In German cities there are about 50 psychotherapists per 100,000 inhabitants. As the need for psychotherapeutic treatment grows, places are scarce and waiting times long. How to get to one of the coveted therapy places explains Michaela Hombrecher of the Techniker health insurance. The psychological psychotherapist Kerstin Sude also reveals why so many therapy offers are missing.
Those who have statutory health insurance in Germany are entitled to necessary psychotherapeutic treatment . But for ill people it is sometimes difficult to find a suitable psychological care. Often there are ambiguities in the way: How does the reimbursement of health insurance work? How do I find the right form of therapy? How do you even find a suitable therapist? Michaela Hombrecher of the Techniker Krankenkasse (TK) explains how every person comes step by step to his therapeutic treatment and does not have to bear any costs himself.
Therapy: This path leads to treatment
People who are in crisis can seek professional help from a psychotherapist. You do not need a referral from your family doctor. With the therapist, the patient clarifies which treatment is right for him. “On the one hand, it can be that the symptoms are so severe that hospitalization is necessary . This is the case, for example, with severe depression or self-endangered borderline . On the other hand, it is also possible that psychotherapy is not appropriate. When it comes to coping with life , those affected need another form of support, such as debt counseling, “explains Hombrecher.
After the therapist and client have clarified that psychotherapy is necessary, they must agree on a suitable form of therapy . “The health insurance companies only reimburse the costs of behavioral therapy, depth psychological therapy and psychoanalysis. If the therapist offers this therapy and has sufficient capacity, the application for reimbursement can be made to the health insurance, “explains the TC expert.
Unfortunately, it often happens that patients do not get a place at the first consulted therapist . Then this can recommend a colleague or the patient must look for another therapist.
Psychotherapy: assumption of costs for GKV and PKV
The statutory health insurance (GKV) grant, according to Hombrecher, in most cases, a psychotherapy. However, there are three key reasons why patients should expect a rejection :
- For therapists without a cash register
- For non-refundable therapy
- When the maximum hourly quota is exhausted
If the approved hourly quota for the therapy, for example in the case of a short-term therapy, but the continuation of the treatment is necessary, it is customary to draw up a report in psychotherapy practice in order to have a long-term therapy approved.
Privately insured patients can only have their psychotherapeutic treatment reimbursed by their insurance company if they have agreed this when signing the contract. Since this is often not the case, many private individuals have to pay their own therapy. The cost of a session is usually between 50 and 150 euros per hour . The duration of a treatment usually extends over several weeks. However, this can vary greatly individually.
“In April 2017, the new Psychotherapy Directive will come into force. Then acute consultation hours are introduced, which must take place before the therapy obligatory. As many patients as possible should receive an early diagnosis. “
Skills shortage? The therapists are there, the cash approvals are missing
The need for psychotherapy is great, but the places financed by the health insurance are in short supply . The reason for the imbalance between therapist and patient is not the lack of psychotherapists or a lack of psychology students. “There is a lack of cash register approvals,” explains psychological psychotherapist Kerstin Sude. Here is a “system error in demand planning” . The number of psychotherapists receiving a health insurance is too low. “The current status of psychotherapists was also declared a target status in 1999. Then in 2013 and 2014 there was too little improvement. Of course, this bill does not work out in today’s increased demand, “reports Sude from practice.
Training funding is a big problem
The missing censuses are not the only problem , says Sude. Graduates of a psychology degree also need to do an expensive, privately funded therapist training if they want to work psychotherapeutically. The psychologist knows what she is talking about: ” Because of a baby break, my own training has been going on for eight years . Once I was done, of course, debts had to be repaid first. Parallel to the training, the basic income had to be earned. That costs strength and nerves. “The costs for the three- to five-year training that follows the course of study are between 20,000 and 50,000 euros . “The required 1,800 hours of practice in clinics are not necessarily compensated, if so, then often only with up to 400 euros a month.”
“The vast majority of psychotherapists in education (PiA) must therefore be supported by their parents , take a credit education and / or keep afloat with part-time jobs, ” continues Sude. She has long been involved in the German Psychotherapists Association (DPtV) in order to improve training for future psychotherapists. She calls for a reform of the Psychotherapists Act, which will improve training for PiAs. The most sensible option would be, “a further education following a license to study medicine, analogous to specialist training.”