Therapists have a secret that they would rather most people not know.
Up to 40% of new psychotherapy clients never come back for a second session.
While many therapists would consider such single session clients “failures,” but the fact is that given how often it happens, they …
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Could we see a bit of a self fulfilling prophecy here? one plans for 1 session interventions so more clients fail to return? On the other side of the coin you could argue that this begins to take the steam out of the ‘drugs are cheaper than psychotherapy so that’s what I’ll prescribe’ attitude. Interesting…
” Others likely just find the therapy experience not helpful to their needs, not what they expected, or disliked the particular therapist they saw ”
Or perhaps they moved to a different therapist and didn’t stop after a single session after all.
True, but from a therapist’s perspective, that would’ve been a “one session” client unless told otherwise.
Most people don’t know this, but it’s okay to not like the first therapist you go and see. So many people build it up in their minds that they feel they can’t go through it all over again with a different therapist, even if it’s obvious there’s no connection or rapport between the therapist and client.
One needs to shop around for a good therapist, just as one would for any health professional, be it a dentist, family doc, etc.
I know a fair few people in therapy and it isn’t at all uncommon for people to see 10 or 12 before finding someone who they felt they could work with. That isn’t (in the significant majority of cases) either the therapist or the patients fault – it is just a matter of fit. Good fit can be hard to find.
I have seen a fair few therapists in my day and I’d say that I’d have a fairly good idea of whether we clicked or not after that first session. I’m well aware that therapists who I didn’t click with clicked really well with some of their other patients. I was surprised, however, at how many therapists thought that because I was seeing them once I was seeing them for the long haul.
That was one thing that really clicked well for me with my current therapist: He said that in the initial session we would see whether we felt we could work together. It was a mutual decision. He asked me some questions. He asked me if there was anything I’d like to ask him. He asked me what I’d like to work on / talk about. Of course that approach might not click well with other people… I guess different people are different. Some might like to focus on one particular problem in that first session, but others might not.
Therapists are like pest exterminators: it’s always in their best interest to NOT fix the problem. The toxic psychodynamic model has so infested nearly all approaches that therapists consistently report finding themselves stunned and skeptical when a client actually gets better. Or worse, gets better without the therapist!
George I think you are on the money! Unfortunately I have seen too many therapists show too much attachment to the money or to their therapeutic approach, instead of looking at what helps the client and what state they are in. The only exception seems to be those understaffed, underfunded therapists, eg in university campuses, hospital clinics and so on. For them they have to get so much done in such a short time the problem tends to be the opposite- kicking the patient out as soon as he passes the actue phase, to help the next suicidal character!
Most therapists I have seen just listen and say uh huh. They thought I just wanted to be heard but what I wanted was real change. My problems are difficult to solve as I have a severe chronic physical illness and anxiety and depression as well. I have found my own way of coping and wouldn’t waste money on therapy again. I was often looking for love and friendship which is a mistake in therapy. I would imagine a lot of people seek those things from their therapist. A good therapist will help the client find their own resources and social connections so that therapy is no longer needed. Clients usually have relationship problems which brings them to therapy. Thank God I am now my own best friend.
Speaking as a single session patient myself I can tell you that after seeking out help for my depression and then actually following through with the appointment and being able to talk with candor about my problems with a complete stranger made me realize that I had a large measure of control when it comes to my mental health, far more than
I had given myself credit for. So even though I wasn’t particularly impressed with the therapist I got the sense of empowerment
I needed from a single visit and have been alot better and more able to head off my mental problems before they become so since that single visit 8 months ago.
Actually, “single session” in the published literature is defined as clients who do not return for a second session but, upon follow-up up, have not pursued further therapy. In fact the 30 – 50% that found a single session helpful never went back for further treatment — one session was enough. (See Talmon, 1990, Bloom, 2001; Hoyt, 1995.)
I believe some individuals find one visit enough because all they need is a totally objective viewpoint about whether their feelings and actions are moving in the right direction after having a crisis in their life. Many times I don’t think it has to do with the therapist, at all. When they listen well and stay objective, the individual will find their way through the muck and mire. If that isn’t accomplished on the first visit, then certainly there could be more.