To think it's unethical for a Psychotherapist to have a client for 15 years?

[canyoutellemehowtoget]

I've been looking for a therapist recently due to a trauma I experienced at work a year ago.

I had therapy when my marriage broke down a decade ago so I'm not completely new to it.

Had an assessment session with a private therapist recently to see if we were a good fit for one another. I asked him about his experience and - because he said he offers long term therapy as well as short term - for some reason I asked what the longest amount of time he's worked with a client is.

He said he'd been seeing a client for 15 years (weekly, not on and off - I checked).

I did like him, or at least could gel with him, but this just gives me weird vibes.

How can it be ethical to take someone's money weekly for a decade and a half? Surely the idea is to make progress and outgrow the therapy?

Sorry I meant to put this in AIBU

I’m planning to see my therapist for as long as possible. I’ve seen him on and off for around 4-5 years. I see him 6 weekly or a bit further apart and I intend to push that out further soon but it has been a very helpful experience and it has helped me to make necessary changes and get along with a significant grief. I don’t take medication. This is my version of taking medication.

Different therapeutic approaches have different aims. Not all are solution focused. The ethics of talking therapies don't include the length of therapy. If you know what ethical body this therapist is under you cream double check their ethics policy, should be on line.

Yabu. That’s up to the client

That will be mutually agreed between therapist and client though- you aren't under obligation to stay and its normal to review every so often whether needs are being met and if you want to continue or work towards an ending

Some people use it for 6 weeks, some people use it as an outlet for as long as they want- years and years. It might touch on unhealed trauma then other times just be about topical things that are going on in the clients everyday life

What if the client is vulnerable and being exploited, though?

I'm not saying that's the case here, but what if they are? What if they feel dependent and the therapist keeps taking their money instead of helping them to build their own coping resources?

If I could afford it, I would have therapy forever. It’s so useful to talk about rhjngs with a non involved party.

I know an absolutely fabulous therapist and she has a client she's seen almost as long as that. Some people have really severe trauma that takes this time to sort out. It's not a magic wand, sit & chat for 6 weeks and you're fixed. And as you heal the situation evolves and new things come up. Also, that therapist will be in regular contact with his own supervisor about the situation so yabu.

I've seen my therapist for nearly 5 years. I don't plan on stopping anytime soon. We have regular check ins where we discuss frequency, progress, whether to take a break etc.

These issues/attitudes would be seen during training and would be part of the education.

I’m a psychotherapist and my longest client has been for 5 years and is still going. I can easily imagine it taking 15 years or more.

It would actually be unethical for me to stop working with her because of the nature of her issues and diagnoses. My work is closely supervised by another psychotherapist of 30+ years experience and she regularly challenges me to justify how I am working and is completely on board with what I’m doing.

The fact is that mental health services in this country are lacking and people like my client who need ongoing support just to stay well enough not to be in hospital, don’t have anywhere else to go.

If it makes any difference I also charge her a reduced fee based on her income.

The Freudian approach is very long term and can give good results though it didn't work for Woodie Allen

I had a very unstable childhood and was repeatedly raped and groomed as a teenager. Multiple abusive relationships, drug addiction, mental health break downs etc. Is a miracle in Alive. I've spent the last 12-15 years in And out of therapy when I'm eligible for it for free, trying to come to teens with my bipolar and CPTSD and the abuse I've experienced. If I could have afforded it, I would absolutely be in therapy, with one good therapist, for the rest of my life. And even then I wouldn't have been able to unlock everything.

You are judging this patient of theirs by your own trauma standards and what you perceive to be as an acceptable recovery time. Simple truth is that some people never recover, but regular therapy helps them to function in the ways they can manage.

Sometimes, I imagine fairly often, people may have issues which they can learn to manage well but that they may have to live with to some extent- and having therapy in the long term may be part of their strategy to living with long term mental health problems/other issues.

I saw a therapist for about 4-5 years and only stopped because she stopped seeing private clients. I had to find a different therapist! It doesn’t mean my therapy hasn’t worked, but I do have long term issues relating to trauma earlier in my life- and I also have had some very stressful times in recent years which having a trusted therapist have made much easier to get through.

I’m a fully functioning member of society and I don’t think many people would realise I have long term therapy or any mental health issues! I’m also happy and balanced. I’d rather spend money on therapy than the cinema/gym/whatever because it improves my quality of life. Just to show it doesn’t necessarily mean something shocking for someone to have therapy long term.

If I won the lottery regular therapy visits would be one of my priorities.

Respectfully, you know nothing about my own trauma standards.

I'm no contact with my family due to sexual abuse.

I'm happy to hear opinions, that's why I started the thread. But please don't assume you know me.

I am a psychotherapist. I would seriously worry about dependence in these situations. I see my job as helping people to be independent of me and to be able to do for themselves what they get from their discussions with me. I would not want to enter therapy with someone who has this approach.

However, different modalities have different approaches and it may work for some.

To be clear, I am not saying you should not see your therapist on and off over years - I have clients like that myself and it is really helpful to have that experience with them - but weekly sessions? That makes me uncomfortable.

Ten years and counting. I’m sure I’ve helped pay for his holiday home. My life is unrecognisable from when I started.
Complex trauma. I have a lot to heal

Why didn't you ask the therapist that question at the time?

Interesting, thank you, yes, dependency was my worry. Psychotherapists wield a lot of power and should always be mindful of dependency. I didn't get a sense - when I was discussing this in the assessment session of how this therapist managed or mitigated dependency as as an issue, he actually seemed embarassed like he was admitting to something he shouldn't when he said 15 years.

Perhaps it was his demeanour that felt like a red flag rather than the length of therapy per se. Like he wasn't sure he could justify it for clinical reasons?

I never think that random questions like this add anything to a thread, so...

I’m a therapist. It can be entirely normal with some clients. With others it wouldn’t be right. However I have clinical supervision - all therapists should - who supports me with decisions and how I work. She would be questioning whether it was right to stay/end work with any client.

YABU. People are different. There is no one size fits all approach to life or therapy.

YANBU to have your own clear boundaries for the therapy and therapeutic relationship. It's really important that you feel as at ease as possible.

It’s certainly possible for clients to need decades of counselling and support, and it’s my view that if this leads to the client leading a better and more fulfilling life, and there is clear clinical need then of course most people wouldn’t object. Supervision will be in place.

However, you seem very dubious, unconvinced and perhaps uncertain of this particular psychotherapist. I would always encourage clients to trust their own feelings and instincts - and perhaps choose someone you are more comfortable with op?
It’s better that you are confident and trust your therapist, and do not enter the relationship with doubts and worries. You need to feel safe and comfortable first and foremost.

Yanbu.