Is A Short Period Of Therapy Worth Bothering With

[Mit]

I've self referred for counselling/therapy in the UK through a local NHS service. I did this because anxiety and panic attacks have in recent months become much more intense, more frequent and longer lasting. At times I feel so frightened all I can think about is suicide to escape the terror. It was during my childhood that I suffered, over many years, traumatising experiences. I have never come to terms with what happened, and more recent traumatic events have compounded my problems, and made me a frightened and anxious person with very little resilience to the stresses of normal life. I still compulsively 'act out' because of the childhood trauma and have done for decades.

I had a telephone assessment yesterday for therapy. The person I talked to was very nice, understanding and insightful. But she said I was limited to six therapy sessions. Having tried unsuccessfully to cope for decades I find it hard to believe I will achieve much in six sessions and that fact that there is a set limit already bothers me.

I know good therapy relies on building a relationship and trust, and it seems to me that by the time we might have achieved that my six sessions will be done, and I might end up feeling worse, not better. Is it worth it?

 

[Friday]

Is a short stint worth bothering with? Sometimes yes, sometimes no. Depends on what your purpose is.

I know good therapy relies on building a relationship and trust

Not always. Some of the most helpful tools I've ever been given have come from complete assholes I wouldn't trust with a gerbil, much less trust to be an advisor & close confidante. It wasn't about trusting them. It was about picking their brains clean of every useful bit of information, then twisting it like a sponge for anything and everything I can possibly wring out of them.

Therapists fill many roles. Sometimes it's as a master manipulator; training you to think, feel, and act in a way that is completely contrary to how you thought, felt, and acted when you first started meeting with them. Sometimes it's as an advisor & confidante. Sometimes cheerleader, ball buster, evaluator, hand holder, authority figure, etc., etc., etc.,. And... Sometimes it's as a teacher.

In 6 sessions is someone going to be able to process your trauma with you and provide support for the entire arc of being symptomatic to not? Nope.

In 6 sessions could someone fundamentally alter and change your life for the better? Yep.

Is that guaranteed? Hell no. It could all be a giant waste of time. Or it could be the start of something that will take several years. Whether they continue therapy with you, or are the first in a series of professionals that fulfill different roles for you.

No way to know which, without trying.

 

[Recovery4Me]

At times for billing purposes (within the USA) those in charge will block out an number of assigned visits for the assessed area or one's concern. After which, if there appears to be more to the assessment that needs to be addressed, a new 'label' or billing code will be applied and sequential visits/sessions allocated.

Being unfamiliar with your country's exact procedures for therapy allocation within mental health and recovery (although I have seen a rockin' list by UK for recovery in a textbook;)) , you might consider asking your T when you see him or her.

I have found support is a beautiful asset within the journey to heal. PTSD can manifest in a way at times that stresses us out over any change. Therefore, unfortunately, I was resistant occasionally & avoided several sessions thus thwarted my own healing. I caught on that I was actually only hurting myself in the long run.

However,staying stuck in hades is equally uncomfortable, you know?:clown: So possibly consider being uncomfortable in the hopes of a positive change. A journey begins with one step.

:hug:'s if you accept.

 

[Lucycat]

Once you are in the system you will be in a better position to negotiate. I have had unlimited ongoing therapy on the NHS for 5 years. You may have to argue your case, or of course you may find 6 sessions enough. Just don't let it put you off and if you need more after 6 make sure you say so.

 

[Deleted member 1860]

My advice? Throw out the need for trust in your therapist. Put your trust in the therapy. Yes, it is a leap of faith, but as I see it, you don't really have any other choice as you can spend a heck of a lot more than 6 sessions building up trust in a therapist.

I've done this, and its worked. I went to intensive trauma therapy (2 solid weeks of individual therapy for 8 hours a day) and there was no time to build up trust in any of my therapists. All of the therapists were female and before I signed on the dotted line I told them point blank that I simply do NOT trust females so I was concerned about this therapy working. (With a nearly $10K price tag, a pretty valid concern!) One of the therapists told me to trust the therapy and the process, but not to worry about trusting the therapists themselves as there wasn't time to build that trust. Well, I can attest that it worked, and it worked well. That therapy was the only type of therapy that allowed me to process my trauma when countless other therapies had failed me.

So bottom line, trust in the therapist him/herself is not necessary for successful therapy, although many sources will tell you otherwise.

 

[Namenotdiagnosis]

I agree with lucycat , get into the system and more therapy will come. I suppose it all also depends on what type of treatment your having, because 6 sessions of intense emdr can be helpful and with techniques to help you , you are better off than no treatment at all. My gp referred me , after a detailed assesment I was offered CBT, but after one session she refused to continue because my trauma was too complex as I have CPTSD, I was then referred to PTSD specialist and unfortunately there is only one in the whole of my area run by NHS and the waiting list was a year.
I decided to go private as I was in a fortunate position to do so, I had 12 sessions of EMDR and it really helped. At the time there was no way I could wait a year because i was really suffering with my flashbacks and dissaccoiating that I needed urgent treatment.
So I would strongly advise you to stay in the system and have the 6 because if the ts any good they will make recommendations on you having more if they feel you need it, if you don't accept the 6 you'll have to start the process again and it may take a very long time .
I kept myself on the referral because in the time my appointment comes Il probably need a top up. Good luck .

 

[Kas_Can_Fly]

I'd like to add my two cents as it specifically relates to UK services. I've seen one therapists but encountered three different forms of therapy available advertised by the NHS.

The first was for a 6-12 limited session run with a private company run through the NHS, advertised solely as an NHS based service which is not true. Even if you need it they cannot offer you more than 8-12 sessions with the same therapist which is why they always offer less to start with. After your initial sessions you MUST break for a minimum of 8 weeks at which point you will need a new referral. Often you will not be allowed to work with the same therapist until after six months, though this may vary across companies, I'm not sure. They rejected me as I was too complex for their services but my mother had a run with them and despite needing more sessions (as advised by the therapist) this was not available due to the reasons stated above. She hasn't bothered chasing another run up, though she has considered it largely because she would like to be able to see the same T as before.

The second was a charity based service that could have offered me potentially an unlimited number of sessions but they messed me around left, right and center. Which led to my first hospitalisations.

The third sort of therapy was a prescheduled stint of 48 sessions from an NHS Psychologist, through the local NHS Mental Health Unit. It has since been extended however and when the time comes that I will have a "therapy holiday", my social worker will arrange other activities and forms of therapy for me. It was arranged between the hospital staff, the crisis team and my social worker once he realised the extent of my trauma which only came out around this time. It also runs alongside a NHS Psychiatrist and my GP with information I consent to share.

If you feel that you need more than six sessions and/or are self-aware of the amount of work you're going to need to go through your traumas, this is likely. You haven't mentioned if you've been officially diagnosed with PTSD or not but to do so you would have had to be referred out of your GP already.

Nonetheless the route I would strongly recommend is going to your GP and being truthful about what you want and need. Get referred to the local mental health unit (not as scary as it sounds), where you will likely get a key worker - a social worker, mental health nurse etc. They will be in charge of your file and care plan, the likely first step is you can be referred to a psychiatrist through them (expect a wait) for an official diagnosis. Between the diagnosis and the appointments with your care coordinator, (be as honest as you can about how you're coping and that you want therapy), you should get referred to proper NHS therapy which is extendable and tailored to your needs as much as possible, though still has to meet some guidelines and limits.

Unfortunately none of this is a quick process and if you can get it, the six sessions maybe useful to work on some smaller issues like coping strategies for anxiety and depression. You are entitled to both (though not at the same time) and can get this while waiting for something more long term.

Good luck.

 

[Mit]

Thanks for all the advice and thoughts. The collective wisdom is to try it, so that's what I'll do.

Thanks again.

 

[Anarchy]

Hi Mit,
Sorry for late addition, I've not had much chance to comment over the past few days, and haven't read the preceding comments so sorry if repeating.
Even a short programme could provide you with some useful skills to work on, and establish a sense of both safety and self determination. You may also be able to recruit the T to recommend extentions or more specialist therapy sessions.

Best Regards
A

 

[KP the nut]

@Mit That is the official line from the phone people. In reality it will be your therapist who makes the decision - with you of course.

I was told the same, however I was eventually in therapy for almost a year. I had EMDR and as we worked on my trauma, a car crash, childhood issues came forward. These had an impact and had affected how I had been during and after the crash. I also started having nightmares about being in danger and trapped. Initially we thought it was being in a crushed car but I'd uncovered childhood memories of being trapped.

My therapist fought my cause a couple of times to get an extension. He told me it would be unethical just to cut me loose whilst those issues were there.

I have been out of therapy for a few years now. I still use the grounding techniques he taught me including one he recorded for me which I have on my iPod.

Wishing you well.

 

[Mit]

@KP the nut @Anarchy thank you both for your help. I've decided to go ahead. The therapist I spoke to on the phone was very nice to talk to, and seemed to understand more than I had expected. She has since written to me asking for more information prior to completing an assessment over the phone. I'm just a bit fearful of feeling I might be getting somewhere and then having it snatched away. I don't think that would be a good situation.

 

[Capt_Gruuvy]

I had a short therapy opportunity once and I used it to "dump" all sorts of thoughts, memories and fears on the person. I figured I won't see them after these three sessions so I dug deep and laid it all out there. I mean ALL out there. They were in shock at the things I said but understood I was trying to empty the bucket so to speak. That was the beginning of my Come To Terms With It adventure. I never regretted those sessions. I had to honest in a hurry and the results shocked me.

I say go for it.