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Rosian, K. and Winkler, R. (2017): Psychotherapy - concepts, effect factors and a comparison of legal regulations in three German speaking countries. HTA-Projektbericht 93.

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Mental illnesses are an increasingly macrosocial issue and, according to the WHO Global Burden of Disease Study, are among the leading causes of illness-related impairments. In the treatment of persons with mental disorders psychotherapy is of central importance. Psychotherapy has developed on the basis of various sciences (e.g., medicine or psychology) and has become an independent scientific discipline with specific methods.

In order to answer the research questions, both a systematic literature search and manual search for key publications were carried out. These searches were supplemented with targeted manual searches for relevant and recent literature on the websites of institutions and expert associations. Furthermore, a semi-structured interview was conducted with three experts from the Federal Joint Committee (G-BA). The presentation of the results was based on a narrative-descriptive synthesis of the literature.

Overall, it should be noted that different terms such as psychotherapy procedures, methods, schools, orientations or techniques are used in specialised literature as well as in policy documents in the thematic context of psychotherapy. With regard to the effect factors in psychotherapy, it should be noted that there is a differentiation between common and specific effect factors that are associated with (positive) therapeutic effects. Common effect factors summarise all those therapeutic variables that are presented across all psychotherapeutic methods and that lead to therapeutic success in patients. In addition, specific effect factors are understood to be explicit theoretic techniques that are both anchored in psychotherapeutic methods and serve a specific goal achievement in the psychotherapy process (e.g. a reduction of anxiety disorders). The significance of the common effect factors for therapeutic effects (in the sense of positive improvements) is considered decisive.

When presenting the results regarding the legal regulations and requirements for state recognition of new psychotherapy methods, numerous differences could be shown: In Austria and Switzerland, for example, there are criteria in guidelines that have to be met for the recognition of new psychotherapeutic methods. In Germany, on the other hand, recognition is regulated by a benefit assessment procedure, based on the Rules of Procedure of the Federal Joint Committee. As a result, there are varying numbers of legally recognised psychotherapeutic methods in German-speaking countries, that are eligible for reimbursement by national insurances for the outpatient sector. The requirements for the professional practice of psychotherapy are also regulated differently in the German speaking countries (e.g. educational requirements, duration of education and entry requirements). During the working progress of this report, it has transpired that common effect factors are attributed greater importance for achieving therapeutic effects than, for example, the application of specific therapy techniques (specific effect factors).

Looking at the results of legal regulations in the German-speaking area, the differences indicate that requirements and standards for the recognition of a new psychotherapeutic method differ substantially, which can be attributed to heterogeneous national legislations.

Item Type:Project Report
Keywords:Psychotherapy, psychotherapeutic methods, legal regulations, acceptance of new methods in psychotherapy cross-country comparison
Subjects:WA Public health > WA 525-590 Health administration and organisation
WB Practice of medicine > WB 300-962 Therapeutics
W Health professions > W 84 Health services. Quality of health care
WM Psychiatry > WM 140 Mental disorders
WA Public health > WA 105 Epidemiology
WM Psychiatry
Series Name:HTA-Projektbericht 93
Deposited on:14 Dec 2017 12:33
Last Modified:15 Jul 2020 17:56

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