Guide
Psychotherapist, psychologist, Heilpraktiker or coach: who's who in Germany
By the TheraPlatz team · Updated
In Germany, Psychotherapeut is a protected title. Only people who hold Approbation, the state licence to practise psychotherapy, may use it, and doctors with the matching specialist training may call themselves ärztliche Psychotherapeuten (§ 1 PsychThG). Public insurance pays only for treatment by these licensed professionals, and Kostenerstattung follows the same rule. A psychologist without Approbation, a Heilpraktiker für Psychotherapie or a coach may well be skilled, but you'll pay them yourself. In English the lines blur, because therapist, psychologist and counsellor aren't protected words, so ask about Approbation before your first session.
Psychotherapeut: the licensed psychotherapist
A Psychotherapeutin or Psychotherapeut holds Approbation. Since a 2020 reform, that licence follows a university degree in psychotherapy; therapists licensed earlier qualified through a psychology or education degree and several years of further training. With a Kassensitz, their treatment is paid by public insurance. Without one, they treat privately insured and self-paying patients, and publicly insured patients through Kostenerstattung.
Ärztliche Psychotherapeuten and psychiatrists
Doctors can specialise in psychotherapy too, most often as a Facharzt für Psychiatrie und Psychotherapie or a Facharzt für Psychosomatische Medizin und Psychotherapie. Unlike psychological psychotherapists, they can prescribe medication. Public insurance covers them on the same terms.
Psychologe: a degree, not a licence
A Psychologin or Psychologe has a degree in psychology. Many work in counselling centres, clinics, research or human resources. The degree alone doesn't allow them to treat mental illness under public insurance, so a psychologist without Approbation can't bill your Krankenkasse, and Kostenerstattung doesn't cover them either.
Heilpraktiker für Psychotherapie
This is a permit under the Heilpraktiker law, granted after an exam at the local health office (Gesundheitsamt). It is a different and much shorter route than Approbation, and its holders may not call themselves Psychotherapeut. Public insurance doesn't pay for their treatment, and in 2016 the Bundessozialgericht ruled that this also applies to Kostenerstattung (B 1 KR 4/16 R): the insurer may refuse even when no licensed therapist was available. Some private tariffs and supplementary policies pay part of the cost, so check your contract if you have one.
Coach, Berater and counsellor
None of these titles is regulated. A coach or counsellor can be a good fit for a career question or a stressful period, but isn't permitted to treat a mental illness, and no insurer reimburses them.
Why this matters in English-language directories
Directories for expats often list licensed psychotherapists, psychologists, Heilpraktiker and counsellors side by side, all described as therapists. Some therapists who trained abroad work in Germany under a Heilpraktiker permit or as counsellors rather than with German Approbation. That says nothing about their skill, but it decides who pays: only a licensed psychotherapist gets you treatment on public insurance or through Kostenerstattung.
How to check
- Ask directly: „Sind Sie approbiert?“ (Are you licensed?) and „Haben Sie einen Kassensitz?“ (Can you bill public insurance?).
- Every practice with a Kassensitz appears in the practitioner search at arztsuche.116117.de.
- Licensed psychotherapists are members of the Psychotherapeutenkammer of their state, and most chambers have a public directory.
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