What is psychotherapy?
Psychotherapy can be used to treat psychological problems – for example, when a person’s thoughts, feelings, experiences and actions are disturbed and no organic cause can be found as a trigger. Common mental disorders include anxiety disorder, depression, obsessive-compulsive disorder and addictive disorders.
Psychotherapy can be conducted on an inpatient or outpatient basis, as individual or group therapy.
Depending on their needs, those affected can take advantage of inpatient, day-care or outpatient psychotherapy.
Inpatient psychotherapy has the advantage that patients receive immediate help in the event of crises, both during the day and at night. They can also take advantage of an extensive range of different forms of therapy.
The advantage of outpatient therapy is that the patient can immediately apply what he has learned in his everyday life. However, the therapeutic care is not as intensive as in an inpatient stay.
As a middle ground, there are also day clinics that allow for partial inpatient psychotherapy. During the day, the patient is in the clinic, and in the evening he returns home.
Group psychotherapy
Group therapy is available in both inpatient and outpatient settings.
However, not everyone is comfortable with the idea of sharing their problems with a group of other people. But people who find it difficult to interact with strangers can benefit greatly from group psychotherapy. In the group, they can try things out and practice interpersonal interactions.
Forms of psychotherapy
Which form of therapy is suitable for you depends on various factors, such as the severity of your mental disorder. How well you can relate to the therapist and the methodology is also crucial. Your family doctor can help you find a suitable psychotherapist.
Cost absorption for psychotherapy
Costs are only reimbursed if a mental disorder has been diagnosed that causes the person to suffer. Health insurance companies recognize the first five sessions as trial sessions. The patient can thus first test out whether he or she gets along with the therapist.
Psychoanalysis
Psychoanalysis goes back to the well-known physician and psychologist Sigmund Freud. Read more about how it works and for whom it is suitable in the article Psychoanalysis.
Behavioral therapy
Behavioral therapy is based on the principle that unfavorable behaviors and thought patterns have been learned and can therefore be unlearned. For this purpose, the patient, with the help of the therapist, practices new behaviors and ways of thinking.
Therapy based on depth psychology
Depth psychology-based forms of therapy represent a further development of psychoanalysis. Here, too, the aim is to solve current psychological problems by uncovering and working on unconscious conflicts from the past.
You can read about what depth psychology-based psychotherapy entails and in which cases it is suitable under Depth psychology-based psychotherapy.
Other forms of therapy
When do you do psychotherapy?
Psychotherapy is necessary when a person’s thoughts, feelings and behavior impair their quality of life. The impairment may result directly from the symptoms of the disorder (e.g., severe anxiety) or from the consequences of the mental disorder. For example, some sufferers can no longer perform their job and lose their partner and social contacts.
Psychotherapy for physical symptoms
It has long been known that the body and the psyche interact. Physical illnesses often affect the psyche, and psychological disorders are almost always accompanied by physical complaints. Psychotherapy is therefore also recommended for psychosomatic complaints – that is, for physical complaints that are rooted wholly or partly in a psychological cause.
Psychotherapeutic methods also provide effective support in pain therapy. This is because the inner attitude has a considerable influence on how pain is evaluated and how strongly it is perceived.
Admission to inpatient psychiatry
People suffering from acute psychosis have no insight into the illness and suffer from delusions, hallucinations as well as thought disorders. They must first be treated with medication before psychotherapy is started.
Addictive disorders are another special case. Before psychotherapy, detoxification must first take place. People with an addiction problem should contact an outpatient clinic or clinic that specializes in addiction treatment.
Many people have difficulty distinguishing between the various professional titles in the psychotherapy setting. It is true that mental disorders can be treated by psychiatrists as well as psychotherapists and many psychologists. Nevertheless, they are different professions.
The psychiatrist, in turn, is a physician who has completed a residency in mental illness. He treats mental disorders with medication. Only additional psychotherapeutic training allows him to treat his patients psychotherapeutically as well – as a medical psychotherapist.
The term psychotherapist is protected in Germany. Only those who have undergone psychotherapeutic training may call themselves psychotherapists and – provided they practice within the framework of the corresponding psychotherapeutic forms – bill the statutory health insurance.
Not only psychologists, but also pedagogues and social pedagogues are licensed to work as child and adolescent therapists if they can prove that they have completed the corresponding training as child and adolescent therapists. They may then exclusively treat children and adolescents.
In the case of psychological problems, patients can either be referred to a therapist by their family doctor or make an appointment with a therapist directly.
What do you do during psychotherapy?
Initial consultation, diagnosis and prognosis
At the beginning of the therapy, the patient describes his problem to the therapist. The therapist then explains how the therapy might proceed. During this initial consultation, the patient can find out whether he or she feels comfortable with the therapist and learn what he or she can expect from the psychotherapy. If the therapy is to be continued, the therapist must make a diagnosis. Without this, health insurance companies will not cover the costs.
Based on the diagnosis and the patient’s individual situation, the therapist assesses how the mental disorder will progress. In general, mental disorders have a better prognosis if they are detected and treated early. If several mental disorders are present at the same time, treatment usually becomes more difficult.
Cause of the mental disorder
For therapy, it is important to find out which family, professional and/or personal problems are involved in the development and maintenance of the disorder.
It is not yet possible to clearly explain how a mental disorder develops. Experts do not assume a single cause for most mental disorders, but rather an interplay of several conditions that contribute to the development of the illness.
An unfavorable genetic predisposition can make a person more susceptible to mental illness. In combination with mental stress, a mental disorder can then develop. If the susceptibility (vulnerability) is high, even a small stress can cause a disorder. However, even people who are hardly burdened genetically can become mentally ill due to severe stresses (e.g. traumatic experiences).
Confidentiality
Psychotherapy: type of treatment
Which form of therapy is used in an individual case depends, among other things, on the diagnosis. The therapist will be guided by methods that have proven effective in treating the mental disorder at hand.
Before starting treatment, patients should ask their health insurer how many sessions it will cover.
In severe cases, the patient receives a combination of psychotherapy and medication. The effect of medication can accelerate success, especially at the beginning of therapy.
End of therapy
At the end of therapy, the therapist prepares the patient for the time afterwards. He inquires about existing fears and concerns that still need to be worked through. If the therapist deems it appropriate, the treatment may be extended in some cases. At any rate, after therapy the patient should feel that he or she can now cope with everyday life without the therapist.
What are the risks of psychotherapy?
Competence of the therapist
There are different reasons for misdevelopments in psychotherapy. On the one hand, the success of the therapy depends on the therapist making the correct diagnosis and selecting a suitable treatment for the patient.
In addition, there are great differences in the competence of therapists. Therefore, it is worth doing some research and asking around before choosing a therapist.
Cooperation of the patient
Psychotherapy also proves difficult when the patient does not want to engage in therapy. Especially in the case of personality disorders (e.g. multiple personality disorder, narcissistic personality disorder), patients often lack the insight that psychotherapy is necessary.
Relapses
In addition, in some mental disorders, symptoms of the disease recur after improvement. Such relapses are normal in addictive disorders, for example, and should not be interpreted as evidence of failed therapy.
Effects of therapy
For example, if an anxious person gains increasing self-confidence in the course of therapy, this also has an impact on his or her environment. Possibly the partner is not used to contradiction and therefore has difficulties with the changes.
However, the fear of change should never be a reason to continue suffering.
Psychotherapy – consequences for the profession
One way to circumvent these difficulties is to undergo therapy privately and pay the costs yourself. Neither the family doctor nor the health insurance company then have any information about it, and the therapist is bound by confidentiality. However, if concealed mental disorders become known at a later date, this can have negative consequences.
What do I have to keep in mind after psychotherapy?
Towards the end of therapy, the focus is on relapse prevention. This means that the therapist prepares the patient for possible relapses and works with him to develop strategies with which the patient can stabilize himself.
Relapses can recur even many years after therapy. In this case, sufferers should not be afraid to seek help from a therapist.
Sufficient sleep, a balanced diet, and exercise and sport additionally make us more resistant to mental disorders. Contact with friends and family also gives us stability in everyday life and thus supports the success of psychotherapy.
