Coming to work in mental health care in the Netherlands (1)? Structure & Professional Relationships

No matter how many years of experience you have in the field of mental health, (re-) starting your career in a new country is always challenging. PsyGlobal wants to guide you in this challenging process, to make

 sure your landing will be as soft as possible. We interviewed Dutch professionals Wendy Weijts, clinical psychologist and psychotherapist, connected to WorldPsychologist, and teacher at RINO Amsterdam and Myra Haakman, psychologist, psychological lead at PsyGlobal, and co-founder of WorldPsychologist, about the Dutch vision on mental health care. In this article, we touch upon the subjects of structure and professional relationships. Articles about the intake, diagnosis, treatment plans and evaluation will follow.

The importance of structure

Probably the most specific characteristic of the Dutch mental health system is that it’s very structured. The level of structure will differ from practice to practice, but it’s always present to some extent. For example, intake sessions follow a certain framework and treatment plans are usually clearly predefined. This is partly due to insurance matters, but it’s also very much due to Dutch culture. The Dutch are a very structured people. This can be challenging. However, in the end it is very helpful to follow a certain structure. Not only for the client, but also for you as a therapist.

It is good to have a predefined plan before you start a treatment. And, for example, a clear timeframe for a session. On the one hand it helps you to maintain control, and on the other hand it gives you a well-deserved 15-minute break in between sessions. It’s also good to explain this to your client. Tell them that your sessions last 45 minutes and that you follow a structured treatment plan with them. If you find it difficult to explain why, you can always emphasize the fact that insurance only covers a certain number of 45-minute sessions, and that your hands are tied because of this.

The client needs to get to work

Another typical part of the Dutch mental health system is that it asks for a proactive attitude from the client. Getting psychological help in the Netherlands means that you, as a client, must get to work as well. The therapist will not solve your problems for you. The therapist does not take over control. They will set the structure, but the client is still in charge. Explain that to your client, manage their expectations: tell them how you are going to work on their issues together. How it is expected that they do their ‘homework’ in between sessions and report back to you about it in the sessions that follow. The more effort the client puts in, the more therapy will bring them. 

When it comes to managing expectations, make sure you get realistic goals together. We will dive deeper into these goals in the next articles. However, it’s good to point out that setting goals does not mean that you cannot give your client hope. Visualize their situation after the therapy has ended, how life will be different. This gives confidence and it will increase their motivation. 

Professional relationship

In the Netherlands, the approach to the client-therapist relationship in mental health care is primarily professional and focused on expertise and guidance towards recovery. Unlike some countries where the relationship may take on a more personal approach, therapists in the Netherlands maintain a boundary between their professional role and personal life. This does not mean that Dutch therapists are not friendly or never get personal, it’s however probably less than what you are used to. While this approach may seem more formal, it can foster a sense of trust and confidence in the therapeutic process. Clients often appreciate the clarity and professionalism that comes with knowing their therapist is solely focused on their well-being and journey to healing. By maintaining a professional distance, therapists in the Netherlands aim to create a safe and supportive environment where clients feel understood and empowered to address their mental health challenges.

We do not say that it’s wrong to have a more personal relationship with a client. Especially for clients that have trust-issues, this might feel like the best way to go. However, we do believe those issues can also be tackled with a more professional relationship, with boundaries and structure.

There is a strong parallel with parenting. It’s important for children to have autonomy, to explore and learn on their own, but they also need clear boundaries and guidance. In a structured and supportive environment, children feel safe and secure. The same holds for therapy: setting boundaries creates a sense of safety and predictability, an important foundation for growth and development.

To further enhance the feeling of safety, emphasize on confidentiality: everything you discuss in the therapy room stays there. You have to do all correspondence with consent of the client. You might need to repeat that a few times for your client to believe you, since they might have heard that before.

No right or wrong

If you start working within the Dutch mental health care, you will be thrown in the deep. Not only because everything is new and different here, but also because you’ll probably have to deal with complex cases of trauma, depression, addiction, and distrust in the system. We want to make your life easier. Hopefully, our articles will help you to understand the processes here, your colleagues, insurance matters.

We believe that frameworks and structure work, especially when dealing with heavy cases and caseload. That does not mean however that proposed protocols and structures are the only right way to do things. You are not ‘wrong’ if you are doing things differently.

We want to emphasize the fact that, no matter what, you are making a huge difference in the life of your clients. And we thank you for that.  

Do you want to read more about working in a merely Dutch culture? We have written another article about stereotypes in the workplace. You can find it here.