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The paper is a response to E. Kalvinska's article "From ethicotherapy to modern psychotherapy" (Cas Lék Ces 2009; 148: 243-245) The author quotes from the original materials of the founder of ethicotherapy and contextualizes them.

The submitted paper is based on experience 1. with enlisting epileptic patients in programmes for neurotic patients during hospitalization (1968 - 1983, a total of 20 patients), 2. an ambulatory psychotherapeutic group for epileptic patients only (period 1983 - 1989, a total of 41 subjects, i.e. 39 patients and two mothers of patients) and 3. a club for epileptic patients (1990 - 1993, a total of 56 subjects, incl. 44 patients and relatives, partners and friends). The majority of patients are not only treated at the neurological department but are also psychiatric patients. The author mentions also excursions made with patients who attend the club and on two arts exhibitions of work made by the patients. He presents also results and discusses positive and negative of these tested forms of psychosocial work. The advantage of the programme for neuroses is the relatively intensive action. The advantage of the ambulatory group is the possibility to discuss in detail specific problems of patients with epilepsy. The club is acceptable for a much wider circle of patients than the other two forms. The author recommends a combination of the described three procedure and the application of the widest possible range of other rehabilitation methods.

Aggressiveness is one of the basic characteristics of human beings. It can be defined as a relatively constant individual disposition or group characteristic manifested by the frequency, intensity and mode of aggressive behaviour. Aggressiveness has an inborn basis but its frequency, intensity and form are acquired during life and can therefore be influenced by the environment, i.e. also by training and psychotherapy. With regard to the genesis and purpose we differentiate between reflex, instrumental aggression, aggression with an end in itself and aggression resulting from affection. Psychological theories on the genesis of aggression can be divided into endogenous, exogenous and the interaction approach. The author discusses in his paper also the relationship between aggression and the type of psychotherapeutic treatment, and expands in more detail on aggressiveness and its control within the framework of Rogers' approach (person-centered approach).

A comprehensively conceived behaviourally oriented therapeutic programme of influencing undesirable sexual behaviour with creation of socially acceptable patterns of sexual behaviour, using in addition to group, regime and sociotherapeutic methods and individual behavioural techniques, (frequently under phallographic control, described in the paper), appears to be most effective in the framework of institutional treatment as regards rate of relapses and economic effectiveness. This is confirmed by ten years of experience with this therapeutic approach at the sexuological department of the psychiatric sanatorium (comparable with results of similar departments abroad), achieved despite difficulties as regards personnel and shortage of professional information. The relapse rate of sexual delinquency during the ten-year investigation, assessed by available methods, was only 9% of all treated subjects.

In the first part the author summarizes views of 95 Czechoslovak psychiatrists as regards the position of psychotherapy in the Czechoslovak health services and the position as regards psychotherapeutic training. From the summary ensues that the number of specialized departments does not correspond to the needs of our health services and the author emphasizes the need of better organization of psychotherapy in practice. At present there are opportunities of training in psychotherapy in particular in the psychotherapeutic section of the Psychiatric Society of the Czech Medical Society and in the Institute for Postgraduate Medical and Pharmaceutical Training in Prague. Both alternatives comprise compulsory participation in psychotherapeutic training groups. To make psychotherapeutic training more available, the author informs in the subsequent part of the paper on the possibility of education and training of health workers in psychotherapy. In this connection the author emphasizes the selection of participants, the principles of group psychotherapy training and the demand of selection of experienced supervisors and tutors. Training in psychotherapy should be differentiated to make differently oriented programmes possible; e.g. the programme for specialists in psychotherapy and another programme for doctors working in clinical medical branches. Finally the author deals with the perspective problem of specialization examinations in psychotherapy and indicates problems associated with institutionalization of psychotherapy.