Now Fund performance: the systemic psychotherapy works

Anyone who goes because of a mental illness in treatment, you can choose between various forms of psychotherapy. The statutory health insurance will have to pay for but only for three procedures: psychoanalysis, behavior therapy and depth psychology therapy. That will now change. With today’s decision of the Federal Joint Esau-shot (G-BA) has declared the systemic therapy officially to the Fund performance. Dr. Caby, with the recording as the guidelines process, the Federal Joint Committee (G-BA) has recognized the systemic therapy as equivalent to the other methods. Why only now?

Dr. Filip Caby: The various reasons. A fundamental Problem was that the German health system is highly focused on the individual patient and his symptoms: A psychotherapy should cause the disappearance of the sick ways of behaviour. In the systemic therapy, it is not just that the Patient gets rid of his symptoms. The healing of the Individual is not the goal of treatment. It’s about working with the System because they no longer have to be sick.

How, exactly, can you imagine?

Caby: The systemic approach is based on the biology: living beings are dependent on each other. We live in systems whose members interact constantly with each other. If a part of a system is altered, with a swing to the other and adapt. This is reflected in the systemic treatment of the concept: While behavior therapists and psychoanalysts in the first place have the individual in view, involve Systemiker the entire System in the therapy.

The System is the family?

Caby: Not always, a System can also have a youth group, a couple or a group of the elderly in the old people’s home to be. If someone has a Problem, then this Problem is often a function in the System. It is an attempted solution. You should not want to get rid of therefore to fast the Symptom. It is rather to work together to find a solution without anyone being sick. In therapy it comes to looking for alternative solutions to make anyone sick.

Can you give an example?

Caby: I recently a girl with anorexia to be treated. The parents were divorced, carried on an evil war of the roses, and no longer understood. In conversation with them, it turned out that at the Moment, as the daughter had to be intensively medically monitored, the parents were again ready to communicate with each other. The daughter was succeeded by her anorexia so, to get a reasonably harmonious relationship between the parents to produce. Of course, this was not a conscious process, but that is how one can think of the function of the disease.

And this realization has helped the daughter to overcome her anorexia?

Caby: The anorexia was not the real Problem. The Problem is the troubled relationship between the parents was, and to this relationship we were able to start the therapy then. We have worked with the parents of a new distribution of roles, which has enabled them to understand better.

At the same time, the girl was encouraged to learn that there is now no more need for the pathological behavior that it needs to make no more pressure. It worked, she was able to focus now back on the healthy.

In systemic psychotherapy, so there is both individual sessions as well as group meetings in which the whole System comes together?

Caby: Yes, the therapist may be flexible, depending on what the context just makes sense.

In the elderly group sessions not eligible Yes is often because the relatives are already deceased. Would you advise in this case is of a systemic therapy?

Caby: You can systemically treat, no matter how old he is, and of what disease he has. Get to know the System and understand it is not always necessary that I meet all the Participants personally – and also in individual conversation with the patient. Systemiker have numerous methods to work with a single patient systemically.

What are the methods in individual sessions often?

Caby: One possibility is the so-called circular questioning, the therapist asks: What would a Person with XY say, if you are here now would be? I can also work in a single session, with the various interests of the patient systemically. Each of us has different parts of the Personality that represents so to speak a private System. A young person who disengages frequently, usually allows for a thoughtful share. I can ask him: How can calm down the balance at the end of in you the Wüterich? Instead of solutions for the Problem of pretending, I encourage him to try and find a solution that works for him.

With an adult who suffers from depression, I can work as a Systemiker, for example, what could be Good about a Depression, and what resources he has available, in order to develop new solutions. In the system of therapy, it is not just the problems within a system, but also to discover the healing resources that it offers.

Dr. Caby, we would like to thank you for the interview!


Psychotherapy. Systemic therapy for adults as a further policy process. Press release of the Federal Joint Committee (G-BA): (status: 22.11.2019)

Interview with Dr. Filip Caby on 19.11.2019

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