Anyone starting psychotherapy soon hears the terms behavioural therapy (Verhaltenstherapie) and depth psychology-based therapy (tiefenpsychologisch fundierte Psychotherapie). Both approaches are recognised, yet they start from different points. This guide explains how the two approaches differ in everyday practice, what the Federal Joint Committee (Gemeinsamer Bundesausschuss) recorded about their recognition and which questions you can ask before you begin.
Short answer: Behavioural therapy works more strongly in the present and structures its work around thought and behaviour patterns. Depth psychology-based therapy looks more closely at unconscious conflicts and relationship patterns, including those from the past. The Federal Joint Committee ended its review of these procedures in 2019 without changing the entitlement to benefits. Which approach fits is something you clarify together with the practice. Last updated: November 2026.
The most important points at a glance
- Behavioural therapy and depth psychology-based therapy are both recognised procedures in outpatient psychotherapy.
- The Federal Joint Committee ended its review of these procedures in December 2019 and stressed that the entitlement to benefits does not change.
- Behavioural therapy usually works with current thoughts, feelings and behaviour, often with concrete exercises between sessions.
- Depth psychology-based therapy looks more closely at backgrounds, inner conflicts and the relationship with the therapist.
- There is no general recommendation for one approach. What matters is your concern, your expectations and what the practice offers.
Which procedures are recognised in outpatient psychotherapy?
In December 2019 the Federal Joint Committee decided to end the review of the recognised psychotherapy procedures. Affected are depth psychology-based psychotherapy, analytical psychotherapy and behavioural therapy. According to the committee, the decision does not change the entitlement to psychotherapy at the expense of statutory health insurance.
The reasoning includes that the aims of the review were only partly achievable for methodological reasons. The review also became secondary after systemic therapy was recognised as a procedure under the guidelines in November 2018. For you, this means that both approaches discussed here are part of the care system, and their use depends on the individual case.
How does behavioural therapy work?
Behavioural therapy assumes that thoughts, feelings and behaviour interact and can reinforce each other. The focus is usually the present: which situations burden you today, which thinking patterns appear there and which new ways of behaving can be tried out? The process is often clearly structured, and exercises for everyday life are frequently agreed between sessions.
This approach can suit people who have concrete goals and like working with tangible steps. It does, however, require active participation between sessions, for example trying out new behaviours or keeping notes.
How does depth psychology-based therapy work?
Depth psychology-based psychotherapy assumes that earlier experiences, unconscious conflicts and relationships with other people shape how you experience things today. The therapy therefore takes more time to understand connections, including those from your life history. The exchange between you and your therapist plays a larger role, because patterns often show up in the contact itself.
This path suits people who want to understand where certain reactions come from and who are willing to engage in a rather open conversation. It requires patience, because change often becomes visible more slowly than with a clearly defined exercise.
Where do the differences show in everyday life?
The differences mainly appear in the focus, the pace and the work between sessions. The table below describes typical tendencies. It does not apply in the same way to every practice, because implementation depends strongly on the individual.
| Feature | Behavioural therapy | Depth psychology-based therapy |
|---|---|---|
| Focus | Current thoughts, feelings and behaviour | Backgrounds, inner conflicts, relationship patterns |
| Look at the past | Rather secondary when current goals are in focus | An important part of understanding |
| Work between sessions | Often concrete exercises or observation tasks | Rather reflection and thinking about the conversation |
| Pace | Often goal-oriented with a clear structure | Often more open, with more room for development |
| Role of the relationship | Important as a working alliance | Central as the place where patterns become visible |
This comparison does not replace a conversation. Many practices combine elements of both directions, and the implementation varies from person to person.
When does which approach fit?
There is no single answer, and this guide does not recommend a particular approach. It helps to clarify in advance what matters to you. Do you have specific everyday problems you want to tackle quickly, or do you want to understand why you react in certain situations? This question often gives orientation already.
In conversation with the practice, you can also check how the process works. Some questions are useful for this:
- What does a typical course of sessions look like, and are there fixed exercises between appointments?
- How are goals and progress discussed, and how often is the course reviewed?
- What experience does the practice have with my concern, and which alternatives does it see for my case?
What does recognition mean for the costs?
Recognition as a guideline procedure means that these approaches are provided for in the contractual medical care. According to the Federal Joint Committee, ending the review does not change the entitlement to benefits. Whether treatment begins in your case and how billing works is clarified by the practice. The first steps are explained in Psychotherapy consultation: what it is and how to book it.
For students, the semester schedule is often tight. Ask the practice how flexibly appointments are given and whether sessions are possible outside lecture periods. An overview of university services is in Psychological counselling at university.
Frequently asked questions
Is one of the two therapies generally better?
This question cannot be answered in general. Both approaches are recognised, and which one fits you depends on your concern, your preferences and the fit with the therapist. The trial phase helps you check that fit.
Can I choose the approach myself?
You can state your wishes and ask about alternatives. Whether a particular approach is offered in a practice, and how quickly a place becomes free, depends on the practice and on local supply. There is no guarantee.
What about systemic therapy?
Systemic therapy was recognised as a guideline procedure in November 2018, as the Federal Joint Committee notes in its reasoning. It looks at problems more strongly in connection with the social environment. Whether it is an option for you is best discussed with a professional.
How long does therapy last with these approaches?
The scope depends on the procedure, the individual case and the course. This guide therefore gives no number. The practice explains the framework before treatment starts and can tell you when an interim review makes sense.
What to do now
- Note which burdens concern you at the moment and whether you are looking for concrete change or deeper understanding.
- Book a psychotherapy consultation and ask the questions from this guide there.
- Use the probatory sessions to check the fit, and then decide the next steps together.
Related guides
- Probatory sessions in psychotherapy
- Psychotherapy consultation: what it is and how to book it
- Private Health Insurance and Psychotherapy: Costs
- Depression at university: signs and ways to get help
Sources:
Federal Joint Committee (G-BA): Press release on the psychotherapy guideline, 19.12.2019 (German)
Kassenärztliche Bundesvereinigung: Psychotherapy, questions and answers (undated, German)
Last updated: November 2026. This guide is general information, not individual advice.
