anthony
Founder
In a world of adaptation, improvement and streamlining to meet present and future demand, it seems therapy duration is stuck in the twentieth century. A conversation is needed to effect change.
What happened to the days where Freud would sit for hours with a client until their level of distress diminished? The psychotherapy industry is working with a model that has little evidence to support the one-hour session. When I say "one hour" that actually means anything from 45 to 60 minutes, depending on the service.
To cut a long story short, insurance got involved in dictating payments based upon 30-to-60-minute sessions. This largely arbitrary dictation is the ongoing issue, and maybe it's one that insurers should investigate to determine whether extending sessions is in their best interest. Therapists are not going to work for free, after all.
For ten years I have been reading the same thing from real people who have endured severe trauma. They start getting into profound trauma discussion by the end of the session, only to be told the session is over. Thereafter lie the consequences--the crux of this issue.
That sufferer leaves therapy utterly symptomatic. It takes all their physical and mental strength to reframe from killing themselves, killing someone else, drinking, turning to drugs, keeping a relationship together, insert extensive list of created problems.
Then, they begin the next week's session focused on that week's struggles.
Nearing the end of the new session at hand session--or completely wasting the session due to issues created by the lack of therapy duration--they may start to get into something new. The cycle repeats. Little to nothing gets solved in an adequate timeframe, as much of the next session becomes focused on the struggles endured, and often caused by, the previous session's discussion.
From my online research, part of the issue falls upon the insurers failing to pay therapists for anything longer than single, one-hour sessions. The other part falls onto the therapeutic industry, as they're the responsible party who provide industry guidelines to the insurers.
Maybe, just maybe, the top echelon of the therapeutic industry (psychiatric associations) should be having conversations with insurers to amend payment guidelines and trial a flexible time capacity, especially for severely symptomatic sufferers.
I watch person after person come to MyPTSD, spend hours, days, initially, then posting how they finally begin to understand an important aspect of their trauma from discussing the issue. That is what longevity discussion achieves. Imagine what a trained therapist could do in a 2-to-4-hour session? Even an extension to 90 minutes would be beneficial.
Maybe insurers should do some investigation of their own. I will take a gamble, stating that the insurer would find it cheaper in the long-term to allow longer sessions for those assessed as severe cases, which would enable faster and more sustained healing with less therapeutic time wasted. In turn, trauma therapists obtain more available time to reduce waiting lists. It's a win win for everyone. If the MyPTSD community were a study, I could tell you now that approximately 70% of severe trauma sufferers within therapy follow this chaotic therapy pattern.
Let's be honest. The financial impact the ill have on the economy is well documented. If we use America as our example, approximately 10% of the country endures PTSD at any given time. Approximately 5% of that sample are lifetime PTSD patients, with around 30% in the severe spectrum.
Simple math on the subject is revealing. 32 million (10% of the population) American citizens live with PTSD at any given time. Approximately 9.6 million (30% of those diagnosed) are suffering at the severe level and costing the economy billions per annum.
I think it's time that the industry and insurers shake things up a little and see what pops out the other end, what benefits all concerned. Clients stop chasing their tails with wasted session time, insurers save money with less sessions as people are getting faster results, and therapists get paid regardless.
Everyone wins with a little exploration and flexibility--unless the insurance industry wants people to remain ill for longer!
What path did your trauma therapy experience follow?
Would you like more time when discussing severe trauma concerns?
What happened to the days where Freud would sit for hours with a client until their level of distress diminished? The psychotherapy industry is working with a model that has little evidence to support the one-hour session. When I say "one hour" that actually means anything from 45 to 60 minutes, depending on the service.
To cut a long story short, insurance got involved in dictating payments based upon 30-to-60-minute sessions. This largely arbitrary dictation is the ongoing issue, and maybe it's one that insurers should investigate to determine whether extending sessions is in their best interest. Therapists are not going to work for free, after all.
For ten years I have been reading the same thing from real people who have endured severe trauma. They start getting into profound trauma discussion by the end of the session, only to be told the session is over. Thereafter lie the consequences--the crux of this issue.
That sufferer leaves therapy utterly symptomatic. It takes all their physical and mental strength to reframe from killing themselves, killing someone else, drinking, turning to drugs, keeping a relationship together, insert extensive list of created problems.
Then, they begin the next week's session focused on that week's struggles.
Nearing the end of the new session at hand session--or completely wasting the session due to issues created by the lack of therapy duration--they may start to get into something new. The cycle repeats. Little to nothing gets solved in an adequate timeframe, as much of the next session becomes focused on the struggles endured, and often caused by, the previous session's discussion.
From my online research, part of the issue falls upon the insurers failing to pay therapists for anything longer than single, one-hour sessions. The other part falls onto the therapeutic industry, as they're the responsible party who provide industry guidelines to the insurers.
Maybe, just maybe, the top echelon of the therapeutic industry (psychiatric associations) should be having conversations with insurers to amend payment guidelines and trial a flexible time capacity, especially for severely symptomatic sufferers.
I watch person after person come to MyPTSD, spend hours, days, initially, then posting how they finally begin to understand an important aspect of their trauma from discussing the issue. That is what longevity discussion achieves. Imagine what a trained therapist could do in a 2-to-4-hour session? Even an extension to 90 minutes would be beneficial.
Maybe insurers should do some investigation of their own. I will take a gamble, stating that the insurer would find it cheaper in the long-term to allow longer sessions for those assessed as severe cases, which would enable faster and more sustained healing with less therapeutic time wasted. In turn, trauma therapists obtain more available time to reduce waiting lists. It's a win win for everyone. If the MyPTSD community were a study, I could tell you now that approximately 70% of severe trauma sufferers within therapy follow this chaotic therapy pattern.
Let's be honest. The financial impact the ill have on the economy is well documented. If we use America as our example, approximately 10% of the country endures PTSD at any given time. Approximately 5% of that sample are lifetime PTSD patients, with around 30% in the severe spectrum.
Simple math on the subject is revealing. 32 million (10% of the population) American citizens live with PTSD at any given time. Approximately 9.6 million (30% of those diagnosed) are suffering at the severe level and costing the economy billions per annum.
I think it's time that the industry and insurers shake things up a little and see what pops out the other end, what benefits all concerned. Clients stop chasing their tails with wasted session time, insurers save money with less sessions as people are getting faster results, and therapists get paid regardless.
Everyone wins with a little exploration and flexibility--unless the insurance industry wants people to remain ill for longer!
What path did your trauma therapy experience follow?
Would you like more time when discussing severe trauma concerns?