If you've tried therapy, was it worth the $$$?

[bigvalboy]

[Rudynate]

$400/hour is WAY over the top when it comes to average price. I pay $125/45 minutes.

 

 

I think $400.00 is fairly typical for psychotherapy with an MD.

[+ TylerandAce]

“The best gift you can give yourself is a good therapist” was told to me by one of my treatment therapists at Gentle Path. I did A LOT of therapy during my coming out process. Being the product of the Southern Baptist meat grinder of Christianity, it took a lot of effort to untangle the truth from the misinterpretations about myself that I believed over the years. Talk therapy helped tremendously after I finally accepted the role it should play. Resisting was just a waste of money and time. I finally allowed myself to listen, embrace the process, and learn from others to eventually realize that I wasn’t defective. It took a while and was wickedly expensive. Having a primary counselor for years and then doing in-patient is an investment I’m glad I made. I hated every fucking minute of it, but in the end, it was well worth being able to watch my children grow and eventually marry the man of my dreams. So, while I agree that a good therapist is a great gift to yourself, it also depends how you receive that gift.

Edited December 31, 2017 by TylerandAce

[LADoug1]

I think $400.00 is fairly typical for psychotherapy with an MD.

 

You’re right. My psychiatrist charges $190 for a 20 minute medication check. God knows what he charges for psychotherapy.

[JayCeeKy]

I think it's important to note that M.D.'s (psychiatrists) do not specialize in "talk therapy" though most of them are very familiar with the various psychotherapy theories and techniques, especially CBT. Psychiatrists are trained in medication, not so much in talk therapy. It's very rare for a psychiatrist to offer an hour of talk therapy since most of them are paid by insurance companies who almost always refer talk therapy clients to a Social Worker or other Master's Level clinician - mostly b/c the reimbursement rate for Master's level clinicians are more in the range of $125 per hour versus a psychiatrist who can get that same amount for 15 minutes (10 minutes with the client to do a meds review, and 5 minutes for documentation). Some therapists obviously charge more, especially if they have developed a solid reputation in the community or whether they have some type of specialty (e.g. eating disorders, PTSD, Borderline P.D.).

 

As far as the efficacy of talk therapy, research shows that the best predictor of a positive therapeutic outcome is the therapeutic relationship. In other words, though it is not essential that you and your therapist are buddies, it is essential that you and your therapist develop a relationship that inspires hope, that engenders the needed commitment and "work" involved in the change process (which is what therapy is all about), and that the therapist is able to challenge you when you would rather suffer in your old ways rather than breaking old patterns of thinking and acting. Bottom line: if you don't like your therapist you probably won't make much progress and probably will drop out before you complete your treatment goals.

 

Most insurance companies today will pay for 12-16 therapy sessions, with the possibility of another 12-16 sessions if the therapist can justify it (and I do mean JUSTIFY IT). Insurance companies know that the research shows that Best Practices indicate that, in general, CBT, Solution-Focused, and other Behavioral Therapies are not only short-term, but also highly effective. That's why you find Psychoanalytical therapists (who focus on the unconscious and the past, and who insist that INSIGHT is necessary for change) in places like Beverly Hills and the East Side of Manhattan, because who can afford paying for 3 hours of therapy each week for twenty years to discover that your mother didn't love you enough?

[Rudynate]

I think it's important to note that M.D.'s (psychiatrists) do not specialize in "talk therapy" though most of them are very familiar with the various psychotherapy theories and techniques, especially CBT. Psychiatrists are trained in medication, not so much in talk therapy. It's very rare for a psychiatrist to offer an hour of talk therapy since most of them are paid by insurance companies who almost always refer talk therapy clients to a Social Worker or other Master's Level clinician - mostly b/c the reimbursement rate for Master's level clinicians are more in the range of $125 per hour versus a psychiatrist who can get that same amount for 15 minutes (10 minutes with the client to do a meds review, and 5 minutes for documentation). Some therapists obviously charge more, especially if they have developed a solid reputation in the community or whether they have some type of specialty (e.g. eating disorders, PTSD, Borderline P.D.).

 

As far as the efficacy of talk therapy, research shows that the best predictor of a positive therapeutic outcome is the therapeutic relationship. In other words, though it is not essential that you and your therapist are buddies, it is essential that you and your therapist develop a relationship that inspires hope, that engenders the needed commitment and "work" involved in the change process (which is what therapy is all about), and that the therapist is able to challenge you when you would rather suffer in your old ways rather than breaking old patterns of thinking and acting. Bottom line: if you don't like your therapist you probably won't make much progress and probably will drop out before you complete your treatment goals.

 

Most insurance companies today will pay for 12-16 therapy sessions, with the possibility of another 12-16 sessions if the therapist can justify it (and I do mean JUSTIFY IT). Insurance companies know that the research shows that Best Practices indicate that, in general, CBT, Solution-Focused, and other Behavioral Therapies are not only short-term, but also highly effective. That's why you find Psychoanalytical therapists (who focus on the unconscious and the past, and who insist that INSIGHT is necessary for change) in places like Beverly Hills and the East Side of Manhattan, because who can afford paying for 3 hours of therapy each week for twenty years to discover that your mother didn't love you enough?

 

 

I have an old friend who underwent a full, classical Freudian psychoanalysis that took over two years. She doesn't denigrate it in any way or feel that it wasn't worthwhile. Who knows? She might have been successful anyway without the analysis, but, for what it's worth, she is an exceptionally accomplished woman who will leave a lasting legacy in the field of civil rights/women's rights.

[MikeBiDude]

$400/hour is WAY over the top when it comes to average price. I pay $125/45 minutes.

This is about the rate I pay, but only $16 copay out of my pocket

[JayCeeKy]

She doesn't denigrate it in any way or feel that it wasn't worthwhile.

 

I wasn't denigrating psychoanalysis or its adherents. I was merely pointing out that it is not very cost effective and that the research shows that insight is not required to produce therapeutic change. And, insurance companies will not pay for therapy beyond a certain limited number of sessions. Insurance companies pay for the alleviation of specific symptoms (e.g. depression, anxiety), not for "insight." If you got the cash and the desire to invest in the long psychoanalytical process, and you find it beneficial, go for it.

Edited December 31, 2017 by JayCeeKy

[+ Gar1eth]

I think it's important to note that M.D.'s (psychiatrists) do not specialize in "talk therapy" though most of them are very familiar with the various psychotherapy theories and techniques, especially CBT. Psychiatrists are trained in medication, not so much in talk therapy.

 

While I think you are mostly correct, it does depend somewhat on the training program psychiatrists go to. I think there are still some -possibly only a few these days-that seem to be more talk oriented than others.

 

 

 

As far as the efficacy of talk therapy, research shows that the best predictor of a positive therapeutic outcome is the therapeutic relationship. In other words, though it is not essential that you and your therapist are buddies, it is essential that you and your therapist develop a relationship that inspires hope, that engenders the needed commitment and "work" involved in the change process (which is what therapy is all about), and that the therapist is able to challenge you when you would rather suffer in your old ways rather than breaking old patterns of thinking and acting. Bottom line: if you don't like your therapist you probably won't make much progress and probably will drop out before you complete your treatment goals.

 

As in everything, it’s an odds game. From personal experience I can tell you that I’ve liked the majority of my therapists, but that hasn’t made a difference.

 

Gman

Edited December 31, 2017 by Gar1eth

[+ FreshFluff]

I think it's important to note that M.D.'s (psychiatrists) do not specialize in "talk therapy" though most of them are very familiar with the various psychotherapy theories and techniques, especially CBT. Psychiatrists are trained in medication, not so much in talk therapy. It's very rare for a psychiatrist to offer an hour of talk therapy since most of them are paid by insurance companies who almost always refer talk therapy clients to a Social Worker or other Master's Level clinician - mostly b/c the reimbursement rate for Master's level clinicians are more in the range of $125 per hour versus a psychiatrist who can get that same amount for 15 minutes (10 minutes with the client to do a meds review, and 5 minutes for documentation). Some therapists obviously charge more, especially if they have developed a solid reputation in the community or whether they have some type of specialty (e.g. eating disorders, PTSD, Borderline P.D.).

 

As far as the efficacy of talk therapy, research shows that the best predictor of a positive therapeutic outcome is the therapeutic relationship. In other words, though it is not essential that you and your therapist are buddies, it is essential that you and your therapist develop a relationship that inspires hope, that engenders the needed commitment and "work" involved in the change process (which is what therapy is all about), and that the therapist is able to challenge you when you would rather suffer in your old ways rather than breaking old patterns of thinking and acting. Bottom line: if you don't like your therapist you probably won't make much progress and probably will drop out before you complete your treatment goals.

 

This guy seems to have a lot of training in psychoanalysis.

 

I share the same doubts about this method, but the fit appears good (for now), and I felt that the fit is more important than the method. This is my first time doing this other an a couple of CBT sessions right after college, so I have to learn as I go. As for insurance, that's irrelevant for me as he doesn't take it, and my HMO doesn't cover out of network.

Edited January 1, 2018 by FreshFluff

[pubic_assistance]

As was stated here previously. A good psychotherapist helps you to help yourself. A professional will bring you to re-evaluate how you experience the world based on the origins of how you started ( blame your mother). Many of us hang onto childhood insecurities well into our adult years, causing anxiety because we don't give ourselves enough credit to be able control our environment and our destiny as an adult. The main thing to accept when considering therapy is that like going to the gym..it's a no pain/ no gain situation. You need to dig up a lot of things you didn't want to remember in order to get rid of their negative impact on your life.

[Golem]

the best predictor of a positive therapeutic outcome is the therapeutic relationship.

This can't be emphasized enough.

 

It doesn't just mean liking your therapist, because this relationship is itself an actual, on-the-table component of almost any successful therapy. So you need someone who you find it easy to communicate with, and who you trust to be "on your team" even when providing tough feedback.

 

Re training background and particular therapeutic techniques: the majority of therapists identify as having an "eclectic" theoretical orientation, meaning that they draw from multiple schools of thought, including both directive therapies (like CBT) and evocative therapies (like psychodynamic approaches). I wouldn't, however, write anyone off based on their training. There are certainly some MDs (= psychiatrists) who focus solely on meds, but I've known multiple psychiatrists who have been incredibly insightful on a non-biological level and have emphasized talk and relationships.

[Walker1]

I have never been to one, but might benefit.

To be honest, one of my fears was that you will be labelled as a crazy person with a record for life, if you use your work insurance. Just my upbringing, where only crazy people needed a "doctor".

 

But I wouldn't know where to start or what to address. Do they do exploratory sessions to see how you are built emotionally etc/

 

I did date a wiccan dude once, who introduced me to all kinds of psychic healing, crystal healing, spells etc-nothing worked-but it was a fun experience.

 

I wouldn't know where to start-I think all my experiences in life and looking at several deaths of those close to me, I realize life is passing. The rest of the stuff, we do the best we can-as long as I am able to go along without falling apart and in decent shape, should be good.

 

While not religious, I do think we have a soul and some sort of God/the force /great blob of matter - I don't know if psychiatrists discuss those beliefs or are purely clinical?

[LADoug1]

I think it's important to note that M.D.'s (psychiatrists) do not specialize in "talk therapy" though most of them are very familiar with the various psychotherapy theories and techniques, especially CBT. Psychiatrists are trained in medication, not so much in talk therapy. It's very rare for a psychiatrist to offer an hour of talk therapy since most of them are paid by insurance companies who almost always refer talk therapy clients to a Social Worker or other Master's Level clinician - mostly b/c the reimbursement rate for Master's level clinicians are more in the range of $125 per hour versus a psychiatrist who can get that same amount for 15 minutes (10 minutes with the client to do a meds review, and 5 minutes for documentation). Some therapists obviously charge more, especially if they have developed a solid reputation in the community or whether they have some type of specialty (e.g. eating disorders, PTSD, Borderline P.D.).

 

As far as the efficacy of talk therapy, research shows that the best predictor of a positive therapeutic outcome is the therapeutic relationship. In other words, though it is not essential that you and your therapist are buddies, it is essential that you and your therapist develop a relationship that inspires hope, that engenders the needed commitment and "work" involved in the change process (which is what therapy is all about), and that the therapist is able to challenge you when you would rather suffer in your old ways rather than breaking old patterns of thinking and acting. Bottom line: if you don't like your therapist you probably won't make much progress and probably will drop out before you complete your treatment goals.

 

Most insurance companies today will pay for 12-16 therapy sessions, with the possibility of another 12-16 sessions if the therapist can justify it (and I do mean JUSTIFY IT). Insurance companies know that the research shows that Best Practices indicate that, in general, CBT, Solution-Focused, and other Behavioral Therapies are not only short-term, but also highly effective. That's why you find Psychoanalytical therapists (who focus on the unconscious and the past, and who insist that INSIGHT is necessary for change) in places like Beverly Hills and the East Side of Manhattan, because who can afford paying for 3 hours of therapy each week for twenty years to discover that your mother didn't love you enough?

 

I see a psychiatrist for meds. He’s excellent. But I have had a bit of conversation with him which borderd on psychoanalysis. He’s not good at it. I doubt he’s had proper training in that area.

[LADoug1]

This is about the rate I pay, but only $16 copay out of my pocket

 

 

WOW! You have great insurance!

[+ FreshFluff]

Is it bad that I fantasized about him? We're not even at the transference stage yet!

Edited January 2, 2018 by FreshFluff

[+ Gar1eth]

Is it bad that I fantasized about him? We're not even at the transference stage yet!

Does that mean you decided to start therapy? Possibly you mentioned this. But it’s a long thread, and I might have missed a post or three.

 

I’ve always had a problem understanding the concept of transference. Or at least-when I hear it described-it seems like textbooks and therapists reserve this concept for what happens between a patient... pardon me, I think we are supposed to be clients now. The Latin root of the word patient is of course pati which means ‘to suffer’. So of course we who were formerly patients need a name change to clients for the comfort of the 1% or less who know what the root of patient is.

 

But as I was saying-I’ve never understood why this concept of transference is reserved for the therapist/client relationship. It seems to me that transference-if it is real at all-must happen frequently in most relationships. But maybe I’m wrong. It wouldn’t be the 1st time.

 

Gman

[amused1]

I saw my first practitioner 40 years ago. I've seen a number of them over the years. Some more effective than others. I've experienced any number of modalities, possibly all of them at this point.

 

My advice is this, work with someone who inspires you to think and work. As a prior poster said, expect homework and smart goals. If you aren't finding these in your experience move on.

 

Be honest with the therapist about why you feel the relationship isn't working for you. A good therapist should accept this with no qualms. You might even consider asking that person to recommend another therapist.

 

My best wishes to you.

[+ quoththeraven]

I've never found a therapist who was more helpful than working through things myself was. But I'm also both introspective and impatient.

 

Also non-directive therapists drive me crazy.

[Golem]

I’ve always had a problem understanding the concept of transference... I’ve never understood why this concept of transference is reserved for the therapist/client relationship. It seems to me that transference-if it is real at all-must happen frequently in most relationships.

You're right -- transference is definitely not reserved for client-therapist relationships, and does indeed happen frequently in most relationships.

 

The basic idea is just that we unconsciously "transfer" elements of our old, formative relationships, to interactions we have with people who are currently in our lives -- perhaps in the form of how we experience them, or assumptions we make without realizing it, or just the emotional cadence or expectations we bring to those interactions.

 

The reason transference is most often discussed in the context of therapy is because it is, again, a critical, on-the-table component of most psychotherapy. It is deliberately watched for in that context (which we don't usually do, elsewhere). A good therapy session thus plays a double role. On the one hand, it has a detached, reflective, analytical side to it, where you can sort out what's going on in your life with a third party who is external to it. At the side time, it is a hands-on laboratory experiment. Your interaction with the therapist is both the tool you use to shed light on your life, and a big part of what you use that tool on.

[+ FreshFluff]

I'll answer my own question. The problem with being attracted to the guy is that it makes me want to edit what I say, which obviously defeats the entire point. It sure is motivating though.

 

The reason transference is most often discussed in the context of therapy is because it is, again, a critical, on-the-table component of most psychotherapy. It is deliberately watched for in that context (which we don't usually do, elsewhere). A good therapy session thus plays a double role. On the one hand, it has a detached, reflective, analytical side to it, where you can sort out what's going on in your life with a third party who is external to it. At the side time, it is a hands-on laboratory experiment. Your interaction with the therapist is both the tool you use to shed light on your life, and a big part of what you use that tool on.

 

Interesting perspective. I hadn't thought of the interaction with a therapist as an experiment.

[+ FreshFluff]

As a prior poster said, expect homework and smart goals.

 

Is that true for psychoanalysts too? How would I ask for that?

[Golem]

Depends. Are they doing actual classical psychoanalysis with you (which is in many ways the epitome of non-directive therapy), or are they doing analytically-informed psychotherapy? If the former, you're unlikely to get homework no matter how you ask for it, and they definitely won't define goals for you. If the latter, you could probably just ask for it directly.

 

"Homework" as a term, and where you have a specific assignment to practice a specific skill, is pretty much a CBT thing. If you want it, ask for it; but I wouldn't expect most psychotherapists to automatically "assign" it every week and definitely wouldn't discount a therapist because they don't. Similarly, there may be a limit to how "smart" your goals can be on day one. Whether you and your therapist set very specific goals (and then update them as needed), or start with a more general, exploratory attitude before identifying what is truly at the heart of things for you, is a question of style and preference as much as anything.

[+ FreshFluff]

Is it bad that I fantasized about him? We're not even at the transference stage yet!

 

This turns out to be a problem. My advice: Go with a plain one.

[bigvalboy]

This turns out to be a problem. My advice: Go with a plain one.