Psychotherapists Act

Basic data
Title:	Law on the Profession of Psychotherapist
Short title:	Psychotherapists Act
Previous title:	Law on the Professions of Psychological Psychotherapist and Child and Adolescent Psychotherapist
Abbreviation:	PsychThG
Type:	Federal law
Scope:	Federal Republic of Germany
Legal matter:	Professional law of the health professions
References :	2122-7, (old: 2122-5)
Original version from:	June 16, 1998 ; ( BGBl. I p. 1311 )
Entry into force on:	January 1, 1999
Last revision from:	November 15, 2019 ; ( BGBl. I p. 1604 )
Entry into force of the ; new version on:	predominantly September 1, 2020 ; (Art. 12 G of November 15, 2019)
Last change by:	(new) Art. 17 G of May 19, 2020 ; ( BGBl. I p. 1018, 1035 ) ; (old) Art. 18 G of August 15, 2019 ; ( BGBl. I p. 1307, 1331 )
Effective date of the ; last change:	(new) May 23, 2020 ; (Art. 18 G of May 19, 2020) ; (old) March 1, 2020 ; (Art. 54 G of August 15, 2019)
GESTA :	M040, (old: B041)
	Please note the note on the applicable legal version.

The Psychotherapists Act (PsychThG) has regulated the practice of psychotherapy by non-medical psychotherapists in Germany since 1999 , that is, by psychological psychotherapists and child and adolescent psychotherapists . It was revised with effect from September 1, 2020.

Until the introduction of the PsychThG, only doctors were allowed to perform psychotherapy in the Federal Republic of Germany within the framework of statutory health insurance . However, qualified psychologists were able to work in the so-called delegation procedure. The prerequisite for this was further training in a recognized and approved method of psychotherapy and a delegating doctor. Accordingly, psychological psychotherapy mainly took place in the delegation process, which meant that responsibility remained with the delegating doctor. The only exception was the Techniker-Krankenkasse procedure ("TK stamp"), which allowed treatment without a delegating doctor and direct billing by psychologists even before the introduction of the PsychThG.

Practice of psychotherapy according to the PsychThG

scope of application

The PsychThG reserves the right to practice psychotherapy under the designation of psychological psychotherapist and child and adolescent psychotherapist to the approved, licensed therapists ( Section 1, Paragraph 1). In the interests of patient protection, the term psychotherapist may only be used by doctors, psychological psychotherapists and child and adolescent psychotherapists (but not, for example, by alternative practitioners ). The misuse of the professional titles psychotherapist, psychological psychotherapist and child and adolescent psychotherapist is punishable under Section 132a of the Criminal Code .

As a prerequisite for practicing the profession, the PsychThG stipulates the acquisition of the license to practice medicine (state approval). This requires a completed university degree and successful further training as a psychotherapist.

Psychotherapy within the meaning of the PsychThG is "any activity carried out by means of scientifically recognized psychotherapeutic procedures to determine, cure or alleviate disorders with disease value for which psychotherapy is indicated". This means that there must be a mental illness that requires treatment so that psychotherapy can be carried out - after obtaining a health insurance license, also as a benefit from the statutory health insurance . On the other hand, the practice of psychotherapy does not include psychological activities that deal with the processing and overcoming of social conflicts or other purposes outside of medical science ( Section 1 (3), advisory psychology ).

If there are doubts as to whether a psychotherapeutic procedure is to be recognized as scientific, the decision on this question is made by the Scientific Advisory Board on Psychotherapy , which is formed jointly by the federally responsible representative of psychological psychotherapists and child and adolescent psychotherapists as well as medical psychotherapists in the German Medical Association ( § 11 ) .

A licensed psychotherapist is only allowed to participate in the psychotherapeutic care of those with statutory health insurance if he is trained in a procedure that is recognized by the Federal Joint Committee (see Psychotherapy Guideline ). Currently only psychoanalytically based methods ( psychoanalysis and psychotherapy based on depth psychology ) and behavior therapy are recognized as so-called guideline procedures .

The PsychThG also stipulates that a somatic assessment must be carried out as part of psychotherapeutic treatment. This means that as part of the probatory exercise (trial sessions), a doctor must clarify whether there are any medical reasons that speak against psychotherapy or certain psychotherapeutic techniques, and whether medical treatment and, if applicable, medication is necessary. (For example, exposure treatment for phobias may be contraindicated in some heart conditions .)

License to practice

The requirements for acquiring the license to practice medicine are specified in Section 2 . The granting of the license to practice as a psychological psychotherapist or as a child and adolescent psychotherapist requires a successfully completed training in a scientifically recognized psychotherapeutic procedure according to § 5 . The training is regulated in more detail in the training and examination regulations for psychological psychotherapists.

Admission requirement for the training is a completed degree in psychology , which includes the subject clinical psychology ( Section 5, Paragraph 2, No. 1) For access to the training as a child and adolescent psychotherapist , a completed degree in pedagogy or social pedagogy ( Section 5 Paragraph 2 No. 2). Regular participation in advanced training events is necessary to maintain the license to practice medicine (regulated by Section 95d SGB V ).

The license to practice medicine also presupposes that the applicant “has not been guilty of behavior that makes it unworthy or unreliable to practice the profession”, “is not unsuitable from a health point of view for practicing the profession” and “about which Knowledge of the German language required for professional activity ”( § 2 Paragraph 1).

Further instructions

The PsychThG also contains provisions on:

Withdrawal, revocation and suspension of the license to practice medicine, waiver ( § 3 )
limited permission to practice ( § 4 )
Recognition of training centers ( Section 6 )
Fees for private treatment ( § 9 ), regulated in more detail in the GOP
Scientific recognition of psychotherapy procedures ( § 11 )

Psychotherapy in the statutory health insurance

Psychological psychotherapists need a minimum of seven years of education and training (four to five years of study, at least three years of theoretical and practical training to § 5 PsychThG), the acquisition of the license to practice medicine and a health insurance license to the detriment of public health insurance act to be allowed. On the application of psychological psychotherapist on a cash approval (branch) is to § 96 SGB V of the admissions committee , which for each district of a physicians' association or for parts of this district (registration district) is formed and expanded formation with two doctors, a psychotherapist, a children - and adolescent therapists and four representatives of the health insurance companies. The details are regulated in the Admission Ordinance for Contract Doctors ( Doctors ZV ).

In addition to the PsychThG, the legal basis for psychotherapy can be found, in particular, in the fifth part of the Social Code (SGB V), statutory health insurance , e.g. B.

Section 27, Paragraph 1, No. 1 of the Social Code Book V - sickness treatment
Section 28 (3) SGB V - Medical and dental treatment
Section 72, Paragraph 1 of Book V of the Social Code (SGB V) - Ensuring medical and dental care by contract doctors
Section 79b SGB V - Advisory committee for psychotherapy
§ 92 SGB V - guidelines of the Federal Joint Committee
§ 95 SGB V - Participation in statutory health care
Section 95c SGB V - prerequisite for the entry of psychotherapists in the medical register
Section 101 (4) SGB V - oversupply
§ 135 SGB V - Evaluation of examination and treatment methods

In contrast to outpatient psychotherapy, psychological psychotherapists in hospitals are not treated on an equal footing with doctors under statutory health insurance ( § 107 SGB V).

Other forms of practice of psychotherapy

Unlike the professional title psychotherapist , the term psychotherapy is not legally protected in Germany. Therefore - regardless of the Psychotherapists Act - people other than doctors and psychological psychotherapists may offer psychotherapy. These services do not count as medical treatment in the sense of the statutory health insurance ( Section 27 SGB V) and are also not billable according to the fee schedule for doctors or the fee schedule for psychotherapists (GOP). The practice of psychotherapy by alternative practitioners or alternative practitioners, restricted to the field of psychotherapy or non-licensed psychologists, is regulated by the Alternative Practitioners Act and the associated implementation ordinance. No license is granted for this, but an official permit.

Individual evidence

↑ Bundestag printed matter, BT-DRS 13/9212, p. 39, Drs. 13/9212 , see also Federal Constitutional Court, decision of June 23, 2000 - 1 BvR 30/00, full text

↑ Psychotherapy guidelines of the G-BA , accessed on July 1, 2011

↑ Text of the training and examination regulations for psychological psychotherapists

↑ Text of the training and examination regulations for child and adolescent psychotherapists

^ Regulation of the KBV on the further training obligation of contract doctors and psychotherapists according to § 95d SGB V , accessed on January 8, 2016

^ Association of Statutory Health Insurance Physicians Hessen: Admission and establishment as a contract doctor or psychotherapist ( Memento from July 1, 2013 in the Internet Archive )