Practice requirements for psychotherapeutic treatment of cancer patients in the outpatient setting-A survey among certified psychotherapists in Germany.

OBJECTIVE: The aim of this study was to delineate the challenges that psychotherapists encounter when they treat cancer patients and how they organise their practices to be able to treat them.

METHODS: A random sample of certified psychotherapists, licensed by the health authorities, with training in psycho-oncology, was asked to complete a questionnaire covering the following issues: therapists' qualifications, organisation of the practice, dealing with appointment cancellations, financing, and networking. Practices with ≥50% cancer patients in their patient load were defined as "practices specialising in cancer" (PSC) and were compared to practices with a smaller proportion of cancer patients (non-PSC).

RESULTS: Of 120 contacted therapists, 83 replied and 77 were eligible. The median waiting time for a first consultation was 10 days in PSC and 14 days in non-PSC (P = .05). Seventy-five of PSC and 56% of non-PSC can offer psychotherapy within 4 weeks. Time spent on dealing with the social problems of the patients was higher in PSC than in non-PSC (P = .04). They spent also more time communicating with other health care professionals such as private practice oncologists (P = .001). Cancer patients need to cancel appointments more frequently than noncancer patients (58% vs 48% cancel ≥1× per quarter). Sixty-six percent of the psychotherapists do not ask for financial reimbursement of these sessions.

CONCLUSION: Psychotherapy for cancer patients in the outpatient setting requires different organisation of the practice. Sessions are cancelled more frequently, waiting time is considerably shorter, and psychotherapists communicate more often with other health care providers than in general psychotherapy.