psychotherapist
Psychotherapist is a professional title for physicians , psychologists and pedagogues who work in psychotherapy and who have advanced specialist training in psychotherapy based on their studies . The job title is protected by law in Germany, Austria and Switzerland . In Germany, the prerequisite for using the professional title is obtaining a license to practice medicine within the meaning of the Psychotherapists Act or the license to practice medicine regulations for doctors . In Austria, other professional groups with a license to practice medicine can also practice psychotherapy. In Switzerland, the practice of psychotherapy is limited to doctors and psychologists.
Psychotherapists generally diagnose and treat mental illnesses using scientific methods. The different clinical pictures and research focuses have led to the development of various scientifically recognized psychotherapy methods. These are behavior therapy and psychoanalysis (see also analytical psychotherapy ), as well as psychotherapy based on depth psychology .
As a freelance profession , the profession of psychotherapist is one of the classic chamber professions , for which strict professional regulations apply. Members of the professional group are either organized in the medical or psychotherapist chambers of the federal states.
Legal Regulations
Germany
In Germany, the terms “psychotherapist”, “psychological psychotherapist” and “child and adolescent psychotherapist” are protected by the penal code ( § 132a StGB) and the Psychotherapists Act ( § 1 PsychThG ) passed in 1998 . Anyone wishing to work as a medical or psychological psychotherapist must first have completed a degree in medicine or psychology . A degree in pedagogy or social pedagogy is also recognized for child and adolescent psychotherapists. After completing your studies, you must also complete further training in psychotherapy (for doctors) or training (for psychologists, educators). While doctors only acquire psychotherapeutic specialist knowledge due to the already existing license to practice medicine, the training for psychologists and pedagogues ends with a state examination as well as obtaining the license to practice medicine. Naturopaths are not allowed to call themselves “psychotherapists”. This also applies to alternative practitioners only for psychotherapy .
Starting in the winter semester 2020/2021, an independent course in psychotherapy is to be offered, which will lead to a license to practice medicine in five years and entitle the holder to take up further training in psychotherapy. Current psychology students and psychologists can complete the therapist training according to the old model by 2032.
Austria
The right to practice psychotherapy is regulated both in the Austrian Doctors Act and in the Psychotherapy Act. The professional title “psychotherapist” is protected by law. Unauthorized conduct means an administrative violation. In Austria , unlike in Germany, there is no restriction to specific courses such as medicine or psychology . So also are nurses , sociologists , journalists , marriage and family counselors, educators , philosophers , theologians and social workers admitted to the course. Anyone who does not belong to these professional groups can apply for approval to the Federal Ministry of Health .
For registration as a psychotherapist, the completion of a two-stage training course, which lasts at least five years and consists of a general part, the psychotherapeutic propaedeutic course , and a subject-specific subject is decisive . The basic training, the preparatory course , lasts about two years. Afterwards, the specialist can be completed, which is used for training in one of the recognized methods and lasts at least three years. Depending on the psychotherapy specialty (method) and the training institution, the duration of the training can exceed the minimum training duration by up to three years. The training costs can be around 15,000 to 45,000 euros, depending on the method chosen and the training institution.
In Austria, 23 scientific psychotherapeutic methods are currently recognized (in contrast to Germany, in Austria it is not procedures - that is, “families of methods” - but individual methods are permitted, which sometimes leads to misunderstandings). The health insurance company can bear the costs of psychotherapeutic treatment.
Switzerland
In Switzerland, doctors and psychologists are approved for psychotherapeutic treatment. Medical psychotherapy is covered by the compulsory basic insurance. The psychological psychotherapy is covered to a certain extent by the supplementary insurance. Medical psychotherapists may employ non-medical therapists, e.g. B. Psychologists trained in psychotherapy.
Psychological psychotherapists
Legal basis and forms
Psychological psychotherapists treat mental disorders in adults. They treat children and young people as a health insurance benefit without additional specialist knowledge and therefore without recognition under social law. Child and adolescent psychotherapists treat children and adolescents up to the age of 21, are specially trained for this and therefore treat them as a health insurance benefit with recognition under social law. In addition to the Psychotherapists Act, psychological psychotherapists are subject to the health professions laws of the federal states.
education
The prerequisite for training as a psychological psychotherapist is a successfully completed university degree in psychology with a diploma or master’s degree. This is followed by at least three years of further training as a psychological psychotherapist in accordance with the Psychotherapists Act (PsychThG). Afterwards, you can apply for authorization to conduct psychotherapy independently ( approbation ). According to the Psychotherapists Act, the minimum training period to become a psychological psychotherapist is 3 years full-time or 5 years part-time (Section 5 PsychThG). The entire training period, including studies in psychology and subsequent training as a psychological psychotherapist, takes an average of 12 years. Psychological psychotherapists work in clinics or in their own practice. You can take part in contract medical care. The training extends to imparting in-depth basic knowledge of scientifically recognized psychotherapeutic procedures as well as in-depth training in one of the following procedures:
- Psychoanalysis / analytical psychotherapy ,
- psychotherapy based on depth psychology ,
- Behavior therapy .
The training includes at least:
- 600 treatment hours of practical training with at least six patient treatments under at least 150 hours of supervision ,
- 600 hours of theoretical training,
- 1,800 hours of practical work, 1,200 of which at a psychiatric clinical facility and 600 hours at a facility for psychotherapeutic or psychosomatic care recognized by a social insurance institution,
- 120 hours of self-experience (Section 5 (2) PsychTh-APrV).
During the psychotherapy training, the trainee is called "Psychotherapist in training" (PiA). The minimum requirements for the training and the details of the state examinations are regulated on the basis of the Psychotherapists Act in the "Training and Examination Ordinance for Psychological Psychotherapists". The training can be completed at university-affiliated institutions as well as at state-recognized private training institutes. As a rule, the training institutes offer training in just one procedure. Only two institutes offer training in all approved psychotherapy procedures. The training costs, which are to be borne by the psychotherapists in training, amount to around 20,000 to 40,000 euros.
During the prescribed practical work in a psychiatric clinical facility, the trainees are usually only remunerated for their work. This is attributed, among other things, to the fact that psychologists are not officially allowed to act independently in psychotherapy during their practical work in training due to a lack of approbation. As a rule, however, these are employed as full-fledged employees in the care of the mentally ill. In the meantime, several court rulings have been issued against clinics that refused to pay psychologists in psychotherapy training during their practical work.
Authority
According to the Psychotherapists Act , the activity of psychological psychotherapists is limited to the determination, healing or alleviation of disorders with disease value for which psychotherapy is indicated. Psychological psychotherapists, for example, are not entitled to original medical activities such as medication prescriptions or certificates of incapacity for work. With the resolution of the Federal Joint Committee (G-BA) within the framework of the implementation of the Statutory Health Insurance Supply Strengthening Act, psychotherapists can prescribe services such as sociotherapy, psychotherapeutic rehabilitation measures, hospital treatment and patient transport.
Medical psychotherapists
A distinction must be made between psychotherapeutic specialists ( specialist in psychosomatic medicine and psychotherapy , specialist in psychiatry and psychotherapy as well as specialist in child and adolescent psychiatry and psychotherapy ) and specialists in other fields (e.g. general practitioners , internists , gynecologists , etc.) with a Additional designation "subject-related psychotherapy" or "psychoanalysis". Doctors with "specialist psychotherapy" are only allowed to work psychotherapeutically in the statutory health insurance for diseases that are in their area of expertise (a gynecologist, e.g. for vaginismus or postpartum depression ); after completing their specialist training, they have completed additional training in psychotherapy .
In order to be able to provide services within the framework of statutory health insurance, doctors must have acquired a field designation ( specialist ). Since the training to become a specialist takes at least five years, the entire training and further training period to become a contract medical psychotherapist is at least 11 years (6 years of medical studies and 5 years of specialist training). Until the implementation of the authorization extensions for non-medical licensed psychotherapists decided in 2015, z. B. Hospital admissions as well as the prescription of medical rehabilitation and ambulance transport are reserved exclusively for doctors. These restrictions no longer exist since 2017, but medication prescriptions can still only be made by doctors.
Child and adolescent psychotherapists
In addition to diploma / master’s psychologists, diploma / master’s pedagogues, diploma / master’s music therapists and diploma / master’s social pedagogues are admitted for training as child and adolescent psychotherapists. Since 1999, psychologists have had to choose between training as psychological psychotherapists and child and adolescent psychotherapists (within the framework of the transitional regulations of the PsychThG , a double license was still possible).
In principle, psychological psychotherapists also have permission to treat children and adolescents as part of their license to practice medicine, but cannot provide this as a statutory health insurance benefit without additional specialist knowledge. For psychological psychotherapists, however, there is the possibility of acquiring additional specialist knowledge (and thus the accounting permit) in child and adolescent therapy.
Definition of terms
Psychiatrist - psychosomaticist - psychologist - psychotherapist
The job titles psychiatrist , psychologist , psychosomatic specialist and psychotherapist are often confused and used incorrectly as synonyms . However, these professional groups are very different:
-
Psychiatrists are doctors who specialize in psychiatry and psychotherapy . Psychotherapy has been an integral part of further training to become a psychiatrist in Germany since 1994. The specialist in psychiatry and psychotherapy must be distinguished from the other two psychotherapeutic specialists (the specialist in psychosomatic medicine and psychotherapy and the specialist in child and adolescent psychiatry and psychotherapy).
In Germany, resident psychiatrists (unlike psychotherapists) are essentially paid their fee not based on the time spent talking, but based on the number of patients per hour. - Psychosomatics are doctors with the field designation specialists in psychosomatic medicine and psychotherapy . You are particularly concerned with the interactions between psyche and body and have extensive further training in psychotherapy. The earlier designation of the specialist in psychosomatic medicine and psychotherapy was therefore also a specialist in psychotherapeutic medicine.
- Psychologists are people who have successfully completed a degree in psychology with a diploma or master's degree. The term psychologist is legally protected and may only be used by the aforementioned group of people. Psychologists must complete their studies to become a psychotherapist if they want to practice psychotherapy. Psychologists with a diploma or master’s degree and a clinical orientation of their studies receive the healing permit for psychotherapy according to the Heilpraktikergesetz without additional examination . However, you can also work in numerous other professional fields (such as in business, in human resources , in research, as a traffic psychologist or in advice centers ).
- Psychotherapists are doctors, psychologists or pedagogues who are licensed to practice medicine ( approbation ) and who practice psychotherapy within the meaning of the medical professional code or the Psychotherapists Act . This includes the diagnosis and treatment of mental disorders using scientifically recognized methods.
Earlier or expiring job titles
When the advanced training regulations for doctors came into force in 1989, the following transitional provisions applied: Anyone using the designation “psychiatrist” or “doctor for psychiatry” or “doctor for neurology and psychiatry” could keep them. Upon request, he was given the right to use the specialist title “Specialist for psychiatry and psychotherapy” if he was allowed to use the additional title “Psychotherapy”, which required further training.
Anyone with the specialist title for “child and adolescent psychiatry” and the additional title “psychotherapy” received the right to use the specialist title “child and adolescent psychiatry and psychotherapy” upon request. Anyone who had the sub-specialization designation child neurological psychiatry in connection with the specialist designation neurology and psychiatry or the specialist designation paediatrics and also the designation specialist for psychotherapy received the right to use the designation "specialist for child and adolescent psychiatry and psychotherapy" upon application.
Those who used the additional terms “psychoanalysis” or “psychotherapy” could keep them. Upon application, he was given the right to use the designation “Specialist in Psychotherapeutic Medicine” if, after acquiring the additional qualification, he had mainly performed psychotherapy for a period of at least five years.
Coverage in Germany
The treatment of mental disorders with illness value by a psychotherapist is usually a benefit case for health insurance. The fees for doctors are regulated in the fee schedule for doctors , those for psychological psychotherapists and child and adolescent psychotherapists are set out in the fee schedule for psychological psychotherapists and child and adolescent psychotherapists (GOP).
Statutory health insurance
Psychotherapists who work in their own practice are often licensed as a contract psychotherapist , i. H. a treatment by them after appropriate application position to assume the costs of the statutory health insurance paid. This approval can be granted by the Association of Statutory Health Insurance Physicians after the license to practice medicine and an entry in the medical register . For psychological psychotherapists - similar to doctors - there is a requirement plan that defines how many therapists are allowed to settle in a district. Therefore, in areas with sufficient supply, a cash register approval is no longer possible. However, health insurance approval can be obtained from a licensed psychotherapist who is giving up his practice.
As a rule, a psychotherapist can at the expense of the statutory health insurance for the group of people with the approval
- Adults: treat patients from the age of 18,
- Children and adolescents: treat patients up to the age of 21, but before starting therapy it should be foreseeable that the age limit will not be exceeded during therapy.
If both permits are in place, he can treat children, young people and adults throughout.
On average, patients in Germany wait three months for an initial consultation with a therapist and another three months for their treatment to begin. In each individual case, this depends on the situation of the person to be treated, as - similar to specialist doctors - psychotherapists also specialize in certain areas (e.g. drug addiction , experience of violence , sexual abuse ). Therefore it is sometimes difficult to get an appointment with the appropriate specialist. There is also an oversupply of therapists in some cities, while some rural areas are undersupplied. Alternatively, the health insurance companies also offer inpatient therapies in appropriate clinics .
The statutory health insurance only covers the costs for treatments that comply with the psychotherapy guidelines. These include treatment and application modalities and the restriction to three previously approved therapy methods. This does not include u. a. the psychotherapy and systemic therapy . Accordingly, you will not be paid by the statutory health insurance companies.
Private treatment
Private health insurances take over psychotherapeutic treatments as part of the individual insurance contract. The Federal Court of Justice denies a coverage obligation if the General Insurance Conditions do not contain any regulation.
Occupational groups in outpatient care
The following table shows for 2011 how many members of the respective occupational groups were involved in outpatient psychotherapeutic care for legally insured persons (benefits from Chapter 35 of the uniform assessment standard - psychosomatic services, psychotherapeutic services and psychodiagnostics). It should be noted that in some professional groups - specialists in psychiatry and psychotherapy, specialists in neurology and specialists in neurology, as well as general practitioners - the individual relatives only provide psychotherapeutic services to a limited extent, while psychological and medical psychotherapists, specialists in psychosomatic medicine and psychotherapy and child and adolescent psychotherapists almost exclusively provide psychotherapeutic services.
| Technical name | number |
|---|---|
| Psychological psychotherapists | 13,740 |
| Child and adolescent psychotherapists | 2,364 |
| Specialists in psychosomatic medicine and psychotherapy | 2,316 |
| Specialists in neurology | 1,226 |
| Medical psychotherapists | 2,316 |
| Specialists in psychiatry and psychotherapy | 1,557 |
| Specialists in neurology | 515 |
| Specialists in child and adolescent psychiatry and psychotherapy | 696 |
| Family doctors | 35,331 |
See also
- Contract psychotherapist
- Private psychotherapist
- Mental disorder
- Federal Association of Contract Psychotherapists
Individual evidence
- ↑ zpid.de ( Memento of the original from March 30, 2014 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ^ Psychotherapy law reform: Information for high school graduates. German Society for Psychology (DGPS), 2019, accessed on September 29, 2019 .
- ↑ Reform of psychotherapist training adopted. In: Ärzteblatt. September 27, 2019, accessed September 29, 2019 .
- ↑ Austrian Psychotherapy Act of 1990 ( Memento of the original from May 10, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ Austrian Psychotherapy Act
- ↑ Profession psychotherapist
- ^ Psychotherapy methods recognized in Austria
- ^ Decision of the Federal Ministry for Health and Women of January 10, 2007, reference number BMGF-93500 / 0002–1 / 7/2007.
- ^ Psychotherapy # Switzerland
- ^ For example, the Health Care Professions Act North Rhine-Westphalia
- ↑ a b bdp-verband.org ( Memento of the original dated December 30, 2008 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ psychotherapeutenkammer-berlin.de
- ↑ Section 95 (2), Section 95c SGB V
- ↑ Training and examination regulations for psychological psychotherapists
- ^ Academy for Applied Psychology and Psychotherapy, Cologne
- ^ Rhein-Eifel-Institut, Andernach
- ↑ FAZ, Psychotherapists: Long dry spell
- ↑ FAZ, psychotherapists on the cheap
- ↑ SPIEGEL, Young Psychotherapists, Full commitment - no salary
- ↑ SPIEGEL, psychotherapists hanging out in training
- ↑ When and under what circumstances is a PIA liable in Gerlach Professional law and professional ethics in psychotherapy. P. 38 http://ra-gerlach.de/publikationen/Berufsrecht_fuer_Psychotherapeuten.pdf
- ^ LAG Hamm, judgment of November 29, 2012, Az. 11 Sa 74/12
- ↑ vpp-pia.de ( Memento of the original from December 15, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ hensche.de
- ↑ gesetze-im-internet.de
- ↑ presseportal.de ( Memento of the original from December 19, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ↑ KVB: In future, psychotherapists may also prescribe. March 16, 2017. Retrieved July 8, 2017 .
- ↑ German Medical Association, model training regulations ( Memento from January 21, 2012 in the Internet Archive ) (PDF; 759 kB)
- ↑ bundesaerztekammer.de
- ^ KBV ( National Association of Statutory Health Insurance Physicians ): Information from KBV 99/2017. (PDF) May 24, 2017, accessed November 3, 2017 .
- ↑ See also Kirsten von Sydow: The image of psychologists, psychotherapists and psychiatrists in public. A systematic research overview. In: Psychotherapist. Volume 52, 2007, pp. 322-333.
- ↑ Christian Heinrich: Profession special: Psychiatry: Attention in chord . In: Die Zeit (Ed.): Die Zeit Online . No. June 24 , 2014 ( zeit.de [accessed June 10, 2018]).
- ↑ BDP - Association of German Psychologists: BDP makes it clear: the title “Psychologist” is protected. March 16, 2004, accessed May 15, 2018 .
- ↑ Career opportunity check psychologist. Education and Knowledge, Nuremberg 1999, ISBN 3-8214-8244-3 .
- ↑ Guideline of the Federal Joint Committee on the Implementation of Psychotherapy (Psychotherapy Guideline) g-ba.de Retrieved on March 31, 2014.
- ↑ Psychotherapists Act of the Federal Republic of Germany gesetze-im-internet.de Retrieved on March 31, 2014.
- ↑ Section work of the further training regulations here of the Berlin Medical Association
- ↑ Fee schedule for psychological psychotherapists (GOP)
- ↑ BPtK, waiting times in outpatient psychotherapy (PDF; 68 kB)
- ^ Psychotherapy guidelines , accessed on March 18, 2013.
- ^ Judgment of the Federal Court of Justice of February 15, 2006 on the question of the obligation to cover psychotherapy services by health insurance companies
- ↑ Sabine Herpertz u. a .: Study on health services research. Preliminary final report December 2011 (pdf; 357 kB).
