Wait to psychotherapy: Five ways to bridge the waiting time

20 weeks: as long As you wait, on average, for a place with a psychotherapist. 20 weeks is too long to suffer. Pathological anxiety, an Addiction or a Depression will disappear not just from itself such as the common cold or a gastrointestinal infection. On the contrary, Mental illnesses will get worse with time, often and sometimes chronic.

In addition, a mental illness, the longer it exists is always more damage, in almost every area of life:

  • Often, the person Concerned his profession, no more or not as usual engaged in.
  • Often causes emotional Distress also physical complaints and/or causes that Affected his health neglected.
  • Usually charged to the mental illness of the partner, the family and the closest friends of the Affected.
  • Not infrequently, the mental Problem is also armed with familiar people. In the worst case, this conflict go so far that the person in question loses its social support.

All of this can in turn result in that the suffering of the person Concerned, even increased – a vicious circle, it is essential to avoid applies. The question is: How? What can mentally do sick people to get to despite the waiting time as quickly as possible mental help? And how helpful of the available alternative offers of help?

Option 1: Acute Treatment

In April 2017 a revised psychotherapy Directive came into force. You should ensure that the mentally Ill fast professional help to get – for example, in the Form of the so-called acute treatment: Who’s in a severe emotional crisis is, is entitled to up to 12 to 24 hours of Therapy.

A date for the first meeting of the acute treatment may agree with the Patient and the therapist directly in the so-called psycho-therapeutic clinic, so in the initial interview. Unlike a regular therapy in the absence of the sample prior to the start of acute treatment sessions will be necessary.

Also it must not first of all by the health insurance Fund are approved. The therapist must tell the cashier in writing, of what disease he has detected in the patient, and when the acute treatment begins.

A long-lasting relief or even cure , the mental discomfort you may be of an acute treatment, not hope. Just in the event of a severe mental disease, the short period of time is not enough to go to the root causes of the problem and to develop effective solution strategies.

The acute treatment is also not intended. You should …in the first place

  • preventthe disease worse or becomes chronic and
  • effect, that the condition of the Affected stabilized.

Option 2: psychotherapists without Treasury approval

Usually the statutory health insurance pays for psychotherapy only if the therapist has a health insurance license. Who can be in a private practice, to treat, to pay for the therapy out of your own pocket.

To this rule there is an exception: If the person Concerned can prove that

  • he urgent psychotherapy needs and
  • in its surroundings is not a licensed therapist-free therapy places can offer,

the Fund is also a treatment in a private practice to pay.

This obligation results from § 13, paragraph 3, of the code of social law. There it is: "Was not able to provide the health insurance is a urgent power in time (…) and incurred costs by the Insured for self-procured power, are these from the health insurance Fund in the amount of such refund, to the extent that the power was necessary."

Theoretically, this so-called "Kostenerstattungsverfahren" Patients the opportunity, to get faster help. Unfortunately, this is not (or no longer) seems to work in practice, not so easy. This was evident in a survey of German psychotherapists Association (DPtV).

The DPtV respondents in the past year, more than 400 private practitioners, psychotherapists, and how their work situation changed due to the Reform of the psychotherapy Directive. The therapist stated that the reimbursement of costs for their patients to become more difficult to be. The health insurance companies have since the Reform, more refund applications rejected than in the past, usually with reference to

  • the new psycho-therapeutic clinic
  • the date of service of the physicians ‘ associations and/or
  • the possibility of an acute treatment.

For people who are in urgent need of therapy, this reference is not helpful:

  • In the psychotherapeutic consultation, you will receive no treatment. The therapist will inform you if necessary, what kind could be a therapy suitable for you. Where you can begin, don’t know you then but still.
  • On the date of service to receive the Concerned again an appointment for (another) conversation. Whether the therapist to be the then sent for, has actually a place, do not know the employee of the date of service set in the rule.
  • An acute treatment is a First-aid measure for the Psyche. Thereafter, the patient need further therapy – and often urgently.

What to do? The reimbursement of costs is difficult to become, but remains possible. The best opportunities, according to the Federal chamber of psychotherapists (BPtK), who proceeds as follows:

  • In the psychotherapeutic consultation certify that a "Richtlinienpsychotherapie" necessary and cannot be deferred.
  • Ask for a minimum of three to five licensed psychotherapists for a free therapy place. You result in log: make a Note of the Name of the therapist, the day and time of your request, and the specified waiting period.
  • Make sure when search for a (private) psychotherapist to the fact that this is applying one of the procedures Directive. You ask him, some of them in writing, that he can take over the treatment in the short term.
  • Ask with your insurance provider, a request for outpatient psychotherapy and reimbursement of costs according to § 13 paragraph 3 SGB V. attach to the application the documents referred to.

Option 3: Advice

In many cities and municipalities there are Advisory bodies, which in the case of psychological problems in a timely, free and usually anonymous help provide.

The staff are usually social workers, social educators and psychologists, but in General, no training in psychotherapy. You can offer the Concerned, so no therapy. For that, you can help you about this,

  • to find practical solutions for problems that affect you Are in addition,
  • to change the external circumstances that have triggered your disease, promote and/or worsen,
  • to process traumatic experiences that have caused the disease (with -), and
  • to find additional offers of help.

The consulting offer is different from place to place. In most larger cities, there are several Advisory bodies with different focal points, such as, for example,

  • Addiction counselling centres,
  • Family and marriage counseling,
  • Senior consultant,
  • Children and youth counseling, as well as
  • Advice for victims of violent crime.

In addition, there are the social-psychiatric services, the General for people with mental illness and their family members are.

Phone numbers, addresses, and opening Hours of local advice agencies you will find in the rule on the Internet, on the official Website of the city. Who on the Internet is not successful, you can also call the municipality to ask, what are the psychological counselling services available.

Option 4: Self-Help Groups

In self-help groups of people come together, with the same disease or a similar mental Problem to fight. In the case of the mostly weekly Meetings to exchange data on everything from what to do with your disease. The conversations can to a cause that the people Concerned understood, strengthened and supported you feel.

On the other hand can arise from the exchange of new knowledge, to assist members in dealing with their illness. This is because, unlike in movies often conveys is, it is in the Meeting about working together to whine. Rather, the conversations turn frequently to the following questions:

  • The problems with the disease in everyday life, in relationships and in the Job? What are the possibilities of dealing with these problems?
  • What strategies has found, each individual in dealing with his disease? These are useful? If Yes: Could it be for other members of the group helpful, these coping strategies to try?

Self-help groups there are in almost all cities and municipalities of Germany. However, there is not anywhere for each Problem, a matching set. In this case, it may be necessary, the search to the nearest large city to expand.

In the case of the placement of a suitable group helps, for example, the National contact and information point for the stimulation and support of self-help groups (NAKOS), either by using the search function on the Website or by phone 49 (0)30 31 01 89 60.

Option 5: Online-Therapy

Mental illness by Internet therapy? Sounds absurd, but it is possible. Alone for depression have been developed in the past years, a variety of Apps and Online-to complement the treatment, support or even to replace it. Known examples of this are

  • the paid Online course Selfapy,
  • the Online self-help programme Moodgym , the AOK, as well as
  • the depression coach of the technician health insurance (TK).

These and many other offers are based on scientific evidence. Also studies showthat Online therapy for certain psychological problems actually effective can help. The depression coach, for example, has been proven in a study at the Free University of Berlin: as an effective treatment method for mild to moderate depression.

The proponents also stress that the programs have compared to the classic therapy of a number of advantages:

  • There are no waiting times.
  • Who’s inhibitions has, go see a therapist, find it perhaps easier, the therapy on a virtual Basis to start.
  • The offers are from anywhere and at any time usable.

Nevertheless, among psychotherapists, Doctors, and other experts disputedthe extent of the Online offerings are actually for the treatment of mental disorders are. Critics fear, among other things, data protection problems (especially if the therapy via Skype or e-mails takes place).

Also complain that it is in a virtual therapy is not possible , the non-verbal signals from the patient to interpret and to take into account. The facial Expressions and body language reveals a lot about the well-being of the people. This level of communication falls away, lost also important information about the mental state of the Sufferers.

Therefore, it is important that patients, their complaints are always first in conversation with a psychotherapist clarify, the Federal chamber of psychotherapists, in a policy paper on the topic of "Internet in the Psychotherapie" clear.

Who decides then to use an Online program, should discuss this in advance with the therapists and the program first critical check. What are the points to note, has summarized the BPtK in a check-list for patients.

Important: in Principle, inappropriate in an Online-therapy for

  • Psychosis,
  • serious mental health crises,
  • severe depression and
  • Thoughts of suicide.


Online information of the psychotherapy information service (PID) of the German psychologists Academy of the professional Association of German psychologinnen und psychologen e. V. (BDP): www.psychotherapiesuche.de (retrieval date: 5.6.2019)

Online information from the Federal chamber of psychotherapists (BPtK): www.bptk.de (retrieval date: 5.6.2019)

Online information of the Association of Shi physicians: www.kvb.de (retrieval date: 5.6.2019)

DPtV-survey "Kostenerstattung" 2017/2018: summary of the main results. Online information from the Federal psychotherapist Association (DPtV): www.bundespsychotherapeutenvereinigung.de (status: 20.2.2018)

Psychotherapy: New claims for statutory health insured. Online information is the Foundation of the test: www.test.de (status: 14.11.2017)were

Bühring, P.: online interventions in psychotherapy: The acceptance is on the rise. Deutsches ärzteblatt PP, Jg. 16, No. 7, P. 303-304 (July 2017)

Bühring, P.: The "Depressionscoach" acts. Deutsches ärzteblatt PP, Jg. 16, No. 7, P. 305 (July 2017)

Dohren Busch, R.: Psychotherapy. Identify opportunities and help shape the future. Verbraucherzentrale NRW, Düsseldorf, 2017

Press release of the Federal chamber of psychotherapists (BPtK): treatment in private practice is still possible – BPtK: the Mentally Ill have, as hitherto, entitled to reimbursement, status: 22.5.2017