Rechtliche Grundlagen der psychosomatischen Rehabilitation Auswirkungen auf die Psychotherapeut-Patient-Beziehung

The legal foundation of psychosomatic rehabilitation, which amounts to more than half of all inpatient psychotherapies performed in Germany, includes the duty of the patient to cooperate, the pre-condition that there is a chance for increasing or restoring patient’s ability to work, and the obligation for therapists, to perform a socio-medical rating of patient's ability to work as well as a judgement about his/her credibility concerning the asserted handicaps and disabilities. All this has an influence on the relationship between psychotherapist und patient and leads to problems in the treatment especially of those patients, who wish to retire. For the psychotherapist not only counter—transferences may be difficult to handle but also role conflicts resulting above all from the challenge being simultaneously psychotherapist and medical expert, who has to rate patient's ability for work and his credibility. To keep capacity of acting, the psychotherapist should reflect these issues and make them transparent for the patient. Sufficient supervision is very important. This will not only improve patient's, but also pension scheme's profit.