"Therapy is not magic" - this is so true!
I was actually a little resistant to going to therapy for a variety of reasons. But I knew I needed to go (I was losing it). I attended through my company's EAP and ended up with a therapist - very nice person - who after three sessions, recommended EMDR. The concept of that treatment wasn't clearly explained to me and even once I read about it, it sounded somewhat mystic and frightening.
As though I wasn't going to have to do any real work...just listen to some clicks and lights and all these thoughts and feelings would go away.
(Which frankly, scared the crap out of me! Maybe it's really not scary. But it wasn't something I agreed to do.)
Anyway, the other part of this is that the therapist HAD to move me on to someone else because of the EAP agreement - six free visits and that's it. You know, the idea that "normal" people will seek this help to get through "typical" issues like death, divorce, etc. in just six visits. So, if she recommended EMDR for me, I would have to go to someone else. Saying, "I feel this would be beneficial to you, but I don't provide this service" sounds loads better than, "We only allow six visits, and your problems are bigger than that."
(Which, by the way, she did say when we agreed I needed to seek other treatment.)
Not the best system...
The human psyche does not seem to fit well into the treatment plans of managed care.
I'll bookmark this because it's a great and deserves much more discussion.
I think I said it wrong on that post, and of course when words are cut and pasted, the nuance, "You don't HAVE to punt," is gone. I think I do communicate in that post that if you can justify what you're doing, if it makes sense to continue to work on goals, if objectives and goal attainment can be measured, of course you can recontract and continue to work together.
If that's not possible, then the therapist may be holding someone's hand, when what should happen is a better treatment plan, which might include doing isomething more or seeing to it that someone else does something more.
We have all kinds of rules about termination, too, and the timeliness and fashion of the termination. It's not as if abandonment isn't discussed. It's at the top of the list.
The process is not as simple as I make it out to be on that post, and I apologize for that, surely appreciate your attention.
At six months we take a hard look at what's going on. If the patient agrees that the two of us are going around in circles together and we can't stop the music, then a change is surely a good idea.
I would love to discuss this further.
Having been in practice for 35 years now and having started before managed care was even a glimmer in anyone's eye, I developed my practice style in a different era. And today, I do not practice within the insurance based system so I am free of much of those requirements.
I am able therefore to assess and explore how things are going on a much looser timetable and very informally. I also tend to work with people long-term and I work from a depth psychological perspective so the whole matter of knowing when therapy will end is an open question until we reach that end point. For some people this is a matter of months, for others a mater of years.
I confess I knew that it was not exactly as you posted -- but you gave me a nice point to spring from. 
Commenting by HaloScan
