Psychotherapy providers in Germany

There are two main groups of psychotherapists in Germany:

• Non-medical psychotherapists (nicht-ärztliche Psychotherapie), also known as psychological psychotherapists (psychologische Psychotherapie)
• Medical psychotherapists (ärztliche Psychotherapie)

They have different qualifications and specializations. But both groups include therapists who use depth psychology or psychoanalytic approaches and therapists working with behavioral or systemic therapy.

These psychotherapists work with people who have mental illnesses like depression or anxiety disorders. The therapy often takes place in a psychotherapy practice. It includes things like talking, behavioral exercises, and relaxation techniques. It does not include treatment with medication. If medication is needed too, a doctor can prescribe it. Ideally, medical and psychological healthcare providers should work closely together.

Most non-medical psychotherapists have studied psychology and then done several years of practical psychotherapy training. That’s where the older job title “psychological psychotherapists” comes from. But a separate university degree in psychotherapy was introduced in Germany in 2020. Anyone who would like to become a psychotherapist now has to complete this degree. So there’s no longer any need for the word “psychological” in the job title. Because this is a recent change, most of the therapists that are already working completed their training in the old system.

Medical psychotherapists are medical doctors who provide psychotherapy treatment. They have to do extra training to become a specialist (Facharzt) or gain an additional qualification in psychotherapy. The rules for this vary between the German federal states.

Medical psychotherapists are also allowed to prescribe medication to treat mental illnesses ( psychotropic drugs) because they’re trained in medicine.

There are different professional categories here too, depending on their training and specialization:

• Psychiatrists: Study medicine and then spend several years training to become a specialist in psychiatry and psychotherapy. They mainly treat mental illnesses where medication plays an important role, like schizophrenia or severe depression. In the past, medical doctors could train to become specialists in neurology and psychiatry (Nervenheilkunde). This qualification, which didn't involve special training in psychotherapy, is no longer an option nowadays.
• Specialists for psychosomatic medicine and psychotherapy (Psychosomatische Medizin und Psychotherapie): Doctors with this specialist qualification mainly treat physical symptoms that are thought to be caused or made worse by mental health issues (somatization disorders).
• Specialist doctors with additional psychotherapy title: These are doctors who are specialized in a different field and have done additional training to work in psychotherapy. They treat mental illnesses or problems that are related to their area of medical expertise. One example is gynecologists who provide psychological support for women who have breast cancer.

Mental illnesses that occur during childhood and teenage years are sometimes different from those that adults experience. The treatment is sometimes different too. For this reason, some psychotherapists specialize in the mental health problems that young people have.

Psychologists and specialists from the field of (social) education sciences can train to become qualified therapists for children and teenagers (Kinder-und Jugend- Psychotherapie). This training is also open to people who have completed the psychotherapy degree introduced in 2020.

Medical doctors can do extra training to specialize in psychotherapy or psychiatry for children and teenagers.

In Germany, only the people listed above can call themselves psychotherapists. But this restriction doesn’t apply to the term “psychotherapy,” which other people are allowed to use when describing the treatment they offer. Most of these people are naturopaths (Heilpraktiker). Before they can practice, naturopaths have to take an exam at a local health authority. They usually complete a training program to prepare for the exam. Unlike for the professions listed above, though, the content and form of this training are not laid down by law. It has little in common with a psychotherapy degree, for example. Because of this, there are big differences in the quality of the psychotherapy treatment offered by naturopaths. Public (statutory) health insurers do not pay for this type of treatment.