolescent psychiatry and psychotherapy as well. Within the following text, the terms “psychiatry and psychotherapy” and “psychiatrist and psychotherapist” relate to both areas of expertise.
Among other things, the development of psychiatry and psychotherapy can be demonstrated by an increasing specialization within both areas of expertise. At present, both areas of expertise have five sub-specializations within private law (see chart 1) [1]. These sub-specializations shall facilitate advanced training in both psychiatric and psychotherapeutic knowledge and skills.
The terms “additional qualification” and “certificate” have been chosen for the following text, thus differentiating them from the point of interests mentioned above.

Introduction
The SSSPP intends to promote the fostering of sports psychiatry and psychotherapy throughout life in Switzerland for both high professional sports as well as for the general public (see box).
Quite a significance has been attached to the health-relevant “dosage of sport and exercise” within aspects of prevention, treatment and rehabilitation in our society, which has been marked by a lack of exercise. This applies to mental disorders as well [2,3]. On the one hand, sport and exercise therapy may be valuable additions to other means of treatment, e.g. pharmalogical, on the other hand, they may present themselves as alternatives to some symptoms.
In elite sports, mental health is of great significance, whether this applies to the active phase or after ending a career. This also applies to sport throughout life [4]. Mental health, well-being, and performance (in sports) relate to each other. Mental strains and illnesses in sport may have an influence on the performance, they may increase the risk for injuries and they may lengthen rehabilitation. Injuries have an influence on the performance, too, and are strains and risks for mental health.
The described relevance of sports psychiatry and psychotherapy throughout life within both fields is supposed to be exactly represented in a curriculum for sports psychiatry and psychotherapy. The basic needs for a specialization (sports psychiatry and psychotherapy, chart 2) result from the respective conditions and necessities in both elite sports as well as for the general public. After medical training, these requirements call for an advanced training in psychiatry and psychotherapy for several years in one of the specialised areas and optional key topics. Ideally, this goes hand in hand with additional, in-depth advanced training in psychosomatic and neurological areas as well as sports medicine. The SSSPP Curriculum Sports Psychiatry And Psychotherapy is supposed to build on these basic requirements, and then convey the necessary, further specific knowledge and skills.

Sport and physical exercise related aspects are of important relevance in psychiatry and psychotherapy, concerting for prevention, therapy and rehabilitation (e.g. dementia) [5]. The requirements in elite sports call for a safe and sound judgement and handling with strains and risks for mental health, as well as in diagnosis and treatment on subclinical illness [4]. The required necessary in-depth knowledge and skills are neither implicated in advanced training programs for psychiatry and psychotherapy nor in sports medicine. To ensure quality assurance, the Curriculum Sports Psychiatry And Psychotherapy is offered and shall be developed further to implement necessary and in-depth knowledge and skills based on voluntary gain of additional qualification.
The SSSPP Curriculum Sports Psychiatry And Psychotherapy is based on the three level Curriculum Sports Cardiology of the German Society For Cardiology – Heart And Cardiovascular Research .e.V. and the German Society For Sports Medicine And Prevention e.V. [6]. In this text, level 1 of the SSSPP Curriculum Sports Psychiatry And Psychotherapy describes the “Basic Health Care In Sport Psychiatry And Psychotherapy”. Furthermore, the text may present an outlook on level 2 and 3 of the curriculum; contents and study goals will be thoroughly worked on by using the experiences of level 1. Chart 3 shows the three level approach of the Curriculum Sports Psychiatry And Therapy.

The SSSPP Curriculum Sports Psychiatry And Psychotherapy is supposed to facilitate further in-depth studies in psychiatric knowledge and developed skills. Participation in the advanced training curriculum level 1 is open to both colleagues who are in advanced studies in psychiatry and psychotherapy as well as sports physician (without psychiatric advanced training but with interdisciplinary sub-specialization) as well as psychological psychotherapists (chart 3). Knowledge and skills of basic health care for sports psychiatry and psychotherapy are important for sports physician and psychological psychotherapists. Granting sports physician access underlines that sports psychiatry and psychotherapy are not only a part of psychiatric special areas and disciplines, but also a cross section of sports medicine. At present, first steps are taken in exchange with the Sports and Exercise Medicine Switzerland (SEMS) to help develop the curriculum and to implement the sports medicine expertise and experience from the interdisciplinary key topic sport medicine of the SEMS into the levels 1-3 of the curriculum.
The text lists contents and study goals, which are to be conveyed and implemented by the SSSPP Curriculum Sports Psychiatry And Psychotherapy, as well as the practical application and the requirements for the candidates and advanced programs, as well as recognition, transitorial rulings and further remarks. All of this as well as further information, including all necessary forms and applications, can be found on the SSSPP homepage [https://sgspp.ch/cmf/de/curriculum].
In charge of the elaboration of level 1 of the Curriculum Sports Psychiatry And Psychotherapy was a team within the SSSPP. Together with the team of the German Society For Sports Psychiatry And Psychotherapy (DGSPP), this level was elaborated. The contents described in the text have been approved by the board of the SSSPP and they differ in some minor points from the curriculum of the DGSPP. Accordingly, the corresponding publication of the DGSPP Curriculum Sports Psychiatry And Psychotherapy is referred to.
Goals
Participation in the curriculum for an additional qualification “Basic Health Care In Sports Psychiatry And Psychotherapy” level 1 of the Curriculum Sports Psychiatry And Sport Psychotherapy serves to gain fundamental basic knowledge. Through the contents of the curriculum defined study goals can be achieved, which enable the graduates of the curriculum for basic health care in sports psychiatry and psychotherapy, study goals see below.
Level 1 of the Curriculum Sports Psychiatry And Psychotherapy (“Basic Health Care In Sports Psychiatry And Psychotherapy”).
Content
The curriculum on level 1 encompasses a time frame of 80 hours (CME Credits). Within these 80 hours, basic knowledge in sports medicine, sports psychology, sports science, and training theory as well as further topics of sports and exercise therapy with mental disorders, disorders related to elite sports, sport as coping and additional topics such as law, ethics, abuse and doping are contained. Chart 4 lists the topics of the SSSPP Curriculum Sports Psychiatry And Psychotherapy Level 1.

Practical implementation of the qualification
Duration of qualification
In order to obtain the additional qualification “Basic Health Care In Sports Psychiatry And Psychotherapy” on level 1 of the Curriculum Sports Psychiatry And Psychotherapy, it is necessary to have a year of qualification at least. The curriculum on level 1 should be well mastered within 3 years – the qualification may be obtained alongside clinical work.
Evidence of Activity
To obtain the certificate, evidence of the following is required (see chart 4, topics).
All required content must be obtained independently and are to be documented in the logbook [https://sgspp.ch/cmf/de/curriculum]. It is also required to have a certificate from any instructor of the advanced training course (certificate if attendance). Part of the advanced training program can be obtained from courses of other societies, institutions, and hospitals and others, which have been recognised by the SSSPP. Up to 10 CME credits may be obtained from eLearning or advanced training courses of medical journals.
Minimal requirements for participants within the curriculum
Participants on level 1 of the SSSPP curriculum have to show evidence for at least 3 years of advanced training courses in psychotherapy or adults’ psychiatry and psychotherapy. Ideally, advanced training in psychotherapy has been already begun. The additional qualification “Basic Health Care In Sports Psychiatry An Psychotherapy” can only be granted after the recognition as medical specialist for psychiatry and psychotherapy has been granted. Sports physician and psychological psychotherapists must have completed their respective advanced training program before being admitted to curriculum level 1.
Recognition
The personal applications for recognizing the mandatory requirements of the curriculum to gain the certificate will be examined by a commission appointed by the SSSPP for accuracy and completion. Tabular resume, medical state examinations, diplomas for medical specialisation, evidence of required advanced medical training according to the curriculum, and the logbook have to be handed in.
A re-certification may follow after 5 years. According to the curriculum, evidence has to be shown for 30 hours.
Transitorial rules
The curriculum for the certificate “Basic Health Care In Sports Psychiatry And Psychotherapy” starts on March 31 2020. There is a time-limited transitorial arrangement regarding the protection of vested rights for already performed advanced training courses for three years (Until March 31 2023). There is a simplified procedure in which the certificates may be obtained by self declaration according to these vested rights.
The information listed within the text as well as any other information, including all necessary forms and applications, can be found on the SSSPP homepage [https://sgspp.ch/cmf/de/curriculum].
Outlook: Level 2 & 3
Level 2 (“Clinical Practical Sports Psychiatry And Psychotherapy”) of the Curriculum Sports Psychiatry And Psychotherapy builds on the acquired knowledge and skills of level 1 of the SSSPP Curriculum. Level 3 builds up on Level 2. Both levels intend to convey specialised practical competence and skills of sports psychiatry and psychotherapy, level 2 focusing on sports and exercise therapy for prevention and theory of mental disorders (see chart 2), level 3 focusing on diagnose and therapy of elite sports people, especially taking into consideration interdisciplinary aspects (regarding sports medicine and sports psychology). In addition to 80 hours level 1, level 2 comprises further 80 hours of advanced training, thus 160 hours are required altogether, so does level 3 with further 80 hours. After completed level 3 a total of 240 hours leads to a certiciate of competence “Sports Psychiatrist and Psychotherapist”.
Specified contents and study goals as well as the practical implementation of levels 2 and 3, based on experiences of level 1 of the Curriculum Sports Psychiatry And Psychotherapy, will be worked on by the team curriculum SSSPP. Further publications will be referred to.
Corresponding author
Dr. med. Carlos Gonzalez Hofmann,
Head working group curriculum SSSPP,
Practice for Psychiatry and
Psychotherapy, Romanshorn,
Switzerland
c.gonzalez-hofmann@hin.ch
References
- SIWF Schweizerisches Institut für ärztliche Weiter- und Fortbildung. https://wwwsiwfch/indexcfm. 2020.
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- Chekroud SR, Gueorguieva R, Zheutlin AB, Paulus M, Krumholz HM, Krystal JH, et al. Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatry. 2018;5(9):739-746.
- Reardon CL, Hainline B, Aron CM, Baron D, Baum AL, Bindra A, et al. Mental health in elite athletes: International Olympic Committee consensus statement (2019). British journal of sports medicine. 2019;53(11):667-99.
- Kram S, Kleppe C.L, Nordhus I.H, Morland A. Exercise as a treatment for depression: A meta-analysis. J. Affect. Disord. 2016;202:67-86.
- Burgstahler C, Pressler A, Berrisch-Rahmel S, Mellwig K-P, Bongarth C, Halle M, et al. Curriculum Sportkardiologie. Kardiologe. 2019; 13(1):26-37.
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