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?

YABU. People have different levels of trauma, as you have said you know. If I found a good therapist, I'd not shop around after a certain period of time.

It's not at all a random question. Therapists are used to answering questions like this. If you feel comfortable with the therapist then you should feel able to raise it directly with him.

My MIL worked with a lot of trauma clients and many were long term.

One of her long term clients at her memorial was full of praise on how much MIL helped her.

YABU.

Irvin Yalom talks about different needs of clients and different approaches to this in one of his books - maybe Love’s Executioner, I can’t remember. He says how some saw him for short times and some for much longer.

Also I think some see therapy as a life long regular maintenance thing like exercise or eating well but for the mind. Others see it as a short focused group of sessions to see them through a rough patch. For others therapy is a sort of re-parenting exercise, and there’s so much that was lacking in childhood that it takes a long time to work through defences to even reach a place where they can relax into trusting the therapist and experiencing dependency before learning to branch out into the world again. It can be a journey from codependency through to dependence through to interdependence.

This is the best article I’ve read about dependency of the re-parenting type of therapy - www.howtherapyworks.com/blog/attachment-to-your-therapist

I was referring to your random question.

Thanks, this has been a helpful thread.

I think that this must have been more to do with him and his demeanour in disclosing than the length of time, per se. He seemed embarassed and then went on to tell me that the client had "a lot of problem in the present" but was "in a better state when they left therapy than when they started".

Which I think also made me feel red flaggy because aren't they not supposed to not talk about their other clients?

You did ask and that's hardly outing!

You seem.very suspicious of him.though. im not sure.it will be conducive to a good therapy relationship. Maybe approach another?

I didn't 'ask' for a clinical history of their client.

I asked, when you say you work with both long term and short term clients could you give me some parameters about what that means.

And he said well short term could be as little as 6 weeks then randomly gave me a potted history of his longest client, which I most definitely did not ask for.

Well, quite. I have already spoken to others, I'm just discussing my thoughts here with others.

I'm sure she'd find an issue any other therapist as well based on her snippy responses to other posters who have reasonably challenged her.

Some people go to therapy for solutions/closure, others go as an ongoing positive way of expressing their thoughts and feelings on a regular basis.

*with any other therapist

I mean, I'm seeing my counsellor for 6 years consistently, and before that had some shorter periods with her.

As we glacially move through the divorce process, I need her more than ever. Our sessions are fundamental to me being able to cope.

Although I don't expect to see her forever, I think it's certainly not going to end any time soon. Post-divorce, I know we hope to return to some issues to do with my childhood.

While sadly my marriage was abusive & traumatic, ultimately it's nothing 'terrible' or deeply sensitive. Apart from helping me deal with my marriage, she's allowed me to understand myself & where I want to grow & develop

I think I can see having counselling as something I continue to do throughout my life, with varying degrees of frequency.

You sound incredibly judgmental.

That's excellently put.

This.

If doing something like yoga helped your mental health, you might do that forever no? Would that be unethical too?

This too! Therapy has such a stigma 🙁 it’s like saying going to a dentist for many years is unethical!

Yabu, I'd love to have a constant therapist

I’m of the opinion of ‘whatever gets you through’, if it helps you live a normal and happy life and you can afford it absolutely do it. I very much agree with the yoga analogy. Some people pay for Reiki (which is clearly absolute bollocks with no scientific basis whatsoever) but if it makes you feel better, why not, no judgement here.

I might have felt the same - and I think v reasonable not to click with this particular therapist - but I've just clocked up a total of 4 years with my therapist, mostly fortnightly, and I don't see myself stopping at the moment. I'm tired of the car crash situations I used to get into and I would say my life is significantly better for being in therapy. I tried to stop for a bit mainly because of money, and though I had some useful tools to use, I hit a whole new string of issues and felt that I wasn't as capable as I would like to be of taking useful action. I'm also another one who goes to therapy as a replacement for medication.

I now see regular therapy as part of a package of ways i take care of myself - exercise, hairdresser, manicures, a cleaner, dentist.... We also have intermittent couples sessions too. We started it to get through a crisis but realised how helpful it was to navigate the tricky bits of life (especially my ex, who continues to find new ways to be nasty even years after we split)

I think I would have found this weird, too, OP. It sounds like he's not the right therapist for you.

I've always thought of therapy as a time-limited thing, the idea being that you heal to an extent that you can manage to negotiate life on your own. Even if it takes ten years or more to get to that stage, the goal for me is to leave therapy.

Reading others' comments on this thread is thought-provoking. Seeing therapy as a form of health support like a yoga class - that's not something that's ever occurred to me but it is quite persuasive. On the other hand, I'd be worried about being dependent on therapy. I've always been very independent. Lots to think about, though.

Good luck with finding someone who's right for you, OP.

I don’t see the scenario you’re talking about as ethical or unethical (like others have said, people use therapy on different ways, complex trauma, life also doesn’t stop whilst in therapy.. you can spend 5 years and feel ready to end and then suffer a serious of blows).
Reading what he said about the other client immediately sat badly with me - I think that is very off. But I’d put that all aside. as you are starting to get to OP, something about it didn’t feel right to you.
if, aside from this, you like him I would bring it up with him. Tell him what you felt and see how he copes. The relationship will either strengthen or weaken.

I’m a therapist and do mostly longer term work. Average client term tends to be between 18 months-3 years, mostly complex work, usually involving childhood trauma.

It’s hard to make a judgement about whether a 15 year therapist-client relationship is ok or not. It depends on the therapist’s modality, the client’s history and presenting issues (which obviously he can’t say anything about, and it would be a red flag if he did). I have a good friend who has been in therapy with the same therapist for 10 years and they feel that they will always need a therapy relationship in their life for various reasons. I can’t see anything harmful at work there, because I know and understand their situation and the reasons behind them wanting that. But of course, we have to be careful of dependency and we must balance client autonomy (including their autonomy to choose to continue working with us long term) with the risk of dependency, what happens if we move away/become ill/no longer able to practice etc.

Ultimately, there’s no way to say if it’s ok or not unless you are privy to that therapeutic relationship, which of course none of us can or should be.