Insomnia, inner turmoil, persistent sadness or an all-numbing exhaustion - all symptoms that should be taken seriously. While the stigma of mental illness is gradually decreasing, those affected often face a completely different problem: the serious lack of therapy places.
Although studies have shown that since the outbreak of the coronavirus pandemic there have been more and more people in need of psychotherapy, the offer remains poor. The expansion of the range of therapies could also prevent suicides - and thus save lives.
According to the Federal Chamber of Psychotherapists, patients wait an average of five weeks for an initial psychotherapeutic consultation. The first step is to determine whether the patient needs treatment at all. Most of the time the answer is "Yes!".
And then the long wait really begins: In 40 percent of cases it takes another three to nine months before the actual psychotherapy begins. The search for a therapist is therefore often a huge challenge, sometimes it seems almost impossible for those affected.
Instead of answers, more and more question marks appear: Where do I start looking? Which therapy is right for me? And how do I actually recognize that my psychotherapist is doing me good? We found answers for you:
There are various contact persons for people with mental illnesses. When looking for a suitable contact point, it depends on the intensity of the symptoms. If your subjective level of suffering is very high and acute, then there is always the option of contacting the telephone counseling service on 0800 1110111 or dialing the emergency number.
If it is not a mental emergency, then psychiatrists and psychological psychotherapists are the best people to contact. The difference: Psychiatrists have basic medical training and can therefore also prescribe medication. Psychological psychotherapists have usually studied psychology and enjoyed additional therapeutic training - they are not allowed to prescribe medication.
In both cases, health insurance approval is important if you are legally insured. Otherwise, there is the possibility of getting the costs back from the health insurance company via the cost reimbursement procedure, but this is only approved in exceptional cases. In principle, it is of course also possible to pay for the psychotherapy yourself - the hourly rate is currently around 100 euros.
If that doesn't deter you, you can theoretically seek therapy from an alternative practitioner for psychotherapy. However, providers with this qualification often have not completed any medical or psychological training, but have proven their psychotherapeutic knowledge in an examination by the health department.
That means: Not every non-medical practitioner for psychotherapy has a well-founded training and can really help you. A point that has often been criticized. Because many patients do not initially distinguish between psychiatrists or psychological psychotherapists and a non-medical practitioner for psychotherapy. There are big differences, also in the exercise of the activity. Psychotherapy practitioners cannot prescribe medication and cannot treat all mental illnesses. Nevertheless, there are representatives of this guild who are a good place to go for depression or anxiety disorders.
You can recognize them, for example, by the fact that they take a detailed anamnesis with all previous medical diagnoses and also advise you to have physical causes ruled out by a specialist. Serious therapy offers also do not contain any unrealistic promises or esoteric, experimental methods. Alternative practitioners for psychotherapy are allowed to use a whole range of forms of therapy. So far, however, only the effect of talk and behavioral therapy has been scientifically proven.
So when choosing your therapist, pay attention to the methods he uses – and whether he can do anything in your case. If you suspect severe depression, schizophrenia or another personality disorder you should be referred to a specialist in psychotherapy, as these clinical pictures exceed the treatment options of an alternative practitioner.
In principle, you do not need a referral from your family doctor for psychotherapy. Nevertheless, a visit to the practice is worthwhile, for example to rule out physical causes or to first talk to a trusted person. General practitioners often also have a direct line to psychotherapists - this can help to get an appointment faster.
However, it usually works like this: They contact a psychotherapist or psychiatrist directly with their psychological symptoms. They often set up an extra telephone consultation hour for this. During the phone call, you roughly explain to the psychotherapist what it is about and he will then inform you about his availability.
As a rule, an appointment for the psychotherapeutic consultation hour is made. This serves to determine the need for therapy and a suspected diagnosis. To do this, the therapist asks a few questions about the symptoms and life history. If necessary, an inpatient stay is also discussed here.
If you are unsuccessful in finding an initial consultation, you can use the appointment service point of the Association of Statutory Health Insurance Physicians. There you will get an appointment within four weeks, in acute cases even within two weeks. However, the psychotherapist can be anywhere within a 100 kilometer radius. You can reach the telephone service on 116 117.
Alternatively, you can ask your health insurance company for a list of psychotherapists with health insurance approval and call them. Nowadays this is often necessary to get an appointment; nerves and patience are required here. By the way, it is often not enough to leave a message on the answering machine - try to reach someone personally instead.
What many patients don't know: It doesn't have to stay with a psychotherapeutic consultation. Health insurance pays for up to six of these sessions. So don't stress if the first session didn't go well or you didn't feel comfortable with the therapist.
However, if things do get in the way with a psychotherapist, then the consultation hour is followed by two to four so-called probatory sessions. The purpose of these trial sessions is to build a trusting relationship between therapist and patient. In addition, the psychotherapist can collect enough information to then apply for psychotherapy with good arguments from the health insurance company.
Good to know: There is time leeway here. Some therapists use this to make the waiting time for the actual start of therapy more bearable for the patient. This means that instead of weekly therapy, the therapy might then take place every three weeks. So the gap between the last trial session and the first real therapy session is not that big and you can start directly from there.
The duration of the treatment is initially at the discretion of the therapist. Together with him, you can determine for yourself how serious the psychological problems are and what length of time is likely to be necessary. There are three options:
Acute treatment: Acute problems are treated in 12 sessions.
Short-term therapy: 24 sessions, for example to get mild depression under control.
Long-term therapy: Chronic or profound mental illnesses are treated here in up to 300 hours.
By the way: There is the possibility of extending the duration of therapy if you notice that the symptoms have not yet disappeared.
The choice of the form of therapy always depends on the goal of the therapy. If you would like to learn how to deal with the symptoms and your own past in a healthy way, then behavioral therapy may be the right option. Here, learned behavior and thought patterns are worked out and gradually changed for the better through practical exercises.
However, if you are concerned with understanding and processing your current situation in depth, then this speaks in favor of psychotherapy based on depth psychology. To this end, connections are made between current problems and the past in direct discussions in order to find the causes.
Psychoanalysis is also about better understanding unconscious connections. But you go even further into the subconscious, for example through free association. This form of therapy therefore lasts significantly longer than the other two. All three are health insurance approved and are offered in individual or group sessions. Which form is suitable for your individual situation will also be clarified in the psychotherapeutic consultation.
Since 2020, systemic therapy has also been one of the approaches that can be covered by health insurance. This form of therapy starts with the social environment of those affected and there are mental illnesses as a result of our social life. Among other things, relationship patterns are processed and checked for risks and opportunities.
The most important thing at the end: the therapist. Even if the search for a place in therapy is challenging in itself, one should not take the first psychotherapist who comes along. At least not if the sympathy is not right. This is the most important thing for a successful therapy. That's the subjective part. But there are also objective characteristics that characterize a good psychotherapist.
A good psychotherapist should be empathetic to his patient and take his concerns seriously. A good balance of closeness and distance plays a major role. It should always be clear that this isn't a conversation among friends, but it shouldn't feel like a conversation among strangers either. A trusting basis is therefore the be-all and end-all. This is the only way for those affected to open up and recover from their mental illness - or learn to deal with it.
Do you suffer from severe depression or suicidal thoughts? Do not hesitate to dial one of the following numbers:
Source: Information portal of the Association of Statutory Health Insurance Physicians, information portal of the Federal Chamber of Psychotherapists