What do therapist-psychologists actually do

Basic information
What is psychotherapy?

Literally translated, psychotherapy means "treatment of the soul" or treatment of mental problems. Psychological methods - such as psychotherapeutic discussions, relaxation procedures or cognitive methods - are used to identify and treat disorders of thinking, acting and experiencing.

Psychotherapy is the treatment of mental disorders with a disease value, including depression, anxiety, eating disorders, compulsions or psychosomatic illnesses. Psychotherapeutic measures are also used more and more frequently as a supplement to medical treatment, for example in the case of tumor or cardiovascular diseases.

Psychotherapy is a targeted treatment of a mental illness. The treatment should aim to rectify a specific problem and should therefore be limited in time.


When is a psychological therapy recommend?

Anyone who is plagued by mental problems and cannot cope with them on their own should not be afraid to seek professional help, as with physical illnesses.

A basic prerequisite for diagnosing a mental illness is the patient's level of suffering. There is an exception in the case of endangering others, such as delusional schizophrenia and certain behavioral disorders. Your personal perception therefore plays an important role. Your personal willingness to undergo psychotherapy also has a major influence on the success of the therapy. The more motivated you are to grapple with your problems and work on them, the better your chances of successful therapy.

Outpatient psychotherapy, however, requires a certain physical and mental stability on the part of the patient. For example, addiction therapy for alcohol-dependent patients is only carried out in dry alcoholics after inpatient detoxification and weaning. Patients in suicidal crises are also initially stabilized during a hospital stay before they start outpatient psychotherapy.


What procedures are there?

The various psychotherapeutic procedures differ both in their understanding of the development of mental illnesses and in their therapy concept and the attitude of the psychotherapist. In the following you will find a list and brief description of the most widespread forms of psychotherapy. The following 4 procedures are currently reimbursed by the statutory health insurances: behavior therapy, psychotherapy based on depth psychology, systemic therapy (for adults) and analytical psychotherapy.

Behavior Therapy: Behavioral therapy assumes that people learn their behavior and experience through experiences in the course of their lives. Mental illness occurs when the patterns learned are problematic or inappropriate; for example by causing distress in the patient or his environment.

In the case of an eating disorder, for example, a patient experiences that slim people correspond to the ideal and are perceived to be more popular than others. As a result, striving to conform to this ideal and fear of gaining weight can develop into inappropriate eating habits such as anorexia or bulimia.

The psychotherapist works with the patient to develop new patterns of behavior and experience, which the patient practices with the help of various methods. The aim is to replace the negative patterns with positive ones. Behavioral therapy is a thought- and action-oriented, problem-related form of therapy.

Psychotherapy based on depth psychology: This form of psychotherapy developed from psychoanalytic therapy. The underlying image of man and the understanding of the development of mental illnesses are similar: Even deep psychological psychotherapy assumes that the current problem is based on an inner-psychological conflict. However, psychotherapy, based on depth psychology, focuses on dealing with the so-called “central conflict” and on this basis searches for possible causes in the patient's personality or past.

The patient should seek changes in his experience or behavior through insight into the context and causes of his problems, with the psychotherapist actively supporting him.

Analytical psychotherapy: This therapy goes back to Sigmund Freud, is based on a theory of normal and pathological behavior and is the oldest form of psychotherapy. In the course of time, different variants of this type of psychotherapy have developed, but they largely coincide in their understanding of the origin of mental illness.

The aim of analytical psychotherapy is to make people aware of repressed feelings and memories that block the development of a healthy, independent individual. According to the theory of neuroses, the causes and solutions to current problems are to be sought in the patient's unconscious and in the past. In the course of therapy, the patient should relive the conflicts of formative development phases in order to process them. This is done in the systematic analysis of transference and countertransference. Frequently used methods are, for example, free association or dream interpretation. With this type of therapy, 2-3 sessions per week often take place while lying down.

The psychotherapist behaves neutrally in order to be able to serve as a projection surface for the patient's emotions, so he usually sits in such a way that he is not visible to the patient. The patient should have the ability and willingness to self-analyze in order for psychoanalytic therapy to be successful.

Systemic therapy: There are various forms of systemic therapy, but all of them not only focus on the individual patient, but also include the most important caregivers, such as the family and the patient's environment. Mental illness in an individual patient is seen as a symptom of a disorder in the behavior or communication patterns of the system,
d. H. seen in the family or in the wider community.

On the one hand, the psychotherapist will try to identify the disturbances in the system and, on the other hand, work out possible solutions with the patient. An example of systemic intervention is paradoxical prescribing. Here the patient is asked to maintain his problematic behavior instead of fighting it, as it is important for maintaining the existing family structures. This forces the individual family members to consider their contribution and their reaction to the central problem.

Conversational psychotherapy according to Rogers: This form of therapy belongs to the humanistic approaches and is also referred to as "client-centered". The focus here is not only on the symptoms or the development history of the patient, but on the person as a whole in his living environment. It is based on an image of man, according to which every person strives for self-realization and thus already has the motivation and drive to work on his problems. The basis of counseling psychotherapy are three variables that describe the behavior of the therapist: an emphatic attitude towards the client, the authenticity of the psychotherapist and a non-judgmental acceptance of the patient and his problems. With the help of a client-centered conversation, in which special attention is paid to the emotional meaning, the patient should learn to understand and accept himself.

Gestalt therapy: The Gestalt therapy according to Perls also belongs to the humanistic forms of psychotherapy. Here, too, it is assumed that people basically strive for the good and the holistic. In this method, the patient is confronted with incompletely processed experiences or suppressed needs, whereby the therapy focuses on the patient's state in the here and now.

The psychotherapist tries to motivate and support the patient to face his problems and to take responsibility for his own actions. The aim of Gestalt therapy is to develop the patient into a holistic individual who is aware of all parts of his personality, his feelings and needs (the so-called "good shape").

Who is who?

Psychotherapist - psychiatrist - psychologist

Three terms *) that are confused again and again when people seek help with mental illnesses, complaints and disorders or physical and social problems and think about whom to turn to. Our explanations of terms should help.

* Three terms - three professional fields.


A psychotherapist does psychotherapy. This can be a psychologist ("psychological psychotherapist"), or a doctor who works in psychotherapy - both are allowed to treat children, adolescents and adults - or an educator who is trained in the therapy of children and adolescents (child and adolescent psychotherapist). In addition to their "basic occupation", all three have completed additional training in psychotherapy or acquired a corresponding specialist title.

The profession of psychological psychotherapist has been regulated by the Psychotherapists Act since January 1, 1999. The law also protects the professional title "psychotherapist" under criminal law for those who have a license to practice medicine (professional license) on the basis of the Psychotherapists Act or as a doctor with appropriate additional training.


Specialist in mental illness or disorders. Psychiatrists approach mental health problems from the physical side.

The psychiatrist studied medicine. During his studies he primarily dealt with the functioning and diseases of the human body and learned to treat these diseases mainly with medication. After completing his medical degree, he completed several years of specialist training as a psychiatrist in medical institutions. During this training he acquired special knowledge about the origin and progression of diseases of the mind and soul and learned to recognize and treat these diseases, mostly with medication, the so-called psychotropic drugs.

Only additional training in psychotherapy entitles a psychiatrist (or another doctor) to also practice psychotherapy and, in addition to the specialist designation (here: psychiatrist), for example, to use the additional designation "psychotherapy" or "psychoanalysis".


University graduate who studied psychology. Psychologists are concerned with describing, explaining, predicting and changing human experiences (e.g. thoughts and feelings) and behavior. The job title "psychologist" may only be used by people who have completed a university degree in psychology.

Through the academic study that is completed with a diploma or master’s degree (diploma psychologist or psychologist M.Sc.), the psychologist acquires scientifically proven knowledge and extensive knowledge of human thinking and feeling, learning and behavior in the various areas of psychology and also about how one can influence human behavior.

In the main course, the psychologist can specialize in clinical psychology and psychological treatment methods. In doing so, the budding psychologist will acquire extensive knowledge of mental and physical health and illness, as well as the basics of scientific psychotherapy. After completing the psychology degree, the psychologist can complete a three-year full-day or a five-year part-time psychotherapeutic training course, which qualifies him to practice psychotherapy independently. The psychologist trained in this way receives the state professional license (Approbation) as

Psychological psychotherapist

A psychological psychotherapist does not use medication. His approach to treatment is different. He supports the patient with psychological means in overcoming the mental illness through a conscious examination of its causes and / or through targeted practice of new behaviors. If an organic illness has to be treated as well, or if a combination of psychological and drug therapy is necessary in the case of a mental illness, the psychological psychotherapist works together with doctors.

What mental illnesses are there?

The international statistical classification of diseases (ICD-10) lists all recognized diseases (www.dimdi.de). This directory is published by the World Health Organization (WHO) and contains all scientifically recognized physical and mental illnesses, from mood disorders such as depression to behavioral disorders in children and adolescents. The indication for psychotherapy is also derived from a diagnosis based on this directory.

The diagnosis of a mental illness comes about through the anamnesis of the complaints of the patient. Often times, patients have a number of symptoms that, taken together, indicate a specific condition. The most common mental illnesses are anxiety disorders and depression. It is estimated that around 10% of the population will develop an anxiety disorder that requires treatment at some point in their life; similar figures are available for depression.

The first sign of a mental illness is the suffering of the person concerned. The patient then has the option at any time to contact a psychotherapist directly in order to have a diagnosis made by him and, if necessary, to start psychotherapy.