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Everyone
wants to know the answer to these two questions, and the answer
to the first one is often determined by the answer to the second
one!
These issues are often determined by insurance
carriers or managed care companies, and no longer by therapists
themselves, as used to be the case. Ideally, when
the problem that you bring to therapy is resolved to your satisfaction,
then you are done. However, therapy is not like going to your
physician, and oft times you may find that the source of your
depression, for example, lies somewhere beyond the precipitating
issue of which you were already aware.
The issue then becomes whether you can
afford therapy on your own. That is, do you have
enough of your own hard earned money to look at other (perhaps
long past) influences which bear on your current depression,
or which are somehow linked to the fact that depression is a
recurrent state in you life? If you can't afford therapy on
your own, then you may be out of luck. Currently, managed care
usually dictates that medication(s) should take the place of
long term therapy. Should you decide not to take medication
or present yourself for a medication evaluation, then you stand
the chance of losing what little mental health coverage you
have.
Over the years, some therapists may have seen clients
longer than was necessary, but most probably have not. While
some argue that with the existence of once unavailable medications
there is absolutely no justification for long term therapy,
others argue that the reason for the long term therapeutic relationship
is just that: to provide a relationship. They contend that if
someone had either little or no relationship with their parents,
or had a horrific relationship with them, then there is no question
about the necessity for a long term reparative relationship.
Others complain that without long term therapy, it
is impossible to provide for structural personality change.
Some counter with the argument that structural personality change
is not possible anyway, and that spending health care dollars
attempting to achieve it is a waste.
Clearly, there is ample justification for both long
and short term therapy. In the end, it is probable that some
people, however few, actually need long term therapy for survival,
and that many people could use long
term therapy, would like long term therapy, and clearly could
benefit from it.
No matter which side of the argument you find yourself on, the
fact remains that reimbursement for long-term therapy has gone
the way of the dinosaur. Therefore, whether you really need
it, merely want it, or some of both, you will have to foot the
bill yourself.
What should you do? Discuss it with a therapist,
talk to your significant other (if you can), look at your budget,
determine your degree of reimbursement, and make your determination.
More than likely, we could all use a little therapy off and
on throughout our lives, and we'd be much happier as a result.
It's a bit of a shame that we don't look upon going to a therapist
they way we do going to a physician, that is, with much more
acceptance and recognition of the value of regular check-ups
and attention.
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