What is psychotherapy and where does it take place?
Psychotherapy has become increasingly important as a branch of medical care in recent decades. We now have more than 50,000 psychotherapists and child and adolescent psychotherapists who are licensed to work with statutory health insurance physicians (source: Federal Statistical Office). Psychotherapy is a medical procedure in which the soul (ancient Greek “psyche” means soul) is treated. It is a medical discipline that is just over 100 years old, and there are already several dozen different approaches and so-called “psychotherapeutic” schools that are growing in number.
Psychotherapeutic care takes place on an inpatient basis (i.e. in psychiatric and psychotherapeutic clinics where patients stay overnight), but also to a large extent on an outpatient basis (i.e. in individual and group practices that patients visit one or more times a week for a session). According to the Federal Statistical Office, there were already 19,344 individual psychotherapeutic practices in 2022. The National Association of Statutory Health Insurance Physicians (KBV) provides an overview of the key figures for outpatient care. In both inpatient and outpatient care, there is a distinction between so-called individual psychotherapy, i.e. psychotherapy in the setting “1 patient and 1 psychotherapist” and so-called group psychotherapy, i.e. psychotherapy in the setting “3 – 9 patients and 1 – 2 psychotherapists”.
Who pays for psychotherapy?
Psychotherapy is a service provided by the statutory health insurance funds, i.e. people with statutory health insurance can choose between psychotherapists licensed by the statutory health insurance funds and receive psychotherapeutic treatment. The National Association of Statutory Health Insurance Physicians recognizes a limited number of psychotherapeutic procedures in individual and group settings. It is also possible to receive treatment as a private payer from psychotherapists licensed by the health insurance funds, and there are also offers from independent alternative practitioners without state recognition and a license from the health insurance funds, who try to relieve the burden on the healthcare system and also organize themselves in associations. Patients wait an average of 142 days for a place with state-recognized individual and group psychotherapists approved by health insurance companies (source: BPtK) The majority of psychotherapy provided is paid for by statutory health insurance companies, but the number of privately billed psychotherapeutic services is also steadily increasing. Germany is also an international exception with regard to the possibility of psychotherapy being paid for by statutory health insurance funds. The reason for this is related to the difficult post-war period.
How does training/further training in psychotherapy work?
It was only in 1999 that the Bundestag passed a law on the training of psychotherapists, which was amended in 2019, in which I was also personally involved and contributed to the content, because psychotherapy training was very complex and urgently needed a change. As head of the federal office of a psychological professional association, which is also a psychotherapeutic professional association, I have spent eight years getting to know the complex system of psychotherapeutic self-administration in Germany at all levels – local, regional and federal – in depth.
In the future, from 2030, psychotherapy training will only be able to be completed by studying at universities. In connection with the completion of a 5-year course of study (Bachelor’s + Master’s), a license to practice will take place and after this, 3 years of further training in a clinic, at an approved training center or in individual and group practices will be required before one can set up one’s own practice as a psychotherapist or seek a full-time position. In future, training/continuing education in psychotherapy will therefore be similar to medical training/continuing education. By 2030, hundreds of institutes for psychotherapy will continue to operate as training/continuing education providers.
Why is data protection important in psychotherapy?
During my 8 years of intensive work, it became clear to me that data protection in psychotherapeutic care is very important. Both in psychotherapy and during training and further training to become a psychotherapist, the most sensitive special personal data is processed and usually archived for 10 years. The very confidential parts of your own life story, your problems, worries, fears and thoughts, sexual orientation, political opinions, your own past and your relationships with other people and thus also such data from third parties, based on your relationships with patients undergoing treatment or with participants in training/continuing education. After all, during their training/continuing education, the training/continuing education participants must also confide a great deal about their own lives to their training therapists or supervisors, first during their “teaching therapy” and later during their “supervision”. Unfortunately, data protection regulations are repeatedly violated, with professional and health consequences for those affected.
The situation is even more worrying for female patients because, according to a very critical and conservative study (Brieger, Menzel, Hamann), mentally ill people are at least 30 to 50 times more at risk of suicide than mentally healthy people. Incorrect handling of patients’ data can therefore have fatal consequences. This fact amplifies in particular the need for a reliable and well thought-out data protection concept both for institutions that provide training and further education for psychotherapists and for inpatient and outpatient care organizations. Sensitization of staff and psychotherapists themselves to data protection laws and the developing technical possibilities must be ensured on an ongoing basis. Special personal data, whether of patients or training participants, must be protected to a high degree.
Who can participate in the Psychotherapy Working Group and who can visit the Psychotherapy Working Group?
Data protection officers who are already working on data protection in the field of psychotherapy are welcome to participate. Interested data protection officers who would like to work on data protection in the field of psychotherapy and whom I would like to introduce to psychotherapeutic care in seminars are welcome to attend the Psychotherapy Working Group. The Psychotherapy Working Group is also open to competent supervisory authorities, institutions in psychotherapeutic self-administration, training and care for the purpose of professional exchange on their data protection organization.
How does the AK Psychotherapie work?
The Psychotherapy Working Group meets once a year for a face-to-face meeting. In between, online meetings are held as required.
The work of the working group is based on a trusting and protected cooperation for the purpose of an open, professional exchange of experiences. The participants in the working group draw up joint internal working aids and statements, provide guidance and discuss with supervisory authorities and experts from organizations in psychotherapeutic care, self-governing institutions and training providers.
Interested parties can contact the office or the head of the working group.
Sources:
(1) Federal Statistical Office, URL: https://www.destatis.de/DE/Presse/Pressemitteilungen/2021/03/PD21_N022_23.html#:~:text=Wie%20das%20Statistische%20Bundesamt%20mitteilt,mehr%20als%20f%C3%BCnf%20Jahre%20zuvor.
(2) National Association of Statutory Health Insurance Physicians (KBV), URL:
https://www.kbv.de/html/zahlen.php#:~:text=Kennzahlen%20der%20ambulanten%20Versorgung%20auf,pro%20Jahr%20in%20den%20Praxen.
(3) ARD, SWR, URL: https://www.tagesschau.de/investigativ/swr/vollbild-heilpraktiker-101.html
(4) Federal Chamber of Psychotherapists (BPtK), URL: https://www.bptk.de/pressemitteilungen/psychisch-kranke-warten-142-tage-auf-eine-psychotherapeutische-behandlung/
(5) Brieger, Menzel, Hamann: “Is the role of mental illness in suicide overestimated?”, 2021, Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz(https://pmc.ncbi.nlm.nih.gov/articles/PMC8650731/)