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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by LauraG on September 27, 2004, at 21:18:46
Last week my T told me she is shortening sessions by 5 min. to 45 min (they are now 50min, which I thought was standard). This is the best place for me to ask, how long are your sessions with your T's?
I got very angry at her for shortening sessions. I've been going to her for 2 1/2 years. Apparently I had "a big reaction". I'd be surprised if I was her only client to get mad. I'm not sure if I was more angry that she is making our time together shorter or that she would not tell me why she was doing it. I guess she doesn't really owe me an explanation. It just seemed that she didn't really care that I was hurt or angry about it. She never tells me she cares about me (I saw how other T's express that to some of you in another thread, and I wish I had that too). She only calls me if I call and ask her to, not to check on how I'm doing. Sorry.... She's a good T I think. Reading some of the posts here makes me wish she did a little more. She has VERY strict boundaries, I think even no touching. She never shook my hand when we first met.
Anyway, did I have the right to be mad? It feels like she thinks I overreacted due to something in my past.
Thanks!
Posted by Pfinstegg on September 27, 2004, at 21:44:06
In reply to T is shortening sessions!, posted by LauraG on September 27, 2004, at 21:18:46
My T does 45 minute sessions, and I've come to think that they are more common now than the *old* 50 minute sessions. That said, you have every right to be absolutely furious! Your T should be well-prepared for your reactions, and willing to help you work through them for as long as it takes.
Posted by alexandra_k on September 28, 2004, at 0:18:41
In reply to T is shortening sessions!, posted by LauraG on September 27, 2004, at 21:18:46
I think that my reaction to reduced session length would be to get upset and of course to wonder why on earth that had to happen for. My experience of sessions is that they last 60 minutes, but by the sounds of it I am lucky there. My guess would be that it is typical to schedule clients one after the other so a 50 minute session would allow 10 minutes for writing up session notes, going to the bathroom etc. Maybe your T thinks things would run more smoothly if she had 15 minutes instead of 10.
If this is the case then you may find that the 'quality' of sessions improves. Perhaps perhaps...
I would suggest that you ask her why she is doing it.
I think that your response is understandable, but it may be more extreme due to events in your past. It may be helpful to examine those, but that is not to undermine your understandable reaction at all.
Posted by gardenergirl on September 28, 2004, at 0:42:07
In reply to Re: T is shortening sessions! » LauraG, posted by alexandra_k on September 28, 2004, at 0:18:41
I think what alexandra k has a good theory here. I know that in several places where I have worked doing therapy and in a different health care provider field I was under pressure to meet a certain goal of billable hours. I know this sounds so danged cold and unrelated to the therapy experience, but maybe that extra five minutes will help her stay on track.
But I really think she should provide some reason and be prepared to handle the repercussions from clients. I'm sorry that didn't happen.
gg
Posted by Aphrodite on September 28, 2004, at 6:54:30
In reply to T is shortening sessions!, posted by LauraG on September 27, 2004, at 21:18:46
I have a very unusual situation in which my self-employed T does 70 minute sessions for the same fee. He says he can't get anything meaningful done under an hour. I think this causes him to sacrifice one potential patient a day, but he's clearly not in it for the money. I don't think anyone could be.
Forty-five minutes sounds very short, and I think your reaction is legitimate especially in context with other things she has done that feel uncaring to you. Be sure to tell her it's not just about the shortened sessions, but other things as well. It sounds like she really needs to do some explaining about her feelings and philosophy. Good luck.
Posted by mair on September 28, 2004, at 7:24:47
In reply to Re: T is shortening sessions! » LauraG, posted by Aphrodite on September 28, 2004, at 6:54:30
I've always assumed that 50 minutes was the norm and that's what I've always had. However, I've also wondered how anyone could regroup, write notes etc. with just a 10 minute interlude. My therapist takes notes during our sessions so she doesn't have to do that, but still.... Whether I think 45 minutes would be adequate depends on how hard a time I'm having communicating. When I can't seem to talk alot, 50 minutes seems an eternity. When were having a really productive exchange, the time flies by. 50 minutes does seem pretty short, at least for psychodynamic therapy.
As to the other issue, I think you have every right and then some to be angry that this switch has been made mid-stream. As a long time patient, you are minimally entitled to a reason. About a year ago, my therapist raised her fees, and she went to great pains to explain to me why she had to do that.
Mair
Posted by Annierose on September 28, 2004, at 8:21:52
In reply to Re: T is shortening sessions!, posted by mair on September 28, 2004, at 7:24:47
I live near a large city and most T's sessions around here are 45 minutes. I wish 50 was the norm in this area. That extra 5 minutes could come in handy sometimes. And yes, I think the T should expect some reaction from you and work it through.
Posted by morning*bell on September 28, 2004, at 8:35:39
In reply to Re: T is shortening sessions!, posted by Annierose on September 28, 2004, at 8:21:52
My sessions are 45 minutes, although if something incredibly tough is being discussed, she'll definitely go over the 45 and not charge me. It's usually only by 5 or 10 minutes though.
It also doesn't seem that she schedules patients back to back. I am thinking there are gaps in her schedule to get work done though.
morning*bell
Posted by Daisym on September 28, 2004, at 11:12:50
In reply to Re: T is shortening sessions! » LauraG, posted by Aphrodite on September 28, 2004, at 6:54:30
I just have to say that I don't know how you last for 70 minutes all the time, Aphrodite. There have been some sessions where I wished we had another 20 minutes or so. But most of the time I'm so exhausted and looking to escape after 50. And when I can't talk at all (like yesterday) the clock just drags. I even offered to leave after 30 minutes yesterday. Of course, he thought that was a bad idea and we did get a little work done.
But, 70 minutes of that? Shudder, shake, shake!
Posted by Aphrodite on September 28, 2004, at 11:42:52
In reply to Re: T is shortening sessions! » Aphrodite, posted by Daisym on September 28, 2004, at 11:12:50
Now you know why I quit all the time! ;) Seriously, we're both quite talkative, so it works out -- it keeps the momentum going. I don't know how *he* does it, though.
Posted by LauraG on September 28, 2004, at 14:01:40
In reply to Re: T is shortening sessions!, posted by morning*bell on September 28, 2004, at 8:35:39
Thanks all!! It would be great if the quality improved! That would be my responsibility I think, to get to my issues right away when the session starts. I have a tendency to not do that. I must be the poster child for the resistant client!!
I'm very glad that you guys feel I deserved an explanation. I even asked her again yesterday and got her reply of something like "It would only cloud your honest reaction." I do get the sense that she wants to get to the bottom of why my honest reaction was so strong, so that's a good thing!
I have to agree with Daisy too. I think 70 min. would feel like an eternity! But then again, some days it would probably fly by.
Funny, I have mentioned to her about feeling like she doesn't care b/c she doesn't tell me. She asked me where was the evidence that she doesn't care. Other than that she doesn't say it, I was blank. I told her I just felt like it was implied. So we had a discussion (unfortunately near the end) about why I feel that not being told someone cares means to me that they don't care. Sigh. Not sure we answered that well enough yet. It seemed to go to my mom not expressing positive things to me very often as a child. But I still wonder if I would feel the same way about not being told someone cares even if she had. Seems to me I'd still want to hear that someone cares!
This whole therapy thing is still so confusing to me!
Posted by vwoolf on September 28, 2004, at 14:12:42
In reply to Re: T is shortening sessions!, posted by LauraG on September 28, 2004, at 14:01:40
I would love longer, 70 minute sessions. We seem to talk non-stop all the way through most sessions, which are 55 to 60 minutes. A couple of times my T has allowed the session to go over 60 minutes, but I start to freak about boundaries, and make her stop. Oh dear. I also understand nothing about this process.
Posted by Speaker on September 28, 2004, at 16:32:46
In reply to Re: T is shortening sessions!, posted by vwoolf on September 28, 2004, at 14:12:42
I do double sessions at least once a month. That way if I want to bring up something emotional I don't feel booted out the door with my emotions, a kleenex, and a see you next session. I'm sure it has to do with being left to deal with everything alone when I was young but I would never risk opening up if I knew I was done in 45 min. My insurance pays a certain amount of visits per year and I feel like the double sessions are the best way around the limited number of sessions. I also think it's funny that when we do a single session it's 50 min. but a double is 110...the T still only needs the 10 min. before the next pt.
Posted by 10derHeart on September 28, 2004, at 17:42:09
In reply to T is shortening sessions!, posted by LauraG on September 27, 2004, at 21:18:46
First,I absolutely agree w/everyone - you had every right to be upset! *Every* minute is precious. Even when I was *cheated* out of 10-15 minutes once or twice for various reasons, not completely his fault, but still..., it caused major angry discussions as I didn't even try to disguise being upset.Not relating to your situation (thank goodness) but on this topic, get this: my former T. is in a new job(2.5 months)in outpatient psych. at one of the larger VA hospitals in the US. He told me he's had to compress 45 mins. to 20 mins.!! THAT's the craziest thing I ever heard! But not the first time I've heard it from a T.; apparently it's a growing trend in some places. Sheesh, it took me 20 mins. just to begin to get comfortable! Ridiculous, IMHO, but he's having to adapt and wondering if therapy will be as effective. I hope to ask him again in a few months how he thinks it's working. I can't imagine.
Posted by shrinking violet on September 28, 2004, at 18:32:13
In reply to It Could be Worse...., posted by 10derHeart on September 28, 2004, at 17:42:09
I'm sorry about your situation, LauraG. I hear that 45-50 mins is pretty standard, though. I never really understood that logic: something as intense as therapy should be at least 90 mins, unless it's more than one session per week. But, that's just my opinion.
As for me, I see my T at the Uni where I'm a grad student. I usually get a whole hour, sometimes 5-15 mins over. Tonight though, I "only" got 45 mins. I haven't seen her in 2 weeks, and tonight's session was pretty light, I guess, and I didn't say much, so....It still kind of bugged me, though. This doesn't happen often, but sometimes it does; usually during sessions where I hardly talk at all. Then, conversely, during the (rare) sessions I'm a bit more talkative, she usually ends up going over the hour. Hm....reward vs punishment? It feels that way...But I probably won't bring it up unless it happens with some regularity.
I think your T should at least give you an explanation, though.
Good luck.
Posted by shrinking violet on September 28, 2004, at 18:57:11
In reply to Re: It Could be Worse...., posted by shrinking violet on September 28, 2004, at 18:32:13
Posted by shortelise on September 28, 2004, at 20:02:29
In reply to T is shortening sessions!, posted by LauraG on September 27, 2004, at 21:18:46
Mine started out at 60 minutes and a couple of years later he shortened to 50 minutes. I prefer because he is now more relaxed, has had some space to breath sometimes, and also we can go over by ten or fifteen minutes and it doesn't cut too badly into the next person's time - or into mine if I am the one waiting while he deals with someone who needs more time that day.
Do you have the right to be angry? Yup. But in my opinion, you have to talk about it with your therapist.
Sneaky, eh?
Sorry it upset you, but I do think changes like this are upsetting when they happen at certain delicate points in therapy. It's just the way it is. Your T must know this and be prepared to work it through with you.
Hope it goes ok.
ShortE
Posted by JenStar on October 1, 2004, at 11:37:48
In reply to T is shortening sessions!, posted by LauraG on September 27, 2004, at 21:18:46
hi Laura,
sorry you were upset!I think that many T's schedule solid packed days of back-to-back clients, and having only 10 min betw. each one doesn't always give enough time for bathroom breaks, water breaks, and most importantly, time to reread notes and reflect on the next person.
Sometimes if they don't have adequate prep time between clients they aren't "up to speed" or don't have enough time to do the mental switch from one person to the next.
Leaving 15 min. might mean she'll be more relaxed & better prepared for YOU and won't waste time thinking about the previous client, or wishing she could have a snack, or trying to remember what you said last time. Hopefully it will make your T sessions better! :)
But definitely ask her. Probably, if she's like most people, she'll feel bad that YOU feel bad and will rush to explain so that you don't need to stress about it further.
good luck! :)
JenStar
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