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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Raven on August 12, 2002, at 17:22:42
Was just wondering if 25 hours of therapy is considered a lot, moderate, or not much?
Although it doesn't seem like much, my HMO wants me to wind up my therapy because it's gone on for a year and a half and their ideal treatment time is between 3 to 6 months...nothing long term.
I don't feel I'm ready to end it but I might not be given a choice.
Thanks!
Posted by Dinah on August 12, 2002, at 19:56:03
In reply to Lots, Medium or Dinky???, posted by Raven on August 12, 2002, at 17:22:42
I would imagine it differs for different people and for different types of therapy. For cognitive behavior therapy, I'm guessing the number of sessions is shorter.
I'm not the best one to ask. The real work of my therapy didn't begin until I learned to trust my therapist 5 years into therapy. Unless learning to trust him was the real work of therapy.
It must be terrible to be constrained by the guidelines of the HMO. Is your therapist willing to work with them for more time for you? Is there any way you can swing a few more sessions yourself?
Have you assessed your initial goals against what has been accomplished?
So you've only had 25 sessions in a year and a half? That doesn't seem excessive. I know a lot of insurance companies have a set number of sessions they allow per year. Is it possible they would approve more next year?
I don't really have an answer for you I'm afraid. Just throwing around ideas. Have you discussed this with your therapist?
Posted by judy1 on August 12, 2002, at 20:35:07
In reply to Lots, Medium or Dinky???, posted by Raven on August 12, 2002, at 17:22:42
It really depends upon what kind of therapy. Cognitive is normally 20 or so sessions, interpersonal can last for years. If yours is the latter- will your therapist offer you a sliding scale for payments (some do). Best of luck, judy
Posted by Raven on August 12, 2002, at 22:23:30
In reply to Re: Lots, Medium or Dinky??? » Raven, posted by judy1 on August 12, 2002, at 20:35:07
Dinah and Judy, thanks for your input.
Originally I went into what they call crisis therapy after my husband left me for an older, really not good looking other woman. This really took me totally by surprise and I didn’t do too well after it happened. My therapist was very sweet and empathetic and was a great sounding board. At that point, all I wanted was some relief from the pain. She also saved my life a few times.
It definitely wasn’t cognitive...I called it *hump* therapy, as in, help me over the...
Right now, the therapy is more to help me find some purpose and find some answers to questions to things that I can’t rationalize away, and maybe to help me better tolerate the negative things in my life. It’s not nearly as critical to me as it was in the beginning. Unfortunately, I’ve fallen into the familiar bag of really enjoying sitting in that dyad.
As far as being constrained by the policy of the HMO, my therapist has to follow their guidelines whether she wants to or not. She was not really happy to have to let me go soon, but she has no choice and I have no options to be able to see her even on a fee basis. She was really pretty demonstrative...less like a blank slate and more like an etch-a-sketch.
Posted by terra miller on August 12, 2002, at 22:34:39
In reply to Re: Lots, Medium or Dinky???, posted by Raven on August 12, 2002, at 22:23:30
i can't believe you can't see her even on a fee basis. that stinks. i think, to answer your question, that it's "low." i know of nobody who only goes 25 times. i think of therapists as like your physicians... you pick one you like, and they are there for you until you move or die, or move on.
my insurance gives me 40 visits a year, which i have learned is actually very generous. there is no limit that says i can't go any after that. i've been going over 3 years (and typically exhaust my limit of allowed visits by May) and my therapy is primarily psychodynamic&cognitive. but that doesn't mean you need to go for 3 years. but it seems from what you have written that your hmo is extremely ignorant of mental health needs. i'm sorry you are having to deal with this.
terra
Posted by Dinah on August 12, 2002, at 22:58:33
In reply to Re: Lots, Medium or Dinky???, posted by Raven on August 12, 2002, at 22:23:30
Wow, that is really awful. :(
I wouldn't be at all happy about not even having the option of seeing her on a fee basis. What a terrible system. I mean I realize that most of us never intended to go to therapy for long, but still there should be an option to continue...
Well, I think your therapist should be helping you with this. She must have been aware of the guidelines, and needs to have structured the course of your therapy to help you as best she could within the prescribed limits, and that would certainly include leaving enough time for termination and resolution, not to mention providing suggestions for the future, such as possible referrals. I think she and you should press the HMO for that much at least, a proper termination. It is the therapist's job to take responsibility for a proper course of therapy.
I'd give her a call or email her with your concerns. Just my own (occasionally humble) opinion.
Posted by Raven on August 12, 2002, at 23:32:26
In reply to Re: Ouch. » Raven, posted by Dinah on August 12, 2002, at 22:58:33
Unfortunately, this isn’t a therapist that works under contract to the HMO. She is directly employed by the HMO and has no authority to do much of anything outside of the job description. She is currently required to take 6 new full time patients a week, and the old patients that she is able to retain, can’t be seen more than once a month...and those are few.
Ah, the old law of supply and demand:)
Posted by Dinah on August 13, 2002, at 7:03:08
In reply to Re: Ouch., posted by Raven on August 12, 2002, at 23:32:26
Sorry Raven,
I guess I just sort of hoped that if your therapist knew about the guidelines that she should have planned a termination phase, so that it wouldn't be so difficult for you. :( A year and a half is a long time, even if it was only once a month lately.)
Take care,
Dinah
Posted by waterlily on August 17, 2002, at 20:09:39
In reply to Lots, Medium or Dinky???, posted by Raven on August 12, 2002, at 17:22:42
Well, that really stinks! I'm having a bit of a similar problem, only not as bad. My insurance will let me see my therapist as long as my therapist thinks it's necessary, but my employer limits me to 20 visits a year - if medically necessary. I got the medical part covered, but the 20 visits a year doesn't cut it if your goal is to make progress. I could pay for more visits out of pocket if I wanted. I live in Virginia, where there is a mental health parity law. Insurance companies cannot limit therapy sessions if the diagnosis has a medical basis. However, my wonderful employer (a hospital) has chosen to self-administer our health plans, making them exempt from state laws. For such a well-respected hospital, I do not understand why they would shortchange their employees that way.
I've been seeing my therapist for a year and a half, so I've had something like 30 sessions, but my therapist thinks I'm resistant to therapy and expects that I could benefit from at least another year.
I feel so bad for you and wish you the best in getting through this situation. Take care.
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