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How should therapists 'dose' therapy?
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Thomas L Schwartz, MD posted:
You can advocate for yourself once you know this. I posted a tip before on how to dose meds for depression, what about therapy? I wouldn't keep you on the same med for years if it wasn't working. If after 3-4 months a med isn't helping, we change meds.... When should you change therapy?

1- start with any therapist you like. Ask if they use time limited short term therapy, or open ended long term. If the latter, ask how long is long term...
2-work with your therapist weekly for 8-12 sessions. Often patients feel they don;t click, have some conflict and quit therapy too soon.. Just like patients quit meds too soon... A key to therapy is to discuss that you feel you are not getting along or there are conflicts in the therapy itself. sometimes it is not the content of what happened to you during the week that is important to discuss, it is the process of dealing with your therapist that is actually the therapy!
3- if you are not at least partially better after about 6 months, seriously ask your therapist what chance you have of responding to their therapy techniques. Consider adding a med, add a group therapy that uses a different style or skill, consider changing therapists.
4- if you are not better at all after a year, really consider a new therapist who uses a different therapy style. It doesn't mean your therapist is poor at doing therapy, it means the therapy style isn't helping you. If you are gradually improving, even at a slow pace stick with the therapist forever- as long as you are improving. Some therapies can take several years, but expect to see gradual imprvement.
5. Like using antidepressants, some meds don't work for some people. So, we switch and add meds around. Some psychotherapies do not work for some people either. know when to stay in and know when to get out. Have this discussion with your therapist if you feel stuck.

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Caprice_WebMD_Staff responded:
Thanks for this very good info, Dr. Schwartz.


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