Most psychotherapy patients unhappy with therapy length

Inter-university study shows most frequent reasons for termination being financial constraints and mismatch with therapist.

By JUDY SIEGEL-ITZKOVICH
psychotherapy 88 (photo credit: )
psychotherapy 88
(photo credit: )
Three-fifths of people who have undergone "dynamically oriented" psychotherapy from professionals in a private practice feel their therapy either lasted too long or ended too soon, despite widespread agreement that an ideal termination of psychotherapy occurs naturally, with an agreement between therapist and client. This was revealed by recent research conducted by an Israeli inter-university team. Prof. David Roe, chairman of the University of Haifa's community mental health department, said his research revealed that "more often than not," therapy is not concluded at the proper time. In the study, which Roe conducted in collaboration with Dr. Rachel Dekel and Galit Harel from Bar-Ilan University and Prof. Shmuel Fennig of Tel Aviv University's Sackler Medical School, 82 people who were in private psychodynamically oriented psychotherapy for at least six months (and average of two years) which had recently ended were assessed regarding the way they experienced the timing of, reasons for and feelings about the termination. The findings were published in three prestigious journals: Bulletin of the Menninger Clinic, The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry and Psychology and Psychotherapy: Theory, Research and Practice. It revealed that 84 percent of participants initiated the termination; the remaining 16% stated that termination was either by mutual agreement or initiated by the therapist. Only 40% of the clients felt the therapy ended at the appropriate time, 37% felt it ended earlier than it should have, and 23% thought the therapy went on for too long. The most frequent reasons for termination among those who experienced it as too early were financial constraints (34.5%) and mismatch with therapist (27.6%). Among those clients who felt therapy lasted too long, the most frequent reasons were feeling uncomfortable toward the therapist (26.3%), hope that the treatment would improve (21.1%) and dependence on the therapist (21.1%). In general, clients who reported that their therapy ended on time were more satisfied with the treatment. Factors contributing to positive feelings about termination included perceiving the termination as an expression of independence, reflection of positive aspects of the therapeutic relationship and a reflection of positive gains from therapy. "Whereas clinical lore has consistently suggested that therapists must help clients focus on the emotionally painful aspects of this period and the difficulty in separating, emerging data suggest that it is equally important to relate to the clients' positive feelings," said Roe. "Results suggest that clients find terminating psychotherapy at the right time important and yet difficult to achieve, and that clients experience a wide range of feelings - many positive - during the termination phase, which call for a reconceptualization of the role of the therapist during this important phase of psychotherapy." KNOW WHERE TO COMPLAIN A bill that will require all health fund clinics to post information for members on how to complain about the service they are getting, including how to reach the health system ombudswoman (now Ettie Semama), has been approved for second and third reading in the Knesset. The bill, proposed by Knesset Labor, Social Affairs and Health Committee chairman MK Yitzhak Galanti (Gil Party), was approved by that committee and will now go to the plenum. The signs will be in Hebrew, Arabic, Russian and Amharic (but apparently not English). Semama told the committee she receives 5,000 complaints a year and believes the number will increase when the signs go up to tell people where they can reach her. WATCH THE PILLS Taking multivitamins on a regular basis can increase the risk of prostate cancer, according to a recent report in the Journal of the [US] National Cancer Institute and reported in the Harvard Men's Health Watch newsletter. While a third of American adults take some type of multivitamin daily, there is no firm evidence to support their hope that it will keep them healthy. Not only has there been no proof of benefit, but using multivitamins may also be harmful. When the researchers further explored this finding, they found no link between multivitamin use and the risk of developing localized prostate cancer, but did find that men who take multivitamins more than once a day were 32% more likely to develop advanced prostate cancer and 98% more likely to die from the disease. However, the study had its limitations, as it was not designed to determine whether multivitamins actually caused cancer; it did not discover which multivitamins were taken; and the results failed to establish a relationship between dose and response. Moreover, other studies have shown no connection between prostate cancer and multivitamins. Faced with this contradictory information, scientists know they need more studies, and several are already under way. The Harvard University publication suggests that a good diet and other lifestyle changes may help lower men's prostate cancer risk, and cautions against excessive use of multivitamins. It does not show harm from a supplement that sticks to the recommended daily amounts of the standard vitamins.