Since the introduction of the Psychotherapists Act of 1999, training, fields of practice, and licenses for psychotherapists have been strictly regulated. While professional groups such as psychologists, psychiatrists, and physicians with additional training are also allowed to perform psychotherapy, only individuals who meet very specific criteria may call themselves psychotherapists.
What is a psychotherapist?
Psychotherapists are in demand when severe psychological and psychosomatic stress is caused by problems in marriage, employment, disturbed parent-child relationships or traumatic experiences that have not been dealt with. Psychotherapists are allowed to perform curative psychotherapy. This is a protected term reserved for persons who have completed a university degree in medicine, psychology or psychiatry and have completed several years of additional training. At the end of their training and after passing all exams, prospective psychotherapists receive their state license. Those who wish to work as a psychotherapist for children and adolescents can also take the path of studying social work, education or music therapy. Additional training focuses on learning a specific therapy method. Heilpraktiker with appropriate additional training may also practice psychotherapy, but they must call themselves “Heilpraktiker für Psychotherapie”, the designation “psychotherapist” is not entitled to them.
Treatments
Psychotherapists work in clinics, hospitals, their own practice, a wide variety of counseling centers, teaching and research. Psychotherapy is generally used for mental illness. Alternative terms are mental disorders or mental illness. To be considered psychotherapy, complaints “with disease value” must be present, for example, depression, anxiety disorders, eating disorders, schizophrenia or addiction problems. Psychotherapists are called upon when severe psychological and psychosomatic stress is caused by problems in marriage, the workplace, disturbed parent-child relationships or traumatic experiences that have not been dealt with. Often the transitions between a mental illness such as a depressive mood and “normal” emotions such as deep sadness are fluid. One criterion for determining a mental illness is that the complaints persist over a long period of time or recur. If there are no complaints with disease value, the psychotherapist’s work is not counted as therapy, but merely as counseling. Health insurance companies only cover the costs of psychotherapy related to illness.
Diagnostic and examination methods
Psychotherapy can be done in individual or group sessions. Five to eight sessions are used by the psychotherapist to clarify the clinical picture. Mainly, in-depth patient interviews and psychological testing are used to make the diagnosis. Family members and spouses may also be interviewed. Furthermore, a medical report must be submitted that rules out a physical illness and indicates exactly what medications the patient is taking. This is followed by short-term therapy of up to 25 therapy hours or long-term therapy. The latter can have a maximum duration of 45 to 240 hours, depending on the disease and the type of therapy used. The health insurance funds support three common forms of psychotherapy: Behavioral therapy has the objective of “helping people to help themselves”. The patient should learn methods to be able to live better with certain situations or a general disorder in the future. To this end, for example, certain stimuli that trigger reactions are analyzed and new behaviors are trained. Depth psychology-based psychotherapy focuses more on causal research. The therapist tries to connect the current disorders with traumatic childhood experiences or unconscious disorders. By finding the causes, the complaints should be alleviated. The third major form of treatment is analytical psychotherapy. This is an indefinite long-term therapy that deals mainly with the patient’s childhood and adolescence. Defense mechanisms and anxiety management are an important focus.
What should the patient pay attention to?
When choosing a psychotherapist, the first question is whether the administration of medication is desirable or necessary.A medical psychotherapist, i.e., one who has studied medicine, may provide psychotherapy and prescribe medication. A psychological psychotherapist is not allowed to prescribe medication, but will additionally recommend a visit to a psychiatrist and work closely with him/her, should he/she consider the administration of medication alongside psychotherapy to be useful. Further, there is the question of whether collaboration with a psychotherapist or a non-medical practitioner of psychotherapy is desired. Psychotherapists are generally well trained due to strict regulations, while there are sometimes great differences in the training of non-medical practitioners. However, they may be very well specialized in certain therapeutic procedures. Other important questions are: Which therapy method seems most appealing and useful? Is individual or group therapy desirable? Which treatments does health insurance pay for? Medical psychotherapists generally have a more scientific-biological approach, while psychological psychotherapists usually work more in terms of the psyche. Ultimately, one thing must be right above all else: The chemistry and the relationship of trust between patient and therapist.
