Not every psychological concern can be placed in a regular therapy place within a few weeks. For situations with an acute need for treatment, the German Psychotherapy Guideline therefore provides a separate service, the acute treatment (Akutbehandlung). This guide explains what it covers and how to get there.
Short answer: Acute treatment serves an acute need for treatment and follows the psychotherapeutic consultation where it is needed. For individual therapy, the Psychotherapy Guideline provides up to 24 individual sessions per illness episode, with a total of up to 600 minutes, and each unit lasts at least 25 minutes. According to the Federal Ministry of Health, the waiting time for an acute need must not exceed two weeks (Last updated: November 2026).
The most important points in brief
- Acute treatment is meant for an acute need for treatment and follows the consultation when required.
- For individual therapy, up to 24 individual sessions per illness episode are provided.
- Under the guideline, each individual unit lasts at least 25 minutes, with a total of up to 600 minutes.
- According to the ministry, the waiting time for an acute need should not exceed two weeks.
- Whether and how costs are covered depends on your insurance and should be clarified in advance.
What is acute treatment?
Acute treatment is regulated in the Psychotherapy Guideline as its own form of care. It is aimed at people whose complaints call for prompt treatment, because waiting until a regular therapy place becomes available would not be justifiable. The treating psychotherapist decides within the framework of the guideline whether such a need exists.
The boundary matters: acute treatment is not emergency care. In case of immediate danger to you or to others, the emergency number 112 or the nearest emergency department is the right contact. Acute treatment complements the care system; it does not replace it.
How large is the scope?
The guideline distinguishes between individual therapy and group settings with several persons. The table shows the key figures under the version of 21 August 2025, which entered into force on 11 November 2025.
| Feature | Individual therapy | Group setting with several persons |
|---|---|---|
| Scope per illness episode | Up to 24 individual sessions | Lower total number of sessions, because units are longer |
| Total duration | Up to 600 minutes | Depends on the number of sessions in the setting |
| Minimum length per unit | 25 minutes | 50 minutes |
The illness episode covers the current calendar quarter and the three following ones. Ask your practice how it counts units within that period in your individual case and how it documents them.
How do you get to acute treatment?
The usual route leads through the psychotherapeutic consultation. There it is clarified whether a suspicion of a mental illness exists and whether an acute need for treatment is present. If the practice identifies such a need, it can offer acute treatment. The appointment service 116117 arranges appointments; for the case that acute treatment is needed, the ministry names a waiting time of at most two weeks.
- Arrange an appointment in the psychotherapeutic consultation, ideally through the appointment service.
- Describe in the conversation since when your concern has existed and how strongly it limits you in daily life.
- Ask the practice whether it sees an acute need for treatment and which units it proposes.
- Clarify in advance how billing works with your health insurance.
Details on the referral are in Psychotherapy through the 116117 appointment service. The process of the consultation is explained in Psychotherapeutic consultation: what it is and how to book it.
How long may the waiting time be?
The Federal Ministry of Health describes a clear framework for the referral. The appointment service is meant to arrange consultation appointments within four weeks. For the case that acute treatment is needed, the waiting time under the ministry must not exceed two weeks.
These periods refer to the referral. How quickly a particular practice has a free place can vary. If it is urgent, say so explicitly when you call and note the date and result of every enquiry. The article on waiting on several lists for psychotherapy (in German) helps if you search in parallel.
Which questions help you assess an acute need?
Acute need means that the complaints are so strong that waiting until a regular therapy place becomes available does not seem justifiable. This is a professional assessment. It is made in the conversation with the practice, and you can help it by describing your situation as precisely as possible.
A clear overview before the appointment helps. Note how long the complaints last, how they affect your sleep, your studies and your daily routine, and whether the situation has changed in recent days.
- Since when have the complaints existed, and have they changed?
- How strongly do they restrict studies, work or daily life?
- Are there situations in which you no longer feel safe with yourself?
- What support do you have at the moment, for example from people around you or from your university?
The last question matters. The practice wants to know where you have support, because acute treatment is not a substitute for it. If you are in a crisis, the rule stays the same: call 112 or go to the nearest emergency department.
What happens during acute treatment?
During acute treatment you work with the practice on the acute complaints and on a perspective for the next steps. The treatment is limited in time and aims to stabilise the acute phase. Whether a guideline therapy follows is decided together by you and the practice. Acute treatment can therefore form the bridge into further treatment.
Pay attention to whether your condition improves, stays the same or worsens. If it worsens, contact the practice immediately. In case of acute danger, the emergency number 112 still applies.
Frequently asked questions
Do I have to submit a separate application for acute treatment?
Whether an application or confirmation is needed depends on your insurance and on the practice’s procedures. Ask in advance. The scope follows from the guideline, and the organisation follows from the rules of your insurance.
How many sessions will I get?
The guideline provides for up to 24 individual sessions per illness episode. How many you actually need is decided in the course of treatment.
Does acute treatment replace therapy?
No. Acute treatment is a time-limited service for an acute need. Longer treatment follows the guideline through other routes. The practice explains which route suits you.
What if I still need help after acute treatment?
Raise it with the practice in good time, before the units are used up. A follow-up treatment is planned in the conversation. If the practice does not suit you, a change may be necessary, and the rules for it are explained in the article on changing psychotherapist (in German).
What does acute treatment cost?
Costs depend on your insurance. Statutory insured persons receive the service through contracted practices. Privately insured persons check their tariff, because reimbursement and the own share depend on its conditions. An overview is given in Private Health Insurance and Psychotherapy: Costs.
What to do next
- Arrange an appointment in the consultation and point out your acute need.
- Ask specifically about acute treatment and clarify billing with your insurance.
- Note appointments, units and deadlines so that you keep track.
Related reading
- Mental health at university: where to find help
- Finding a psychotherapist
- Psychotherapeutic consultation: what it is and how to book it
- Psychotherapy through the 116117 appointment service
- Private Health Insurance and Psychotherapy: Costs
Sources: Psychotherapy Guideline (Psychotherapie-Richtlinie), version of 21.08.2025, in force since 11.11.2025 (in German), Federal Ministry of Health: entry on the psychotherapeutic consultation, status 08.01.2026 (in German).
Last updated: November 2026. This guide is general information, not individual advice.
