Psychotherapy guideline

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Psychotherapy Guideline is the abbreviated and commonly used name for the guideline of the Federal Joint Committee on the implementation of psychotherapy . It regulates the practice of therapeutic psychotherapy in Germany. As another set of rules, there is the Psychotherapy agreement between the doctors' Confederation and the Central Federal Association of Health Insurance (short: SHI Head Association), which deals with the psychotherapy as provided by statutory health insurance deal.

Psychotherapy guideline

After psychotherapy was included as a healing method in the catalog of services provided by statutory health insurance physicians in 1967, largely at the instigation of Annemarie Dührssen , guidelines were issued to regulate its implementation. Changes are worked out in cooperation by the Subcommittee on Method Evaluation and the Subcommittee on Psychotherapy and submitted to the Federal Committee for resolution. The current psychotherapy guideline is published in the Federal Gazette . The most recent edition is the guideline from 2009, which was changed in 2019 and has been in force since January 24, 2020 ( BAnz AT January 23 , 2020 B4 ). It comprises ten sections with a total of 42 paragraphs.

In the General section (A), ten paragraphs specify, among other things, the subject matter of the guideline, describe the term mental illness in more detail, name the characteristics of psychotherapy and provide definitions of psychotherapy procedures and methods.

The section Psychotherapeutic forms of treatment and use (B) is divided into 13 paragraphs. You deal with the organizational design of a psychotherapeutic practice and determine consultation hours. In addition, the so-called probatory sessions, acute psychotherapeutic treatment and relapse prevention are regulated. As forms of treatment, psychoanalytically based procedures are specified , which include in particular depth psychology and analytical psychotherapy , behavioral therapy and systemic therapy . Furthermore, the provisions for the recognition of new psychotherapy procedures and methods are laid down. In addition, there are statements about forms of application such as individual or group therapy and the frequency of treatment.

The third section (C) regulates basic psychosomatic care in three paragraphs with verbal interventions on the one hand and practicing and suggestive interventions on the other. The fourth section (D) contains only one paragraph that regulates the areas of application and brings together the indications for the use of psychotherapy. The fifth section (E) defines the scope of the various procedures in four paragraphs and makes statements about the so-called approval steps. The scope of treatment for practicing and suggestive interventions is also determined.

The sixth section (F) deals in five paragraphs with the regulation of consultation , application and expert procedures . In doing so, the required qualifications of the applicant and the reviewer are also determined. The seventh section (G) regulates qualification and documentation in two paragraphs , whereby reference is made to the psychotherapy agreement for the qualification of the service provider .

The eighth section (H) refers in its single paragraph to the psychotherapy agreement and its regulatory area, and the ninth and final section (I) sets out the transitional regulation.

In the final appendix , it is stated in the first section that Katathymes Imagery , Rational Emotive Therapy (RET) and Eye Movement Desensitization and Reprocessing (EMDR) are not independent psychotherapy procedures, but can be used within the framework of superordinate therapy concepts. The second section of the annex excludes procedures "because the requirements of the Psychotherapy Directive are not met". Discussion psychotherapy, gestalt therapy , logotherapy , psychodrama , respiratory biofeedback and transactional analysis are mentioned by name .

Faber and hair knitting

Health insurance funded psychotherapy is a so-called application process and, if it exceeds a certain number of hours, it must be applied for in advance with a report to the health insurer and approved by an expert commissioned by the health insurers.

Since the application process is complex and the psychotherapy guideline is multi-layered, established psychotherapists with health insurance approval often use a standard work when applying for health insurance funded psychotherapy, which is known under the name of its author ( Faber & Haarstrick ) and is also referred to as that in short. The two authors commented on the text of the psychotherapy guideline, explained the regulations and supported the care providers in applying for the intended and indicated treatment. In 2018 Michael Dieckmann et al. as editor a new edition.

The work describes the history of the introduction of psychotherapy into statutory health care, takes a position on the concept of illness in the psychotherapy guideline and justifies the need for a theory of diseases. Based on the wording of the guideline, it presents the individual paragraphs in detail and deals with questions of indication and questions on differential indication. Social law and other legal aspects are examined and various recommendations are given, for example on therapy goals, treatment planning and especially the final phase of treatment. In the event of a rejection of the application, the procedure for a so-called top report is described. Finally, the work makes familiar with the application forms, the state aid rules and the procedure for privately insured persons. A separate chapter is dedicated to the Psychotherapy Agreement and the Psychotherapists Act .

Helmut Thomä described the book by Franz Rudolf Faber and Rudolf Haarstrick - who, along with Annemarie Dührssen, had helped design the inclusion of psychotherapy in the health insurance service catalog from the beginning - in his review in the Ärzteblatt as an “indispensable reference work”.

Referring to the 2011 edition of Faber / Haarstrick, the Association of Psychological Psychotherapists (VPP) called the new inclusion of trauma-therapeutic interventions in the service catalog a "small paradigm shift ". This made it possible to use a modified therapeutic approach in outpatient psychotherapy for patients with trauma-related disorders at the expense of the health insurance companies, including post-traumatic stress disorder , for example .

Psychotherapy agreement

The agreement on the use of psychotherapy in the contractual medical care (short: Psychotherapy Agreement ) is between the physicians' Confederation one hand and the Statutory Health Insurance Funds Association on the other. Currently it applies in the version of 2 February 2017. The National Association of Statutory Health Insurance Physicians on its website an overview of the history of psychotherapy agreement since 1967. The agreement is set out in Annex 1 to the Federal Mantelvertrag -Doctors (BMV-Ä).

The core of the agreement is the second part with nine and the third part with six paragraphs. All other parts each have a paragraph. The agreement makes several references to the Psychotherapy Directive . In the second part (B) it is determined who is entitled to exercise psychotherapy. In particular, it regulates which “professional qualifications” medical and psychological psychotherapists and child and adolescent psychotherapists must show and how this “ proof of professional qualifications ” is to be provided. The third part (C) regulates the implementation of the treatment analogous to the guidelines. In the fourth part (D) it is stipulated that the billing of the services provided must be carried out by the responsible association of statutory health insurance physicians .

literature

  • Michael Dieckmann, Andreas Dahm, Martin Neher (Eds.): Faber / Haarstrick. Comment psychotherapy guidelines . 11th, updated and supplemented edition based on the currently valid psychotherapy guidelines (as of spring 2017). Urban & Fischer, Elsevier, Munich 2018, ISBN 978-3-437-22865-0 .
  • Franz Rudolf Faber, Rudolf Haarstrick: Commentary. Psychotherapy guidelines. Expert procedure in psychotherapy. Basic psychosomatic care . 1st edition. Jungjohann, Neckarsulm, Munich 1989, ISBN 978-3-8243-1000-5 .

Web links

Individual evidence

  1. ^ Psychotherapy guideline. Overview. Federal Joint Committee , January 23, 2020, accessed on July 26, 2020 .
  2. ↑ Guideline of the Federal Joint Committee on the Implementation of Psychotherapy (Psychotherapy Guideline). (PDF; 190 KB) Federal Joint Committee, December 21, 2018, accessed on July 26, 2020 .
  3. ↑ a b c Agreement on the use of psychotherapy in contract medical care (psychotherapy agreement). (PDF; 170 KB) Annex 1 to the federal contract for doctors. National Association of Statutory Health Insurance Physicians , National Association of Health Insurance Funds , July 1, 2020, accessed on July 26, 2020 .
  4. ↑ Guideline of the Federal Joint Committee on the Implementation of Psychotherapy. (PDF; 169.15 KB) Federal Joint Committee, January 24, 2020, accessed on July 26, 2020 .
  5. ^ A b Helmut Thomä: Franz Rudolf Faber, Rudolf Haarstrick: Commentary on psychotherapy guidelines . In: Deutsches Ärzteblatt . tape 87 , no. 21 , May 24, 1990, ISSN  0012-1207 ([url = https://www.aerzteblatt.de/archiv/103354/Franz-Rudolf-Faber-Rudolf-Haarstrick-Kommentar-Psychotherapie-Richtlinien Online] [accessed on 5 November 2018]).
  6. ^ Franz Rudolf Faber, Rudolf Haarstrick: Table of Contents. (PDF; 240 KB) In: Comment. Psychotherapy guidelines. Expert procedure in psychotherapy. Basic psychosomatic care. Pp. IX – XIII , accessed November 5, 2018 .
  7. ↑ Ingo Jungclaussen: Current Faber / Haarstrick Commentary: Silent opening of the TP in favor of traumatized patients. Association of Psychological Psychotherapists (VPP), March 28, 2012, accessed on November 5, 2018 .
  8. ^ History of the psychotherapy agreement. National Association of Statutory Health Insurance Physicians, accessed on July 26, 2020 .