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Depression, anxiety disorders and eating disorders: More and more people in Germany suffer from psychological complaints. Those who want to seek help are often confronted with the question: How do I get a therapy place?

Insomnia, inner turmoil, persistent sadness or numbing exhaustion – all symptoms that should be taken seriously. While the stigma of mental illness is gradually diminishing, those affected often face an entirely different problem: the severe lack of therapy sites.

While studies have shown that more and more people need psychotherapy since the outbreak of the coronavirus pandemic, the supply remains subdued. Expanding the range of therapies can also prevent suicides – and thus save lives.

Five weeks waiting time for a therapy place

According to the Federal Chamber of Psychotherapists, patients wait an average of five weeks for a first psychotherapeutic consultation. The first step is to determine if the patient needs treatment. Usually 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 an enormous challenge, sometimes it seems almost impossible for those affected.

Instead of answers, more and more question marks appear: where should 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:

Who can I contact in case of psychological problems?

There are several contact persons for people with a mental illness. When looking for a suitable contact person, it depends on the intensity of the complaints. If your subjective level of suffering is very high and acute, there is always the option of contacting the emergency services on 0800 1110111 or calling the emergency number.

If it’s not a mental emergency, psychiatrists and psychotherapists are the best people to contact. The difference: Psychiatrists have basic medical training and can therefore also prescribe medicines. Psychological psychotherapists usually have studied psychology and have additional therapeutic training – they are not allowed to prescribe drugs.

In both cases, approval of the health insurance is important if you are legally insured. Otherwise, there is a possibility to recover the costs from the health insurer via the 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 also seek therapy from an alternative psychotherapy practitioner. Psychotherapists with this qualification, however, often have no medical or psychological training, but have proven their psychotherapeutic knowledge in an investigation by the GGD.

That means: Not every non-medical psychotherapy doctor can really help you. Nevertheless, there are of course representatives of this guild who are a good address for depression or anxiety disorders. It may be worth a try, especially for people seeking help quickly or interested in alternative forms of therapy.

How do I make an appointment with a psychotherapist?

In principle, you do not need a referral from your GP for psychotherapy. Nevertheless, a visit to the practice is worthwhile, for example to rule out physical causes or to talk to a confidential advisor first. GPs often also have a direct line with psychotherapists, which can help to make an appointment faster.

However, it usually works like this: they contact a psychotherapist or psychiatrist directly with their psychological complaints. They often use an extra telephone consultation hour for this. During the telephone conversation, you roughly explain to the psychotherapist what it is about and he will then inform you about his availability.

An appointment is usually made for psychotherapeutic consultations. This serves to determine the need for therapy and a presumptive diagnosis. To do this, the therapist asks some questions about the symptoms and life history. If necessary, a recording is also discussed here.

If you are unable to find an initial consultation, you can use the appointment counter of the Association of Statutory Health Insurance Doctors. You will receive an appointment there within four weeks, in acute cases even within two weeks. However, the psychotherapist can be anywhere within a radius of 100 kilometers. You can reach the telephone service at 116 117.

You can also ask your health insurance company for a list of health insurance approved psychotherapists and call them. Today this is often necessary to get an appointment; nerves and patience are required here. Incidentally, it is often not enough to leave a message on the answering machine – try reaching someone in person instead.

What happens after the psychotherapeutic consultation?

What many patients don’t know: It doesn’t have to stop at a psychotherapeutic consultation. The health insurance will reimburse a maximum of six of these sessions. So don’t worry if the first session didn’t go well or if you didn’t feel comfortable with the therapist.

If it does get in the way of a psychotherapist, two to four so-called trial sessions will follow after the consultation hour. The purpose of these trial sessions is to build a trusting relationship between therapist and patient. In addition, the psychotherapist can collect sufficient information to subsequently request psychotherapy from the health insurer with sound arguments.

Good to know: time has passed. 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 can then take place every three weeks. The gap between the last trial session and the first real therapy session is therefore not that big and you can get started right away.

How long does psychotherapy take?

The duration of the treatment is initially at the discretion of the therapist. Together with him you can determine how serious the psychological problems are and how long this is probably necessary. There are three options:

acute treatment: The acute problems are treated in 12 sessions.

short-term therapy: 24 sessions to get a grip on, for example, mild depression.

long-term therapy: Chronic or severe mental illness is treated here in up to 300 hours.

By the way: there is a possibility to extend the duration of the therapy if you notice that the symptoms have not yet disappeared.

Which form of therapy is right for me?

The choice of therapy always depends on the goal of the therapy. If you want to learn 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 thinking patterns are elaborated 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, in direct discussions, connections are made between current problems and the past 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 offered in individual or group sessions. Which form is suitable for your individual situation will also become clear during the psychotherapeutic consultation.

How do I recognize a good psychotherapist?

The most important at the end: the therapist. Even if seeking a place in therapy is a challenge in itself, one should not take the first psychotherapist who comes along. At least not if the sympathy is not justified. This is the most important for 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 between proximity and distance plays a major role. It should always be clear that this isn’t a conversation between friends, but it shouldn’t feel like a conversation between strangers either. A foundation of trust is therefore the only and only in this way can those affected open up and recover from their mental illness – or learn to cope with it.

Do you suffer from severe depression or suicidal thoughts? Do not hesitate to call one of the following numbers:

  • Depression information line: 0800-3344-533
  • Number against sadness: 116111
  • Pastoral care by telephone: 0800-1110111
  • In an emergency: 112

source: Information portal of the Association of Statutory Health Insurance Physicians, Information portal of the Federal Chamber of Psychotherapists

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