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Psychotherapy procedure: Systemic therapy from now health insurance

Psychotherapy procedure: Systemic therapy from now health insurance


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Systemic therapy: assumption of costs

The statutory health insurance companies are now taking over the costs of systemic therapy for adults if this is necessary for the treatment of a mental illness. This is pointed out by the German Society for Systemic Therapy, Counseling and Family Therapy (DGSF) and the Systemic Society (SG) in a joint communication.

According to the information, the reimbursement regulations for the new psychotherapy procedure included in regular care were laid down a few days ago by health insurers and the National Association of Statutory Health Insurance Physicians, and the legal basis - psychotherapy guideline and psychotherapy agreement - was changed accordingly a few months ago.

Not focused on the individual person

As explained in a communication from the Federal Joint Committee (G-BA), systemic therapy is a psychotherapy procedure that attaches particular importance to the social relationships within a family or group for the development of a mental illness.

Accordingly, the therapy does not focus on the individual, but on the interactions between members of the family and the wider social environment. Among other things, attempts are made to change symptom-promoting relationships or to counter them with a more functional self-organization of the patient.

Systemic therapy can - like the other psychotherapeutic procedures - be offered as individual or group therapy or as a combination between individual and group therapy. So-called “multi-person setting” will also be possible as a specific application of systemic therapy.

Relevant caregivers of the patient are included in the treatment. If necessary, the use of systemic therapy in multi-person setting can also be combined with the use of individual or group therapy.

Highly effective psychotherapy procedure

According to the information, about every fourth adult in Germany is affected by a mental illness every year. For the almost 18 million people affected and their relatives, mental illness is usually associated with massive suffering. This can also lead to considerable restrictions in the social relationships of the person concerned.

"This highly effective psychotherapy procedure is finally available to all adult insured persons," says Dr. Ulrike Borst, Chair of the Systemic Society (SG). It has yet to be decided whether the costs of systemic therapy for the outpatient treatment of children and adolescents will be borne by the health insurance companies.

Certified positive effect

Sufferers in Germany had to wait a long time: Twelve years after their scientific recognition by the Scientific Advisory Board on Psychotherapy (WBP), systemic therapy for adults is part of the standard care. According to the DGSF, after 33 years - behavior therapy was last approved in 1987 - a new psychotherapy procedure is used in the context of health insurance.

The approval for a psychotherapeutic procedure was given for the first time based on the results of efficacy studies: On behalf of the G-BA, the Institute for Quality and Efficiency in Health Care (IQWiG) assessed the benefits of systemic therapy. It confirmed that systemic therapy had a positive effect in seven so-called disorder areas, including the most frequently occurring impairments such as anxiety disorders, depression and addiction disorders.

According to the experts, there are still a few psychological and medical psychotherapists available who can bill systemic therapy directly with statutory health insurers. In the meantime, however, corresponding training and further education are increasingly being offered. The training regulations for doctors are also currently being adapted accordingly so that systemic therapy can be offered to insured persons as soon as possible.

Information on available therapy places can be requested from the statutory health insurance associations, for example via the nationwide free telephone number of the appointment service points: 116117.

Approval of therapy for children is still pending

A further evaluation procedure by the G-BA is required so that children and adolescents can also be treated with outpatient psychotherapeutic care with systemic therapy. The approval of systemic therapy for children and adolescents as a service of the statutory health insurance is still pending.

A corresponding application for method evaluation was announced in the G-BA on November 22, 2019 and is now urgently expected by the systemic specialist associations. The GB-A must then make a decision about the admission of systemic child and adolescent psychotherapy within two years.

"It shouldn't be," says Dr. Filip Caby, chairman of the German Society for Systemic Therapy, Counseling and Family Therapy (DGSF), “that children and adolescents are denied something that has already been made available to adults”. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


Video: Bowen Family Systems Theory (June 2022).


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