Anxiety, depression or psychosomatic illness – psychotherapy can help. But how do you find a therapist? And which method is suitable?
Anyone who has mental or psychological problems and is looking for help will find many offers on the Internet. However, psychotherapy offers real professional help. Four approved procedures are paid for by health insurance companies for adults as well as for children and young people: behavioral therapy, systemic therapy, and depth psychology-based and analytical therapy. The latter two are summarized under the term psychodynamic therapies.
All procedures are designed to treat major disorders such as depression or anxiety disorders. Depending on the case, different numbers of session hours are approved.
Humanistic methods are currently not (yet) permitted, explains Susanne Berwanger, behavioral therapist and chairwoman of the Professional Association of German Psychologists. There are various approaches to this, such as conversational or Gestalt psychotherapy, as well as psychodrama.
The first access to the psychotherapist
Which method is suitable for whom? “This is exactly the question that can be answered in a psychotherapy consultation,” says psychotherapist Gebhard Hentschel, who is the national chairman of the German Psychotherapists’ Association. According to Hentschel, consultations are offered almost nationwide and are mandatory before treatment. Those interested do not need a referral.
Patients with statutory health insurance can also make an appointment through the central appointment booking office of the Association of Statutory Health Insurance Physicians, by phone at 116117 or online (https://www.116117-termine.de/). If this is not possible within a few weeks, the appointment service office will refer you to an outpatient clinic, explains Christa Roth-Sackenheim. She is a specialist in psychiatry and psychotherapy and the second chair of the Professional Association of German Psychiatrists.
Doctors and therapists from various disciplines offer consultations. In three sessions lasting 50 minutes or six sessions lasting 25 minutes, an examination is carried out to determine whether a mental disorder is present and whether psychotherapy would be appropriate. A recommendation for a psychotherapeutic procedure is also made or alternative forms of help and treatment are agreed upon.
Testing different psychotherapy methods
Before the actual psychotherapy begins, up to four trial sessions can be attended, and different procedures and therapists can be tried out. During this time, a change is also possible. Only then do you apply for approval to the health insurance company? In cases of urgent treatment requirements and crises, there is the option of acute treatment, which consists of up to twelve therapy sessions of 50 minutes each – without an application to the health insurance company and trial sessions.
Pay yourself or contact training institutes
In principle, there is still the option of paying for the therapy yourself and getting reimbursed later. You could go to a private practice for this. “When making your choice, make sure that the therapist is licensed, either as a doctor or psychologist,” says Berwanger. However, you should get approval from the insurance company beforehand, and advise the experts. Some insurance companies require a certificate from several therapists that they cannot treat you or documentation of a waiting time of more than six weeks.
If the case is not serious or urgent, you can contact training institutes. They offer psychotherapeutic consultations and outpatient psychotherapy under supervision. Depending on the clinical picture, options can also include group therapy or a combination of individual and group therapy. “Take a look and trust yourself, you are not alone in the boat,” says Berwanger, who offers combined sessions herself. A lot of knowledge is imparted in the groups.
Behavioral therapy
Behavioral therapy is well suited to treating anxiety and obsessive-compulsive disorders. In this case, behavior refers to thinking, feeling, and practical behavior. “Here you get concrete results relatively quickly,” says Roth-Sackenheim. With phobias, for example, the patient is confronted with the fear or the location of the fear. They then discuss the reactions with the doctor or therapist, become aware of their thoughts, and try to change them. “Behavioral therapy works a lot with exercises on concrete symptoms,” says Hentschel. Relaxation exercises are also part of the program.
Psychodynamic procedures
The basis of psychodynamic procedures is always a conversation. “In-depth psychology, you start with the current conflict and look to see whether there is a connection to what has already been experienced,” says Hentschel, who himself offers therapy based on depth psychology. Are learned patterns repeating themselves here, for example? Are there unresolved conflicts in the past that make it difficult to deal with them in the here and now?
For example, someone who cannot set boundaries at work takes on a lot of responsibility and therefore develops burnout or depression, may have already learned at home to take on too much responsibility for family tasks (too early), for whatever reason. Practical elements can also be included here.
Psychoanalysis
Analytical therapy focuses on conflictual relationship experiences and works with the unconscious. “It is assumed that the old childhood relationship experiences and conflicts will show up in the current relationship with the therapist and will not only be made transparent but also resolved through the therapeutic relationship,” says Berwanger. Incidentally, this therapy no longer necessarily takes place in the classic lying down manner as it did in Sigmund Freud’s time.
Systemic therapy
Systemic therapy includes the immediate environment, such as the family. “It’s about relationship structures, so a session can take place with several people – either in real life or by imagining them,” says Hentschel. Family constellations are a typical variant of systemic therapy.
Whatever you decide, as Hentschel sums it up, “No matter how well suited the procedure may be, the important thing is the professional psychotherapeutic relationship. If there is no harmony between patient and therapist, then it will not achieve the goal.”