The development of treatment guidelines alone does not improve patient care. The implementation of guidelines depends on various conditions, including structural conditions. The update of the S3 guideline "Psychosocial therapies for severe mental illnesses" systematically describes very different psychosocial therapies and reviews their effectiveness. The implementation of the resulting recommendations, which are coordinated in a complex consensus process, is hampered by the structured social legislation in Germany. The present article shows to what extent the recommendations of the update of the S3 Guideline Psychosocial Therapies follow the Federal Participation Act (BTHG).