Finding a therapist in Germany as an expat: waiting lists, costs and options

Short answer: with German public insurance, therapy is covered, but you usually wait months for a place, and most therapists work in German. The faster routes are acute treatment, the cost-reimbursement procedure, paying privately (around €100–€150 a session), or online therapy in English.

How it works with public insurance

1. Initial consultation (psychotherapeutische Sprechstunde). Book it directly with a therapist who has a public contract (Kassensitz), or through the appointment service on 116117.
2. Acute treatment (Akutbehandlung), if the therapist thinks you need help quickly.
3. Probatory sessions, then the therapy itself (Richtlinienpsychotherapie), which your insurer approves.

You do not need a referral from your GP.

How long is the wait?

The best-known figures come from the Federal Chamber of Psychotherapists (BPtK). In its 2018 study, the average wait was:

• 5.7 weeks for the initial consultation;
• 19.9 weeks from there to the start of therapy, nationally;
• 13.4 weeks in Berlin, and almost 30 weeks in the Ruhr area.

Many people call dozens of practices before finding a place. Ask to go on several waiting lists at once, and keep a record of every call: you may need it for the next option.

The cost-reimbursement route (Kostenerstattungsverfahren)

If you cannot find a therapist with a public contract in reasonable time, you can ask your insurer to pay for a licensed therapist in private practice. You must apply before starting, usually with proof of your search and a note of urgency from a therapist. Insurers can, and do, refuse.

Paying privately

A licensed psychotherapist in private practice usually charges about €100 to €150 for 50 minutes, based on the official fee scale (GOP). You start quickly, and nothing goes on your insurance file. Some costs may be tax-deductible as extraordinary expenses.

Be careful with titles: in Germany, Psychotherapeut is a protected title for licensed professionals. A Heilpraktiker für Psychotherapie has a different, much shorter training.

Therapy in English

Big cities have English-speaking therapists, but they are in high demand and many only take private patients. Online therapy with psychologists licensed in another EU country is another option, legal under EU rules on cross-border healthcare. It is not reimbursed by German public insurance.

At Lon Clinic you can start this week, in English, from €35: English-speaking therapist in Berlin.

In a crisis

Call 112. TelefonSeelsorge is free and open 24 hours: 0800 111 0 111 or 0800 111 0 222 (in German). In Berlin, the Berliner Krisendienst helps around the clock and can arrange English with some notice.

Sources

• BPtK waiting times study, 2018
• therapie.de: who pays for therapy
• Berliner Krisendienst