Psychotherapeutic treatment for depression relies on several scientifically verified and recognized approaches. Regardless of the specific method used, all therapy types pursue the same overarching goal: to alleviate symptoms, prevent relapses, and sustainably improve quality of life.

The official medical guideline for "Unipolar Depression (S3/NVL)" defines how this goal can be achieved. It serves as a manual for doctors and therapists, establishing the best practices for diagnosing and treating depression based on the highest standard of scientific evidence. This guideline recommends psychotherapy for all levels of severity. Depending on the individual situation and the preferences of the person affected, psychotherapy can also be combined with medication in the form of antidepressants.

Cognitive Behavioral Therapy (CBT)

• Focus of Therapy: Targets unhelpful thinking and behavioral patterns. It helps to change these in a practical way. Effective across all levels of severity.
• What happens in therapy: Learning to take action: You recognize dysfunctional thoughts and behavioral routines and develop new strategies—such as through behavioral activation, problem-solving training, and relapse prevention.

Depth Psychology-Based and Analytical Psychotherapy

• Focus of Therapy: These psychodynamic approaches work intensively with biographical experiences and current relationship patterns. They are frequently used for recurring patterns.
• What happens in therapy: Understanding conflicts: You explore how unconscious conflicts from the past shape your current experiences in order to develop new coping mechanisms.

Systemic Therapy

• Focus of Therapy: Places the entire relational system (family, partnership, social environment) at the center of attention.
• What happens in therapy: Looking at the bigger picture: You work on changing the patterns and dynamics within your social environment to create relief for yourself and those around you.

Interpersonal Therapy (IPT)

• Focus of Therapy: Clearly focuses on current role transitions, grief processes, conflicts, and social deficits.
• What happens in therapy: Mastering social challenges: You specifically target your current interpersonal issues to strengthen your social skills and your social integration.

Which therapy type is best for you depends on your personal goals, the severity of your symptoms, and, above all, on how well the approach and the therapist fit you. The psychotherapeutic consultation hour is an excellent opportunity to get to know the person and the offered method to see if they are a good match.

The thought of starting psychotherapy may feel like a step into the unknown, but the path is clear and structured. This established sequence helps you maintain your bearings and actively take the next step despite your depression.

Your family doctor is your primary resource to establish a diagnosis and refer you to a psychotherapist for an initial consultation—known as the psychotherapeutic consultation hour. A psychiatrist can also handle this referral.

Alternatively, you can reach out directly to a psychotherapeutic practice for a consultation hour. Providing these sessions is mandatory for all licensed therapists, allowing you to secure an initial appointment promptly. During this interview, the therapist determines whether a treatable disorder is present and which form of therapy is appropriate.

To get a consultation hour or a slot for trial sessions—called probatory sessions—as quickly as possible, please use the 116117 service via phone or online. The Appointment Service Desk (TSS) is required to offer you an appointment within one week, and the appointment itself should take place within four to five weeks at the latest.

If your depression is severely overwhelming, ask the TSS for an appointment for an acute consultation hour (Akutsprechstunde). This is a short-term appointment (within four to five weeks, often faster) designed to quickly evaluate if you are experiencing an acute psychological crisis that requires immediate intervention. If this session concludes that rapid assistance is necessary, acute treatment can begin right away. This treatment includes up to 12 sessions aimed at providing immediate relief and stabilization before any actual long-term therapy begins.

In the psychotherapeutic consultation hour, you and the therapist clarify whether a mental illness requiring treatment is present, what options are available, and the level of urgency. This is followed by the probatory sessions—typically up to four trial sessions—where both parties evaluate if the method fits and if the working relationship feels right. Diagnostics and mutual goal-setting are also part of this process.

If you decide to move forward with psychotherapy, your therapist's practice will prepare all the paperwork for you, from your medical history to the diagnosis. Together with your therapist, you will submit an application for cost coverage to your health insurance provider. To continue therapy after the trial sessions, your application must be reviewed by an external expert—this assessment is usually conducted by a specialist in psychiatry or psychotherapy. Your therapist compiles the necessary reports and forms for this. The approved scope and frequency of the sessions depend on the chosen method, the severity of your illness, and your daily life stressors.

Many people sharing their initial experiences with psychotherapy for depression report that improvement begins within the first few weeks. Over time, this is followed by a noticeably better mood, stronger self-esteem, and the regained ability to actively shape one's own life.

The choice of the right person for your treatment is crucial. In fact, the quality of the therapeutic relationship is one of the strongest predicting factors for the success of your therapy.

Make sure that the therapist holds a state license for psychotherapy—the so-called "Approbation"—and has completed specialized post-graduate therapeutic training in the respective method, such as Cognitive Behavioral Therapy, psychodynamic therapy, or systemic therapy. For the costs to be covered by your health insurance, a public health insurance license is also required.

If it does not feel like a good match on a human level, you are allowed to change therapists. It is absolutely legitimate, and often highly beneficial, to address this early on during the trial sessions. A strong therapeutic relationship forms the foundation that allows for deep, meaningful change.

Treatment can occur in various settings:

• Outpatient: As a rule, therapy takes place in the practice rooms of the psychotherapist.
• Video: Therapy sessions via video conference are also possible, provided they are structured by the psychotherapist in compliance with data privacy regulations.
• Group: Depending on the method, therapy sessions in a group setting can take place to complement individual sessions.
• Day Clinic: Psychotherapy can also take place in day clinics, which makes very little difference compared to a psychotherapist's regular practice.
• Inpatient: For acute treatment, a stay in a psychiatric or psychosomatic clinic can be beneficial. The difference compared to a day clinic or a private practice is that more therapy sessions take place per week, and these are supplemented by additional treatments, such as behavioral activation through movement or relaxation techniques.

Especially in cases of severe depression or when outpatient care cannot be found in a timely manner, it is worth considering entering a clinic or a day clinic.

Costs for Outpatient Psychotherapy

• Public and private health insurance companies fully cover the costs of psychotherapy for approved methods.
• This includes diagnostics, consultation hours, acute treatment, as well as short-term and long-term therapies.
• Co-payments (out-of-pocket expenses) do not apply to adults undergoing outpatient psychotherapy.

Costs for Psychotherapy in Private Practices

• In exceptional cases, health insurance providers may reimburse treatment provided by private practices if timely care is unavailable.
• An example of this is if all nearby therapists have waiting times exceeding 6 months.
• Note: This must strictly be clarified and approved with your insurance provider in advance.

Having to wait for a therapy placement can be distressing. Nevertheless, you can take active and self-determined steps during this time to alleviate symptoms—while this does not replace the actual treatment, it can make the waiting period easier and improve stability.

Speak regularly with your family doctor about your symptoms, the possibility of a sick leave certificate, and potentially about medications that can provide relief. You are not alone!

Even while waiting for your therapy to begin, you can take action: Integrate firm structures into your daily routine, ensure regular physical activity, pay attention to good sleep hygiene, and maintain your social contacts. All of these steps are scientifically proven building blocks that can demonstrably ease symptoms while you wait. Set small, achievable goals for yourself to actively strengthen your sense of self-efficacy—the vital feeling that you can make things happen.

As a valuable supplement, the Digital Health Application (DiGA) deprexis can assist you during the waiting period. This interactive online program was developed to support you with depression and provide you with targeted content. Since it is BfArM-listed, you can have it prescribed by your doctor via a prescription, and the costs will be covered by your health insurance.