Zur ambulanten Psychotherapeutischen Vorsorgungssituation (English shop)

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The entry into force of the Psychotherapists Act (Psychotherapeutengesetz, PsychThG) at the beginning of 1999 and the associated new admission of psychological psychotherapists and child and adolescent psychotherapists to the statutory health insurance system of care provision and billing subsequently led to far-reaching changes in the working situation of the occupational groups involved and to fierce professional-political disputes over appropriate remuneration for psychotherapeutic services on the one hand and needs-based outpatient psychotherapeutic care on the other, disputes which continue to this day. Before long, the need for psychotherapeutic care was regarded as covered — indeed more than that: according to the purely quantitative criteria of needs planning in statutory health insurance practice, “oversupply” was found in many statutory health insurance districts, at least in the old federal states, leading to bans on new admissions. Against this background, the present questionnaire survey among psychotherapists in private practice under statutory health insurance contracts investigated how the reality of practice and the actual psychotherapeutic care situation in the adult and the child and adolescent fields in fact presented themselves a good two years after the PsychThG. Two statutory health insurance districts, Göttingen and Kassel, were included; while differing in socio-structural terms and in their supply-and-demand structure, both are officially regarded as far “oversupplied”. The results of the complete survey show that, notwithstanding the asserted favourable psychotherapeutic care situation, there are still serious specific deficits and bottlenecks in the prompt initiation of necessary psychotherapeutic treatment, pointing to a previously latent need for care. This applies in particular to child and adolescent psychotherapy, where the striking shortfall in care provision is further exacerbated by evident shortages of new entrants among the predominantly female body of therapists with a high average age. The findings provide ample reason to change the blanket needs-planning practice hitherto applied in the field of outpatient statutory psychotherapy in favour of a separate assessment of needs for children and adolescents, as well as, overall, a greater differentiation between the actually available treatment capacities in terms of time and personnel of the various occupational and therapeutic specialist groups within guideline psychotherapy.

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A questionnaire survey among psychotherapists in private practice under statutory health insurance contracts examines how the reality of practice and the actual psychotherapeutic care situation in the adult and the child and adolescent fields presented themselves a good two years after the introduction of the Psychotherapists Act (PsychThG) in the Federal Republic of Germany. Two statutory health insurance districts, Göttingen and Kassel, were included; they differ in socio-structural terms and in their supply-and-demand structure, but both are officially regarded as far “oversupplied”. The results of the complete survey show that, notwithstanding the asserted favourable psychotherapeutic care situation, there are specific deficits and bottlenecks in the prompt initiation of psychotherapeutic treatment, which points to a previously latent need for care. This applies in particular to child and adolescent psychotherapy, where the shortfall in care provision is further exacerbated by shortages of new entrants among the body of therapists. The findings provide reason to change the blanket needs-planning practice hitherto applied in the field of outpatient statutory psychotherapy in favour of a separate assessment of needs for children and adolescents, as well as, overall, a greater differentiation between the actually available treatment capacities in terms of time and personnel of the various occupational and specialist groups within guideline psychotherapy.