You can pay for therapy in Cologne privately, or go through the statutory system. Public health insurance (gesetzliche Krankenversicherung) covers four recognised treatment approaches: behavioural therapy, depth psychology, psychoanalysis and, since 2020, systemic therapy. To use that route you need a therapist holding a Kassensitz, a contracted practice place. Cologne falls under the Kassenärztliche Vereinigung Nordrhein, which publishes an online directory of the contracted psychotherapists in the region. Your GP and your health insurer can also give you names.
Waiting for one of those places takes an average of three months nationally. The Terminservicestelle is the central office meant to arrange an initial assessment appointment within four weeks of your first enquiry. After that, you go back to approaching contracted practices from those lists.
Paying privately is usually quicker. Most therapists on It's Complicated work with self-paying clients (Selbstzahler:innen) and set their own rates, and some are psychotherapists in training, who tend to charge less. Several are listed as Heilpraktiker:in für Psychotherapie (non-medical practitioner for psychotherapy), a title that works privately and can't bill public insurance.
If you hold public insurance and can't find a contracted therapist, ask your insurer about Kostenerstattung. It covers sessions with a state-licensed psychotherapist who doesn't hold a Kassensitz, and insurers like TK are legally obliged to pay where psychotherapy is necessary and urgent, as long as you can show you approached several contracted therapists and kept a note of when you asked and what each one said about availability.