Victims’ rights – early psychotherapeutic intervention in trauma outpatient care

By February 22, 2021 News from members

Winter 2021 News from Weisser Ring, Germany 

Since 1 January 2021, victims of violent crime in Germany are now entitled by law to treatment in trauma outpatient care under the reformed ‘Crime Victims Compensation Act’ (OEG).

Since the turn of the millennium, the state of North Rhine-Westphalia has operated a network of trauma outpatient centres providing victims of violence with psychological and psychotherapeutic interventions to prevent the formation or entrenchment of trauma disorders such as PTSD.

The efficacy of treatment in trauma outpatient centres was verified in an evaluative study conducted in 2011, which showed that 12% of people applying for compensation under the OEG availed of the offer of such outpatient care. Victims of violent crime were successfully reached out to soon after the crime, something that would not have been possible otherwise, given the (months-) long waiting lists for psychotherapy. Almost two thirds of the victims attended a trauma clinic within the first four weeks after the crime (i.e. even before PTSD could develop, e.g. in the case of a single-incident traumatic event). It was shown that complaints and symptoms regress to a highly significant degree during treatment and that this success is maintained until a follow-up examination is conducted six months later.

The amount of treatment provided was and still is limited to 15 sessions. The evaluative study showed that only one third of the patients availed of more than five sessions. Like other studies in the field of accident insurance, the evaluation verified that early intervention not only has sustained efficacy, but is also cost-effective for the social services provider, in that the savings resulting from reduced follow-up costs significantly exceed the cost of treatment.

The WEISSER RING organisation has supported the trauma outpatient centres from the very beginning and has pushed for the same service to be provided by other states in Germany. Over the years, more and more states have also become involved, and by 2019 there were about 160 trauma outpatient centres in total, covering most of the federal states. When the reformed Crime Victims Compensation Act was finally adopted in December 2019, the decision was made to establish trauma outpatient centres throughout the country. Since 1 January 2021, victims of violent crime are entitled by law to treatment in such a facility.

WEISSER RING works to ensure that the trauma clinics meet both organisational and professional quality standards. At present, these are the central issues for implementation of the legal entitlement to care.

With regard to professional standards, there is a consensus that those providing treatment must be licensed to practice medicine/psychotherapy, and that the work carried out must comply with the guidelines for PTSD therapy and for the diagnosis and treatment of acute impacts of psychological trauma. WEISSER RING also demands that those providing treatment have gained an additional qualification in trauma psychotherapy.

The therapy on offer must address the needs of different target groups. Trauma outpatient clinics are needed not only for adults, but also for children and adolescents. Patients should be allowed to choose between female and male therapists.

Trauma outpatient clinics must be very accessible and should offer an initial therapy session within one or at most two weeks of being contacted.

It is essential to ensure that appropriate therapy and waiting rooms are provided. The application for ‘social compensation’ is a prerequisite for treatment, but in the case of highly traumatised victims may still be submitted after the second session. The need for cooperation between the trauma outpatient centre and local and regional victim support organisations is self-evident.

WEISSER RING welcomes the rules now applying and will continue to actively monitor their implementation and development, paying particular attention to ensuring as far as possible that every victim who needs such support will also receive it.

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WEISSER RING e.V. Germany