The diagnosis of vocal dysfunction is a prerequisite for referring a patient for specialized medical therapy. This mostly requires a holistic approach, and should also consider related symptoms and the social environment of the patient. Regulations on psychotherapy, promulgated in 1999, have provided clarity in relation to the indications for treatment in an inpatient and outpatient basis. Within the German health care system, every individual can now directly contact an officially certified psychotherapist (so called psychological psychotherapist) for probationary sessions, aimed at determining a basis and indication for further psychotherapy. In case of psychotherapy provided from others than physicians, an additional medical report from a physician is obligatory. Patients with functional and psychogenic voice problems often believe that organic disorders are the reason for their dysphonia. Thus, when caring for voice disordered patients and sending them to a psychotherapist, it is of great importance that physicians facilitate their referral by reacting in an empathic, fear reducing, and professional way.
