Outpatient treatment and therapy at the Centre for Mental Health and Psychotherapy

ZPP Outpatient Clinic for children, young people and their families

For an initial enquiry, we are available during our telephone consultation hours. We will take down the details of those interested and, where appropriate, arrange a consultation appointment with the parents and the child or young person. If demand is high, we may not be able to offer an appointment straight away.

The therapeutic consultation is a kind of initial meeting during which parents and the child can get a first impression of our centre and describe any existing concerns. Together, we assess whether there is a mental health condition requiring treatment and which counselling or treatment options might be helpful.

Should we recommend outpatient psychotherapy, treatment cannot always take place at the ZPP or with the same psychotherapist who conducted the consultation. It may be the case that there are no treatment places available at our outpatient psychotherapy clinic for children, young people and their families. Parents and carers then have the option of having their child added to our waiting list. At the same time, they should look for a therapist outside the ZPP to increase the chances of starting therapy promptly.

Please bring your health insurance card to the first consultation. Your health insurance will cover the cost of the consultation. A doctor’s referral is not required.

As soon as a therapy place becomes available, we arrange an initial consultation with the child and, where appropriate, with the parents. This is followed by four further trial sessions: during these, we get to know the child and their issues better. In addition, the therapists work with the child during these sessions to plan the next steps in their treatment. During this phase, the child can assess whether they feel comfortable with the therapist and whether there is a good ‘chemistry’ between them. A trusting therapeutic relationship is a fundamental prerequisite for successful therapy.

At the end of the trial period, the therapist discusses both the diagnosis and the treatment plan that has been drawn up with the parents and the child, and informs their health insurance provider about the planned psychotherapeutic treatment. Psychotherapy can then begin.

Psychotherapy begins following the assessment sessions. We tailor the psychotherapeutic treatment individually to our patients’ circumstances, goals and context.

The initial phase

At the start of psychotherapy, the aim is to establish a solid therapeutic relationship so that the child and their parents feel well looked after and can engage fully with the therapeutic process. Once the issues at hand have been identified and assessed, the therapist works with the child and their parents to set treatment goals. The focus then usually shifts to the child coming to terms with their mental health condition and the underlying issues, and, with support, developing and trying out new, helpful coping strategies.
As well as addressing distressing symptoms, the aim is also to identify the child’s strengths and abilities and to highlight the things that are going well and could be helpful as treatment progresses. Shifting the focus from the difficulties to the positive aspects can also help to ease tensions within the family and make it possible to enjoy positive moments together again.

Main phase and between sessions

As well as the psychotherapy sessions, the time between sessions is particularly important – and, above all, the child’s active participation is key here. During this time, what has been learnt can sink in and be consolidated through exercises. To this end, the therapist regularly gives the child – and sometimes the parents as well – small exercises to do at home, which support the therapeutic development process.

Final phase

The final phase of therapy focuses on preparing the child and parents for the future and preventing relapses (relapse prevention). The therapist helps the child to cope as far as possible without psychotherapeutic support in the future. In this phase, the intervals between sessions are significantly increased.

When difficulties arise during psychotherapy

Periods during which patients doubt that the therapy is working can be a normal part of the treatment. In psychotherapy, it is also quite common for psychological symptoms to temporarily worsen or for new symptoms to emerge. Change is often challenging, particularly at the beginning, and the child may occasionally feel that it is all becoming too much. Equally, it is possible that symptoms will improve rapidly and the child will soon be able to return to an active and age-appropriate daily routine. We are aware of the problems and difficulties that can arise during treatment, and we would like to encourage parents and the child to discuss how they are feeling and their experience of the therapy process regularly with the psychotherapist. Together, they can look for solutions and assess whether the therapeutic approach remains appropriate for everyone involved.

Most mental health conditions develop over a prolonged period, and treatment therefore requires sufficient time. You should allow for a treatment period of several months.

Treatment at our outpatient clinic for children and young people usually takes the form of individual therapy sessions, with one 50-minute session per week. If necessary, several sessions per week or longer sessions can be arranged. Family sessions, discussions with other key people in the child’s life and group therapy can complement the individual therapy. The treatment schedule, as well as all other details of the treatment, will be discussed with the therapist.

Those with statutory health insurance

We bill the statutory health insurance provider directly via the patient’s insurance card. Initial consultations and assessment sessions can be accessed without any formalities. A request for regular psychotherapy must be submitted jointly to the health insurance provider.

Private health insurance/subsidised health insurance

A 50-minute individual psychotherapy session costs €153.02 (3.5 times the standard rate) in accordance with the fee schedule for child and adolescent psychotherapists. In most cases, private health insurers and subsidy providers cover treatment costs up to 2.3 times the standard rate (€100.55 per individual session), meaning that patients may have to pay a co-payment.

Private insurance cover is not standardised; the extent of cover depends on the terms of the individual policy. Our patients discuss this with their health insurer in advance.

To help our patients determine whether treatment at the ZPP Outpatient Clinic for Children, Young People and their Families is suitable for them, we would like to provide information about the specific features of the treatment offered at our clinic.

Questionnaires

Treatments at the ZPP are subject to strict quality standards and are, in some cases, supported by research projects. For this reason, we ask our patients to answer a few questions during the course of their therapy about how they are feeling, how they are finding the therapy session, and what their hopes and wishes are. The child answers these questions at computer terminals provided for this purpose. It takes about 5 minutes to complete and usually takes place immediately after the therapy session. We also ask parents to take part in these assessments and to complete their own questionnaires on the computer.
In addition, comprehensive assessment sessions are held at regular intervals during treatment to monitor the progression of symptoms and the effectiveness of the therapy. These sessions can last up to an hour and also take place immediately after the therapy session.

Video recordings

Another distinctive feature of the therapy sessions at the ZPP is that they are video-recorded. The video recordings serve the purposes of quality assurance, professional development and psychotherapeutic treatment, and are subject to strict data protection and professional regulations. The recordings enable high-quality supervisory support for the treatment, with a view to improving the therapy for our patients.

Data protection

In the treatment of patients and the handling of health data, we comply with the legal requirements of the EU General Data Protection Regulation. When patients commence psychotherapy at the ZPP outpatient clinic, we provide them with detailed information in advance during a face-to-face consultation and give them the opportunity to ask any questions they may have.

Ambulance service: 112

Police: 110

Hospitals with departments of child and adolescent psychiatry responsible for providing emergency psychiatric care for children and young people up to the age of 18:

Hagen, Herdecke, Ennepe-Ruhr district:

Herdecke Community Hospital

Telephone: +49 2330 620

Dortmund:

Elisabeth Clinic, Dortmund

Telephone: +49 231 9130190

Bochum:

VALEARA Bochum

Department: Child and Adolescent Psychiatry

Telephone: +49 234 418 375

In the event of a child and adolescent psychiatric emergency, you can contact our colleagues 24 hours a day.
At weekends and on public holidays:

Telephone: +49 234 418 303

Unna, Soest district, Hamm, Warendorf district, Schwerte:

Institute for Child and Adolescent Psychiatry, Hamm

Telephone: +49 2381 8930

Wuppertal, Remscheid, Solingen:

Sana-Klinikum GmbH

Telephone: +49 2191 133805

“Helpline”

Telephone: 116111 and +49 800 1 110333

The children’s and young people’s helpline is available Monday to Saturday from 2.00 pm to 8.00 pm. As well as telephone counselling, email counselling is also available. Parents can also seek anonymous advice (Parents’ Helpline: +49 800 1110550).

www.nummergegenkummer.de

Telephone Counselling

A free service offering conversations with people who are trained and experienced in dealing with crises. The helpline is available round the clock.

Telephone: +49 800 1 110111 or +49 800 1 110222

Anonymous counselling for parents and those facing family difficulties

Telephone: +49 800 1 110550

Sexual Abuse Support Portal

Telephone: +49 800 2 255530

Enquiries can also be made by email: beratung@hilfetelefon-missbrauch.de

Opening hours: Mon, Wed, Fri: 9.00 am to 2.00 pm / Tue & Thu: 3.00 pm to 8.00 pm

www.hilfeportal-missbrauch.de

FIDEO

FIDEO is an online information service with an integrated discussion forum for young people aged 14 and over. Under the umbrella of the German Depression Aid Foundation, FIDEO provides information about depression in young people, raises awareness and helps to break down prejudices. Young people affected by depression can share their experiences online and support one another in coping with the condition. The forum is moderated to ensure a safe environment, and moderators step in when necessary.

www.fideo.de

Women’s Advice Centres & Opening Hours in the Ennepe-Ruhr District

www.frauenberatungsstellen-nrw.de/beratungsstellen/witten

Bochum Women’s Shelter

44707 Bochum

Telephone: +49 234 501034

Weißer Ring Ennepe-Ruhr District

Support organisation for victims of crime and violence

Telephone: +49 151 55164777

Hotline … before something happens

Anonymous help for people at risk of committing a crime

Telephone ( Mon–Fri: 09:00–18:00): +49 800 7 022240

www.bevor-was-passiert.de

Psychotherapy literally means ‘treatment of the mind’ or ‘treatment of mental health problems’.

The aim is to identify and treat psychological and emotional problems so that distressing symptoms are reduced and quality of life can be improved. When children and young people experience distressing situations, this usually affects their thinking (e.g. ‘I can’t cope with any of this’), their behaviour and actions (e.g. ‘Most of the time I just lie on my bed and do nothing at all.’) and their feelings (e.g. ‘I’m constantly anxious’, ‘I’m just sad all the time’). If stress persists over a longer period or is particularly severe, this can lead to significant changes and limitations in the everyday lives of children and young people. For example, they may become increasingly withdrawn, stop meeting friends or find it impossible to attend school. Restlessness, irritability and aggression can also be signs of feeling overwhelmed and under stress.

Through psychotherapeutic sessions or exercises, and with the help of ‘homework’ between sessions, the child learns to deal with their difficulties in a targeted way and to overcome them. The aim of the treatment is to resolve or alleviate a specific problem. Once the agreed goal has been achieved and no further stressors or goals are identified, the therapy can be concluded. Parents are also involved in the treatment and are informed about what happens during therapy and how it is conducted. Depending on the specific issue, it may also be crucial for parents to play an active role in the therapeutic process, for example by reflecting on their own behaviour or supporting their child in adopting new behaviours.

Billing is handled through statutory and private health insurance schemes or through the government health allowance. As a result, families generally do not incur any costs for outpatient psychotherapy. However, the health insurance provider requires a high level of motivation and cooperation from the child and the family; this includes, for example, attending appointments punctually and regularly.

Depending on the specific mental health condition, therapy sessions may need to take place outside the ZPP’s premises, in which case the family may incur costs. We discuss this in advance with our patients or their parents.

Psychotherapy sessions usually take place once a week and last 50 minutes. We arrange the appointments with the child (depending on their age) and, where appropriate, with the parents at the end of the session.

Appointments are binding and should therefore only be cancelled in the most urgent of cases. Last-minute cancellations result, on the one hand, in costs such as the cancellation fee and, on the other hand, in the therapy process being interrupted. We ask that you let us know in good time if, for example, the child is invited to a birthday party or has other commitments. Cancellations made up to 48 hours before the appointment are not a problem, as it is then possible to reschedule the appointment with other patients.

Children and young people fall ill more frequently than adults; therefore, we do not charge a cancellation fee if the child or their parents provide us with a doctor’s note at their next appointment.

Of course, parents or the child may prefer to be treated by a woman or a man. If they are already able to decide this, our patients or their parents may and should let us know right at the start. We will try to accommodate this preference.

We also ask children and parents to let us know if they are unable to build a satisfactory relationship with the therapist. This takes a lot of courage, but it is very important to ensure the treatment is effective! We will then try to find another therapist. As a rule, this rarely happens, as all our therapists are very friendly and try to respond to and understand each of their patients and their family members.

As a rule, parents or carers are involved in the treatment. They can and should support their child in achieving their goals. In addition, so-called ‘caregiver consultations’ offer parents an opportunity to share their perspective, explore their own patterns of thought and behaviour regarding their child, and receive guidance on how to interact with their child. In most cases, such meetings take place every fourth session. The younger the child, the more closely parents or carers are involved.

For effective therapeutic treatment, it is desirable to involve as many of the child’s key caregivers as possible. We know that parental separation can pose a major challenge for everyone involved in all areas of life. It is therefore all the more helpful if both parents agree to the child’s treatment and are willing to play an active role in supporting them. If this is not the case, we are happy to help find a solution.