Starting with January 2023, Luxembourg’s national health insurance (CNS) began covering the costs of psychotherapy. While the news was widely announced in the country’s main languages, the details remain unclear or confusing for many. The complexity of distinguishing between psychiatry, psychology, psychotherapy, psychoanalysis, coaching, counseling, and other mental health services—each with its unique approaches and regulations across countries—makes understanding the system challenging, even for those without mental health concerns.
Here I summarise my knowledge and understanding about the situation to help you navigate a bit the system.
So what is reimbursed and especially what are the conditions for being reimbursed in Luxembourg? What are the best professionals to look for depending on your needs? How to make the difference between them? I try bellow to answer all these questions in such a way that you can make an informed decision.
First: who is who?
Psychiatrist
A psychiatrist is a medical doctor who has specialized in psychiatry after completing medical school. Psychiatrists can do all kind of medical investigations, diagnose and treat mental health problems, often focusing on conditions that require medical intervention (e.g., prescribing medication). They are specialists in mental illnesses and disorders.
Psychologist
A psychologist holds a bachelor’s and master’s degree in psychology and practices as a specialist in human behavior and mental processes. Psychologists have a diversity of specialisation, and you have a few examples bellow, so accordingly to your needs you might look for a different psychologist:
- Clinical Psychology: Supporting individuals with mental health issues.
- Counseling Psychology: Helping people navigate life changes and challenges.
- Occupational/Organizational Psychology: Improving workplace dynamics and employee well-being.
- Child/developmental or Family psychology: work with children and teenagers and/or families
- Coaching psychology: the scientific study and application of behaviour, cognition and emotion to deepen our understanding of individuals’ and groups’ performance, achievement and wellbeing, and to enhance practice within coaching (definitions given by British Psychological Society – first to recognise this branch of psychology
- Sports, health, neuropsychology, forensic psychology, etc.
Some psychologists perform assessments, contribute to diagnoses, and design interventions to maintain mental health, prevent illness, or aid recovery. Most of them would be able to analyze a situation and design interventions (at individual or group/family/organizational/social level) that will preserve/maintain mental health, prevent metal illness or help to recover from metal illness or difficult situations.
Some psychologists (like sports or coaching psychologists) will be interested in motivation, performance and what is meaningful in life. Others will help to better understand ourselves and others like social or evolutionary psychologist or help the police and justice (like forensic psychologist).
My personal note, and it might be that not everyone will agree with me, is that most of the work of a psychologist is to understand how we function, design and implement interventions that are rather preventive. Their work often emphasizes prevention, motivation, and personal development.
Psychotherapist
A psychotherapist- accordingly to the regulations in Luxembourg- is a clinical psychologist or psychiatrist who has completed additional training (typically three years) in a specific form of therapy, such as:
- Psychoanalysis (e.g., Freud’s approach or modern psychodynamics).
- Cognitive Behavioral Therapy (CBT).
- Humanistic or Person-Centered Therapy.
- Systemic Therapy or Gestalt Therapy.
Psychotherapists diagnose and treat mental health disorders, traumatic experiences, and distress. The key word here is treatment.
They are recognized in Luxembourg if they are registered with the Collège Médical.
Besides the main psychotherapies are also countless of other approaches or a mix between them (called integrative approaches) or derivates of them. The integrative approaches are not recognized in Luxembourg.
Coach
Coaching is a separate profession that focuses on personal or professional development. Coaches may have various educational backgrounds and specializations, such as life coaching, business coaching, or health coaching. While coaching is not traditionally categorized under mental health, some research indicates that coaching interventions can contribute to mental well-being. Check here a few useful info about how to chose a coach.
Situation in other countries
For example in Belgium the state regulates and recognizes the psychologists (so only psychologists graduated from specific faculties and fulfilling certain criteria can register and profess as psychologists for specific specializations). There is no further requirement for psychotherapists. In France also a psychologist needs to register and have a registration number but the profession is not further regulated.
In Luxembourg, after many years where there was nothing, a law was adopted in 2015 that regulates the psychotherapists and they have to be agreed and recognized by the Collège Medical.
Therefore, we arrive to our main question: who is reimbursed (by CNS)?
Who qualifies for reimbursement?
Patients with a medical prescription (from a general practitioner or psychiatrist) for psychotherapy are eligible for reimbursement when they consult a psychotherapist registered with the Collège Médical. This applies primarily to individuals with a diagnosed or diagnosable mental health condition.
- CNS Coverage:
- CNS reimburses approximately 75% of a psychotherapy session, priced at €144 per hour.
- Patients must pay upfront and claim reimbursement from CNS.
Private Insurance Options
Some private insurance providers cover sessions with psychologists (e.g., for counseling, psychological support, or coaching) and psychotherapy. For instance:
The European Commission and Parliament follow Luxembourg’s local rules, reimbursing only psychotherapy.
The European Investment Bank (EIB) covers part of any session with a psychologist or psychotherapist.
Many institution or organisations will have an internal service for Occupational health that might orient you towards some mental health professionals that have an agreement with them (any many times free of charge as a service for their employees).
The good, the bad and the ugly
The good thing is that you can get treatment when you have a mental illness from a psychotherapist and be reimbursed by CNS. The bad is that CNS decided that a session of approximatively one hour is 144€ and it will be reimbursed about 75% (so you pay the session and you send the invoice to the CNS and get reimbursement like for any other doctor consultation). The ugly is that you will need several sessions depending on your problem, the gravity of it, your resources and general resilience. I understood that there are quite long waiting times of for a first session with a psychotherapist and if you do not like him or her…you will just have to wait even more.
Please read all the conditions and the limitations here: https://cns.public.lu/en/assure/vie-privee/sante-prevention/prestations-medicales/psychotherapie.html
Choices, choices….
You might also wonder how to make the difference between the different therapeutical approaches and whom to choose.
Choosing the Right Professional
When selecting a mental health professional:
- Prioritize the (therapeutic) relationship. Research indicates that the bond between patient and mental health professional significantly impacts outcomes.
- Consider professionals who align with your values, goals, and needs.
- While the type of therapy (e.g., CBT vs. psychoanalysis) may not drastically affect outcomes, finding someone you trust and feel comfortable with is critical.
Preventative Care Options
If you do not have an acute mental health issue but want to maintain your mental well-being, consider:
- Psychologists specializing in counseling, coaching, or occupational health.
- Coaches for goal setting, performance improvement, or personal growth.
So try to find one that you like, with whom you have a good vibe (no worries we all have likes and dislikes), that has same values as you or has experience with your type of problem or objective and you truly feel you can trust him/her in order to be able to poor your soul with.
The good news is that there are on the market a very good number of psychologists that, as I said previously, do an amazing work and it is rather preventive. So instead of waiting to develop a problem and that sets in, it is better and advisable to go and see a psychologist specialised in counselling, coaching, occupational or other specialisations that might be related to your situation. Or you can see a coach (remember that this is a related profession to psychologists but they do not need to be psychologist).
Of course some times trauma or suffering comes over us unannounced …therefore, no time for preventive work. It is still good, while you wait for a psychotherapist session to check with a psychologist or a coach. Find one that suits you and give it a try. Of course, you will have to pay it from your own pocket especially if you do not have a complementary or private insurance that covers it. There are different prices, you just need to search and I am sure you will find something within your budget. Most important, the psychologists or the coaches, as they do not deal with CNS they have the freedom of designing their prices as they want, so feel free to negotiate. I do not know anyone who, if explained the situation will not agree to a price or way of working that will be possible for you. I know I do…because I preferer people to come even if it is two times per month for a few months than do nothing. You will find the work you do with them meaningful and useful preparation until arrive in the office of a psychotherapist.
So, to summarize…talk to your GP if you are struggling and than find a professional that suits you and your needs (psychotherapist, psychologist, psychiatrist, coach etc). Find a psychologist that suits you to prevent as much as you can, work with coaches when their competences fit your objectives and needs. Keep your mental health on check the same way you do with your physical health.
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