How do you choose a psychologist

Psychotherapy: How do I find the right therapist?

The personal relationship between the practitioner and the patient is the decisive factor for a successful therapy. Harald J. Freyberger, doctor for psychiatry and psychotherapy, explains what to look out for when choosing a therapist

Interview: Claus Peter Simon

GEO KNOWLEDGE: Professor Freyberger, how can people with burnout syndrome or depression find a good psychotherapist?


Prof. Harald J. Freyberger: First of all, every patient should ask themselves: What do I want from the therapy? Am I looking for a biographical approach to my problem? Then I should choose a therapist who works psychodynamically or in terms of depth psychology. Or would I rather have access that allows my symptoms to be controlled without
but to come to terms with the past? In such a case, one should see a behavior therapist.

As a patient, how can I know which approach makes more sense for me?


Many of those affected can answer this intuitively. Because they suspect what suits them better. Because they have a feeling for what has happened in their life - and whether that one
Has significance for depression or burnout. Anyone who has been depressed for a long time, may have lost a parent at an early age and experiences how the depression then worsens after their own divorce, for example, probably suspects that it makes sense to work up their biography. On the other hand, there are people who are overburdened professionally but have not had any drastic biographical experiences. Then a behavior therapy approach is more promising. If I am sitting across from a therapist for the first time, how do I know if he is right for me? Every therapy has an introductory phase, the probatory, in which you meet three to five times. This is used to take stock of the disease - but above all to find out whether you are a good match.

What exactly can a patient check?

In particular, mutual sympathy. Most patients feel quite quickly whether they are sitting across from a therapist with whom they would like to spend many hours.

Is that really that important for the success of a therapy?


Therapy research has shown that the interpersonal level is crucial, the single most important factor. This also includes a common language: whether what I like a
Therapists tell stories, is understood and understood in my sense. Whether I, as a patient, get adequate answers that I can understand.

A therapist's experience or specific approach isn't that important?


It may sound amazing to a layperson, but the most important thing is actually the personal level. And whether the therapist undergoes regular supervision - i.e. advice
and control by experienced colleagues: The therapist presents his specific cases and his treatment approach and discusses this with the colleagues. Benefit as a patient
one very much like it. So you should entrust yourself to an experienced therapist who is under supervision? Even very young psychologists in training who are supervised work as successfully as experienced colleagues. The older ones, however, sometimes reach their goal faster.

Which therapist is right for me?

Various professional groups are responsible for the treatment of mental illnesses *. A distinction is made primarily between psychological psychotherapists and medical psychotherapists.

Psychological psychotherapists offer by far the most therapies. You have studied psychology, but no academic training in medicine. After completing their studies, they must complete at least three years of psychotherapy training at a university or a state-recognized institute. With the final examination, they are granted permission to practice psychotherapy on their own responsibility, but only according to the procedure that was the content of their training. More than one in two of them work in behavioral therapy. Psychological psychotherapists are not allowed to prescribe or use medication. You either work in a private practice or at clinics. There is training to become a child and adolescent psychotherapist especially for the treatment of minors; the prerequisite for this is a degree in psychology, pedagogy or social pedagogy.

Medical psychotherapists have studied medicine and completed specialist training that entitles them to psychotherapy or acquired a corresponding additional qualification; as doctors, they are allowed to prescribe medication. There are several groups:

  • Specialists in psychosomatic medicine and psychotherapy completed further training in psychotherapy after completing their studies, which includes at least 1500 hours of treatment and supervision. In the past they often preferred psychoanalytic procedures. Nowadays, many also work with behavioral therapy methods. Like psychological psychotherapists, they mainly look after those affected by depression, anxiety and adjustment disorders, but also patients with psychoses. Most of them treat in their own practice, a minority in clinics.
  • Specialists in psychiatry and psychotherapy have completed further training in psychotherapy, which, at 240 treatment hours, is significantly shorter than that of specialists in psychosomatic medicine and psychotherapy. But they have extensive skills in the diagnosis and treatment of mental disorders. Their activities are broad, so that they usually have a large number of patients and hold consultations like a general practitioner. They are responsible for both emergencies and long-term psychotherapeutic support for the chronically ill. For the treatment of minors, there is special training to become a specialist in child and adolescent psychiatry and psychotherapy.
  • Doctors with an additional title such as “Psychotherapy”, “Psychoanalysis” or “Psychotherapy subject-specific” are general practitioners who have acquired additional qualifications in a psychotherapeutic procedure, but they have to prove comparatively few hours of treatment. Their task is to identify the interaction of psychological factors with physical illnesses in their specialty and to incorporate them into treatment. The doctors with such additional qualifications include general practitioners, but also orthopedists, gynecologists, cardiologists and other specialists.
  • Neurology specialists have psychiatric knowledge and experience, but their domain is physical ailments such as Parkinson's disease, paralysis, and dementia. They are only admitted to psychotherapy if they have completed additional training.
  • Specialists in neurology. This term used to summarize the fields of neurology and psychiatry. The title is no longer awarded today, but many general practitioners continue to practice under this name. They also need an additional qualification to be able to practice psychotherapy. Jochen Paulus

Is Gender Important? Can men treat men better, women better women?


In principle, male and female therapists do not differ in their effectiveness. But depending on the gender constellation, different processes can occur in a therapy
expire. Because every patient has had experiences that make it easier or more difficult for them to deal with women or men.

In what way?


For example, if a woman's depression is the result of sexual assault, a male therapist must be prepared to generate a lot of anger, frustration, and anger
gets off. Because he is, so to speak, a representative of the perpetrator. But whether the therapy is helpful in the end does not depend on whether the therapist is a man or a woman.

Does a good therapist work with all patients?


Not necessarily, one may not get on so well with older patients, the other may not get on so well with younger ones. However, a large age difference isn't bad per se. However, it should be mentioned what it can mean if a treating person is, for example, 30 years older than the patient: Do they both have a very different view of life that makes it difficult for them to find a common language - or the greater life experience of the Therapists be very helpful?

What are serious warning signals for patients in the probatory sessions that it may not suit them personally?


As a patient, I have to ask myself above all: How do I feel when I leave the conversation? Do I have the impression that the therapist does not understand my concern, or is he even unsympathetic to me? That would not be a good prerequisite for treatment. Even if I don't feel empathy, little respect, my counterpart doesn't answer questions
or constantly distracted, these are not encouraging signs. If you don't get on good terms with your therapist in the first few sessions, you'd better look for someone else. If problems arise later, you should first look for causes and solutions together.

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