Measurement-Based Care for Psychotherapy in Germany
Germany puts a larger share of its health budget into mental health than most OECD countries. HiBoop helps psychotherapists and clinics see what that care changes for each client: validated scales sent between sessions, scored on submission, and charted from intake onward.
Why Germany
Germany sits in a small group. When the OECD benchmarked mental health systems in 2021, it counted five countries whose mental health spending passed a tenth of all health spending in 2018 or the latest year: the United Kingdom, Canada, Germany, Norway and France.
Outpatient psychotherapy for people with statutory health insurance (GKV) follows the Psychotherapie-Richtlinie, the guideline set by the Federal Joint Committee (G-BA). Since its 2017 reform, practices offer a psychotherapeutic consultation hour (Sprechstunde) and acute treatment (Akutbehandlung) alongside longer guideline psychotherapy.
Training is changing as well. The 2019 Act reforming psychotherapist training created a five-year university degree, a bachelor's followed by a master's, that ends in a state examination and the licence to practise (Approbation), with further specialist training (Weiterbildung) required for work in statutory care.
What HiBoop Does for a Practice in Germany
A measurement tool for care teams: it sends the scales you choose, scores them, and keeps every result on one timeline per client.
Scales Completed Before the Session
Send the PHQ-9, GAD-7 or other validated scales offered in the app by email or QR code ahead of an appointment. Scores arrive already calculated, so a consultation hour or therapy session starts from the numbers instead of from paperwork.
Progress Across a Whole Course of Therapy
Each result joins the client's timeline. When a course of guideline psychotherapy is reviewed or extended, the trend since intake is already charted and can be exported as a report.
Health Data Under the GDPR and the BDSG
The GDPR treats mental health information as special-category data, and the Federal Data Protection Act (BDSG) adds its own rules for processing it in health care, including a duty of confidentiality. HiBoop is SOC 2 Type II certified, with data encrypted at rest and in transit. HiBoop is also GDPR compliant, acting as a processor for your practice.
A Practice Tool, Not a DiGA
Germany's DiGA route is for applications that treat patients and are prescribed to them. HiBoop sits on the clinician's side of the room: it measures progress alongside the therapy you deliver.
Priced in Euros
Care is €23 EUR/month for one clinician, month to month. Team starts at €180 EUR/month with unlimited clinicians. Network is custom. Published prices in euros.
From a Single Practice to a Clinic
Set up one licensed psychotherapist, a shared practice, or a psychosomatic or psychiatric clinic with several teams, each with its own clients, scales and reports.
Mental health in Germany
Research data
Each figure below links to the source it comes from.
> 10%
of health spending went to mental health in Germany, one of only five OECD countries to report a share that high (2018 or latest year)
19.9 weeks
average wait from first enquiry to the start of guideline psychotherapy in a 2017 survey of practices, against 5.7 weeks for a first consultation hour
10,300
people in Germany died by suicide in 2023, about one death in every hundred
Research from Germany
GAD-7
In a nationally representative household survey in Germany (5,030 people, 2006), the GAD-7 had a single-factor structure with an internal consistency of 0.89, about 5% scored 10 or more, and the study published general-population norms by sex and age.
Löwe et al., Medical Care, 2008 PMID 18388841
PHQ-9
Nationally representative household surveys in Germany (5,018 people, 2003 to 2008) produced PHQ-9 norms by sex and age, supported a one-factor structure, and found moderate to high depressive symptoms in 5.6% of respondents.
Kocalevent et al., General Hospital Psychiatry, 2013 PMID 23664569
PHQ-9 (sensitivity to change)
In a University of Heidelberg study that followed 167 medical outpatients for about a year against structured clinical interviews, PHQ-9 change scores differed significantly between patients whose depression improved, stayed the same or worsened (effect sizes -1.33, -0.21 and 0.47).
Löwe et al., Journal of Affective Disorders, 2004 PMID 15183601
Collaborative care (PHQ-9)
GermanIMPACT, a cluster-randomized collaborative care trial in German primary care for adults aged 60 and over, found better PHQ-9 remission in the intervention group; a secondary analysis of 136 patients linked planned but unimplemented activities to worse 12-month PHQ-9 outcomes.
Boczor et al., Behavioral Sciences, 2025 PMID 40282083
Care Teams Across the Länder
HiBoop works online, so a practice in any of Germany's 16 Länder can use it, in person or alongside video sessions.
Berlin
The capital and a city-state; the BPtK's 2018 survey put the average wait for guideline psychotherapy in Berlin at 13.4 weeks
Hamburg
City-state and home of the University Medical Center Hamburg-Eppendorf, where the German general-population GAD-7 and PHQ-9 norm studies were led
Munich and Bavaria
Munich, Nuremberg, Augsburg and Würzburg, with practices serving both statutory and privately insured clients
NRW and Rhine-Ruhr
Cologne, Düsseldorf, Dortmund and Essen; the BPtK's 2018 survey recorded its longest average wait for guideline psychotherapy, 29.4 weeks, in the Ruhr area
Frankfurt and Hesse
Frankfurt am Main, Wiesbaden, Darmstadt and Kassel, from city practices to clinics serving rural districts
Baden-Württemberg
Stuttgart, Heidelberg and Freiburg; Heidelberg researchers ran early German studies of the PHQ-9 as a measure of change
Eastern Länder
Saxony, Thuringia, Saxony-Anhalt, Brandenburg and Mecklenburg-Western Pomerania, from Leipzig and Dresden to Erfurt, Magdeburg, Potsdam and Rostock
Data sovereignty
Regions hereOther regionsLow CO₂ (Google)
Local hosting on request
HiBoop runs on Google Cloud and is hosted in the US or Canada by default. On request, we can deploy in Google's regions here. Google Cloud locations
Google Cloud regions
- Frankfurt, Germany
europe-west3 - Berlin, Germany
europe-west10
- Frankfurt, Germany
Why Germany clinics choose HiBoop
Built Around the Therapy Hour
- The PHQ-9 and GAD-7 both have norms from representative German population samples
- Scores are calculated on submission, so session time goes to the client
- One timeline per client, ready when a course of therapy is reviewed
- Care is €23 EUR/month, month to month, with no credit card to start
- Security controls independently audited for SOC 2 Type II
- GDPR compliant, with your practice as the controller and HiBoop as its processor
EUR pricing & support
Transparent pricing in EUR with flexible payment options for clinics of every size.
CareOne clinician, month to month€23EUR/monthTeamStarting price, unlimited clinicians€180EUR/monthNetworkMulti-site organizationsCustomEnterprise pricing
100+ validated scales for Germany clinics
Validated scales grouped by what they measure, each with its scoring and source. Public programmes often call this routine outcome monitoring (ROM), or patient-reported outcome measures (PROMs): the same practice of giving a validated scale at regular points and reading the scores over time.
Depression, Anxiety and Somatic Symptoms
- PHQ-9 (Depression)
- GAD-7 (Anxiety)
- PHQ-8 (Depression, 8-item)
- PHQ-15 (Somatic Symptoms)
Trauma and Risk
- PCL-5 (PTSD)
- ITQ (ICD-11 PTSD and Complex PTSD)
- ACE (Adverse Childhood Experiences)
- C-SSRS Screener (Suicide Risk)
Children and Adolescents
- PHQ-A (Adolescent Depression)
- SCARED (Anxiety)
- SCARED-P (Anxiety, Parent Report)
- CRAFFT-2.1 (Substance Use)
Further Clinical Questions
- OCI-R (OCD)
- MDQ (Bipolar)
- MAST (Alcohol Use)
- SWLS (Life Satisfaction)
Resources for Germany practitioners
Billing guides, compliance documentation, and clinical practice resources.
- DepressionPHQ-9 Clinical Guide
Scoring, severity bands and how to read change between sessions
- AnxietyGAD-7 Clinical Guide
Scoring, cut-offs and tracking anxiety across a course of therapy
- TraumaITQ Clinical Guide
The International Trauma Questionnaire for ICD-11 PTSD and complex PTSD
- PracticeMeasurement-Based Care
How routine outcome measures work in practice, from intake to the last session
Clinical practice resources · Germany
Official bodies, clinical guidelines, and regulatory references. Germany.
- Psychotherapie-Richtlinie
Gemeinsamer Bundesausschuss (G-BA)
The guideline that governs outpatient psychotherapy paid by statutory health insurance, with the G-BA's evaluations of the consultation hour and other 2017 changes.
- Reform of Psychotherapist Training
Bundesministerium für Gesundheit (BMG)
The 2019 Act that moved training to a five-year university degree, a state examination and further specialist training.
- Waiting Times 2018
Bundespsychotherapeutenkammer (BPtK)
The chamber's survey of waits for consultation hours, acute treatment and guideline psychotherapy one year after the 2017 reform.
- Digital Health Applications (DiGA)
BfArM
How digital health applications are assessed, listed in the directory of reimbursable DiGA, and prescribed.
- Section 22: Processing of Special Categories of Personal Data
Federal Data Protection Act (BDSG)
The conditions under which health data may be processed for diagnosis, care and treatment.
Crisis and urgent help lines
If someone is in immediate danger, call 112. HiBoop is not a crisis service.
Emergency
For a life-threatening emergency, call emergency services first.
TelefonSeelsorge
24/7
116117 Patientenservice
24/7
Measurement-based care
…starts with what we measure, and how long.
Send your first check-in today, with your own assessments and clients. For teams, we set up your assessments and schedules with you. Prefer a guided start? You can book a walkthrough on the next page.
Start- Everything in HiBoop, by workflow, and what shipped lately.Features
- 100+ validated measures, with scoring guides and sources.Assessments
Frequently Asked Questions
Is HiBoop a DiGA?
No. A DiGA has passed the BfArM's assessment and is listed in its directory of reimbursable digital health applications. HiBoop has not been through that process and is not meant to: it sends validated scales, scores them and charts the results for your team.
Where is client data hosted, and what does data protection law ask of my practice?
On Google Cloud in the US or Canada, with other regions on request. HiBoop is GDPR compliant and acts as your processor. Your practice is the controller under the GDPR, so it is your call whether a processor and its hosting region fit Article 9 and section 22 of the BDSG. Ask us about hosting region and processing terms before you start.
Can I use HiBoop alongside therapy paid by statutory health insurance?
HiBoop does not submit anything to a health insurer and does not replace your practice management software. It sends and scores the scales you choose. How those scores feed your documentation, applications and reports under the Psychotherapie-Richtlinie stays your clinical decision.
Have the PHQ-9 and GAD-7 been studied in Germany?
Yes. Representative household surveys in Germany produced general-population norms for the GAD-7 (5,030 people) and the PHQ-9 (5,018 people), and a University of Heidelberg study found that PHQ-9 change scores tracked whether outpatients' depression improved or worsened. Ask us which language versions of each scale are offered before you plan your intake process.
Official sources for Germany
Health authorities
Billing and payment routes
- 1.Einheitlicher Bewertungsmaßstab (EBM) · fee schedule
- 2.Gebührenordnung für Psychotherapeuten (GOP) · fee schedule
- 3.Gebührenordnung für Ärzte (GOÄ) · fee schedule
Fee codes and amounts are set by each payer and change; check the linked schedule before you bill. HiBoop does not submit claims.
Listed for reference so you can find the official source. HiBoop is not affiliated with, and is not endorsed by, any of these organizations.