(Please read below this open letter from Rüdiger Retzlaff , Dr. sc. hum., Dipl.-Psych. Psychotherapist & Child and Adolescent Psychotherapist, Vice-Director of the Helm Stierlin Institute, Heidelberg/Germany)

I am absolutely delighted  to be able to inform  you that, after so many years, Thursday last week, systemic therapy with adults has been accepted to be added to the list of treatments which are paid for by public health insurances. The GBA, the federal board of health care providers and public health care insurances has just made the decision a few hours ago. Although this decision needs to be reconfirmed by another board within the GBA , it is most likely that they will do so.

Prior to today’s decision, IQWiG, a highly reputed non-partisan scientific board (which normally deals with pharmaceutical products) re-checked the evidence in favor of systemic therapy, and concluded in their over 600-pages long report that  there is a sufficient number of high quality rct to meet the necessary requirements to be accepted.

This means that  when the necessary amendments have been made and various implementation rules have been adapted, about 85% of the adult population in Germany will have access to systemic therapy as part of their health care insurance.  I am confident that private insurances will adopt this decision into their insurance contracts.

When I returned  from the AFTA conference  in Miami in 2003, fully determined to start our project on the evidence base of systemic therapy, I would never have expected that it would take 15 years  to reach this goal.

Of course, many people have been involved in this endeavor:

Ø  Stefan Beher, Kirsten von Sydow and Jochen Schweitzer, with whom we published our report on systemic therapy in 2007, which got us the recognition by the Scientific Board for Psychotherapy, which is mandatory to even be considered to be accepted by the health care systems

Ø  Markus Haun, also trainer at the Helm Stierlin Institute, who brilliantly contributed especially to our official statement on the IQWiG report and controversial reports by parts of the GBA, and Matthias Ochs

Ø  Ulrike Borst, president of the Systemic Society (SG) – like Jochen Schweitzer and me member of AFTA- and  Enno Hermans as president of the German Society of Systemic Family Therapy and Counselling (DGSF)  

Ø  Sebastian Baumann (DGSF) and Kerstin Dittrich (DGSF),  who did a fantastic job networking in Berlin- all professional organization- behavior therapists, psychodynamic therapist, the Federal Board of Medical Doctors, the Federal Board of Psychotherapist- supported the pledge of systemic therapists to become part of the public health care system!

Over the years, many of you have contributed to  our success in various ways- giving is hints on rct trials, discussing our papers with us, translations from Chinese into German- a fine example of collaboration across borders…thank you again!

Much remains to be done:

o   It will take 1-2 years before regulations  will have been adjusted to include systemic therapy in insurance plans

o   Existing systemic therapy training institutes will face huge challenges posed by the very strict legal rules in the state license system.

o   And last not least, we will have to push for a similar decision in favor of systemic therapy with children and adolescents, which unfortunately was not included in today’s ruling

For me, this is absolutely great!


Rüdiger Retzlaff , Dr. sc. hum., Dipl.-Psych.
Psychotherapist & Child and Adolescent Psychotherapist
Vice-Director of the Helm Stierlin Institute