45 minutes not long enough

[Peanut]

Thanks...actually, one thing that my therapist did tell me that really helped was he asked me if I was surprised at how these family members were acting.? I thought about it and said that I really wasn't all that suprised.? He then told me "In crisis situations people rarely act better than they normally act"

I've thought of that a number of times and I don't know why but it really helps.

 

[comfortzone]

Sounds like you have a good therapist! I like that statement. Thanks for sharing it.

 

[Peanut]

I should change the topic of this thread to 40 minutes not long enough.? My only major complaint with my therapist is that almost every single one of my sessions is 40 minutes OR LESS.? My initial appt was 45 min, then a couple 40 min, one 20 minute phone call (I couldn't go in because I was throwing up and I had to talk to him on the phone so he could bill the ins.).? Then, I went in one last time and 30 minutes through the session I look at the clock, and he asked me if I was anxious to get going!? I think it's more like he was anxious to get done early.? It's really weird.? I drive 45 minutes each way and sit out front and wait for my appt for another half an hour.? Weird Weird Weird

 

[comfortzone]

I would certainly address this issue with your therapist Toeless. You could say something like, "I have noticed that you have been decreasing the time we spend in session." "When this happens, my anxiety increases." "I would prefer to keep the sessions at 45 minutes as I seem to do better when we do." Your time is valuable and your time addressing your concerns is just as important too. Go over the phrases I spoke of and try them out for yourself. Keep us posted. Take care,

 

[Peanut]

Is this time thing normal for therapists? Do you often cut visits short if you feel like the person doesn't need it? I think that he may not know what direction to go in, like maybe I don't have enough problems. He asked me "What should we focus on now?" Which was a little strange since the marijuana use is totally unresolved and unimproved. He said it sounded like I didn't have problems associated with the use and that I didn't have a problem with it (which I think came off that way because, like in on of Eunoia's posts, I don't want to quit 100% so sometimes it sounds like I don't want to). I go back and forth about it but we hardly talked about it in therapy at all. I'm not sure...maybe he wants to terminate therapy? I couldn't really tell and I wasn't sure if I should go back, so I didn't this week. I'm really puzzled. Last night I had a dream that I ended the session instead of him and it worked a lot better=)

I know I should say what you told me to, and I thought about it for awhile, but I don't think I can! Knowing me I probably won't say anything until it bubbles over and I say too much! I mean, I don't want to force this guy to be around me if he doesn't want to be, you know? Maybe I'm boring him with my lack of real problems.

 

[comfortzone]

Hi Toeless,

I would not end a session unless I knew that the client was overwhelmed. I typically keep the sessions right between 45 to 50 minutes depending upon the "flow" of each session. Flow meaning where the client takes the session. It sounds like your therapist is trying to be nondirective and allow you to "steer" the therapy sessions. You might need to let him know if you have any difficulties with his approach. I think it is typical for clients to move from wanting to quit and maintaining attendance. Therapy as you know brings focus to the issues that you might feel uncomfortable handling...but the difference is that you are not alone in handling these situations, feelings and thoughts.

You are not forcing the guy to be around you...and I truly doubt that you are boring to him. These perceptions you have are important to bring up. Your experience in the therapy are ways for you to work through past issues by how they are impacting you today. Issues that arise in therapy that involve your therapist give you a chance to build and to strengthen your understanding of yourself in relation to others in your life. I would like to encourage you to return to your therapist. I realize going is difficult but the alternative is even far more difficult. You take care and I will be thinking of you,

 

[Banned]

My therapist has tried to end early a couple of times. I too find it disconcerting. When he says "Well maybe we should stop here today" one of two things happens - either I tell him I haven't told him everything I need to tell him, or if I actually don't have anything else to say, when I pay him I deduct the 15 minutes. On the flip side, if we go over time I pay that as well. I count on my hour, and if it was a regular occurrence of him ending early, I would have a huge problem and flat out ask "why are we always ending early?" Thankfully it's not a regular, ongoing problem. Usually we actually go over, but when he ends it early, I think to myself "where does he need to rush off to today at my expense?"...I guess I figure if I'm booked for an hour, I deserve that hour, no matter how productive or unproductive it might be. It's my hour.

 

[Peanut]

Thanks for validating my thinking that my therapist was acting a little strangely.? Now I don't feel like I'm being as unreasonable.?

and I truly doubt that you are boring to him

?
That makes me feel a lot better...I hope that you are right!? That is one of my worst fears with therapy...that he is thinking "why is this boring girl here" or "oh no, not her again".? People always tell me that if there is one thing about me it's that my life is definitely not boring.? It end up feeling like added pressure to be entertaining.?

It sounds like your therapist is trying to be nondirective and allow you to "steer" the therapy sessions

That is good to know...maybe the reason everything is getting 'touched on' and nothing is getting 'dealt with' is my fault.?? It's like I'm so bent out of shape about the time constraints that I hesitate to delve into anything for fear that it will eat up all the time.?

BG, I was going to quote a bunch of what you said but I think I'll just respond to the whole thing and say that is EXACTLY how I feel about the situation.? I could not have said it better.? I whole heartedly agree with everything you said and those are my setiments exactly.? I'm really glad you posted that.? It made me feel a lot better.?

It just feels like I have to come up with something MORE exciting to say aside from all of the drama going on in my life.?

I was just having a really hard time telling if I am being difficult (which not doubt is possible) or if he is not fulfilling his 45 minute obligation (literally).? Like you said comfortzone, I guess I should ask him but I just get so jumbled when I go in there.? Often my heart starts pounding fast in the waiting room and I also start sweating a lot, touching my face and hair, and well, I'm sure you get the picture.?

Do you think that if he wanted to terminate me that he would have came right out and said it, or do you think that maybe that was what he was hinting at me not coming back and wasting his time when he referenced me 'no longer thinking the smoking was a problem and what did I want to focus on now' ??

 

[comfortzone]

You are most welcome! Talking things out with your therapist is important. Then if things don't improve after a few more sessions you could find someone else if necessary.

None of my clients are boring. I find each person I meet interesting and worth knowing. Try not to allow the time frame to distract you from the areas of your life that you would like to explore.

I think if he wanted to terminate with you that he would be right up front and would then refer you to another therapist. I don't think he would try to give hints regarding this issue. I might suggest before going into your sessions that you sit down and write somethings you would like to discuss. This way you are prepared to talk about these topics. Then if he moves you on, you can say something like, "I am not finished with that topic." Building this therapeutic relationship is important. Time needs to be spent on developing rapport, which can take a while. I have one client that it took her nearly six months of getting to know me before she began to share her more specific details. I hope this helps as I so hope for you to be able to bring healing to your life. Best wishes,

 

[David Baxter PhD]

I usually end up going over time rather than ending early, but it does sometimes happen if we have reached a point where I think going on to the next step/issue will take more time than I have before my next appointment. Since some sessions inevitably go over time, it all evens out.

 

[ThatLady]

Every session with a psychologist/psychiatrist is not the same. Some of them feel as though a major breakthrough has occurred, while others don't give us that same "thrill". It doesn't necessarily mean there has been no progress. Often, it means that the gain is more subtle. Since you've just started with this counsellor, you two will have to get to know one another. That is accomplished through each encounter, whether or not that encounter results in a feeling of "Wow! I think I've got a better handle on <pick your issue>". In my experience, even those sessions where it seemed to me that nothing was accomplished turned up later to have been much more fraught with meaning than I realized.

 

[Peanut]

I usually end up going over time rather than ending early

That would be my inclination too.? Not just for therapy, but even with the work that I do, I get paid to go somewhere for x amount of time and work with someone and I never end early, I always err on the side of a couple extra minutes.? Or like if you go buy a pound of candy, they give youat least a pound, not 3/4 of a pound and call it good!

I guess that's why I don't understand it, I would not do it that way and it does not feel good to have it done to me.

 

[comfortzone]

The reason I don't go over the 45 minutes is that I have clients booked back to back.? This is the way I have to do it to be able to pay my bills.? If I run over on the time I am most likely going to affect the next client and it could be like a domino effect on all of the subsequent clients.? When I was in therapy I was disturbed when my therapist went over (and into my time) with the previous client before me.? I think this is why I try to stick with the 45-50 minute session.? I want to be respectful of all of my clients.? I have only stopped a session several times prior to the normal length.? One of these when my client (now former) suddenly became (unprovoked) verbally abusive toward me. The longest that I would allow an appointment to go is 90 minutes as that is typically the limit on billable hours.? Private pay would be different.? However, the majority of my clients are Medicaid recipients. Like I have said before, I do have clients that want longer sessions but I am not able to do this due to the limits GIVEN to me by Medicaid.? I am only allowed 45 sessions per client per calendar year.? If I do go over, then it eats into the 45 sessions.? It is something I would address with your therapist so that you can work through your feelings and bring closure to them.? Take care,

 

[JA]

As Dr. Baxter said, my sessions are usually longer, rather than shorter. Then again, I'm doing an unpaid internship, so I have more time in-between sessions and less constraints, wich makes that easier. When I did end sessions early, it was usually because I felt like my client had had enough, either because the session had been intense and the client seemed overwhelmed or because I had clients who didn't like to sit down for a long period of time. If I ever thought of ending a session early because of my personal schedule requirements, I would advise my client of this at the begining and apologise for not respecting our engagement (never happened yet).

As far as the 40 minutes not being enough, I can understand that you feel that way and I thing I'd have trouble giving 40 minute therapy sessions (mine are 60-90 minutes). However, maybe short sessions have a certain advantage too. It may be easier to remember what went on and to learn from every part of the session when it's shorter... I sometimes worry that with long sessions, my clients will forget important aspects if we go over more than one or two. Also, as another member has said, sessions are only part of the therapy process, what you do in between them (at least, in my way of doing therapy) is also very important. I try to avoid going over too many things in one session, because I like to give my clients a chance to practice what they learned before we move on to something else. So another reason why I sometimes end a session early is feeling that the client has learned enough for one time.

All this to say, I guess, that I think there are many reasons why a therapist could be choosing to end sessions early... talking to him about these concerns would be the best way to know what is going on... sometimes, progress is really boosted by an honest conversation. I understand, however, that confronting someone is really hard. If you're better on paper, maybe you could write him a letter? I don't know, just a thought.

I wish you the best of luck in getting better and having productive therapy sessions!

 

[Peanut]

The longest that I would allow an appointment to go is 90 minutes as that is typically the limit on billable hours

I was not aware that insurance could be billed for different amounts of time.? Maybe that is something I should look into.? I only get x amount of appointments and now I'm wondering if they can be any length I want up to 90 minutes.?

I think after talking it over with all of you guys, I will simply say "I'm finding myself getting very anxiuos about the time constaints because I feel like I don't have enough time to talk about anything in depth so I just keep glazing over topics and going from one thing to another."

Maybe that will be enough.? Hopefully he can take it from there.? If he ends early after that than that will be the last straw!

 

[comfortzone]

How many sessions are you permitted? For Medicaid, the additional 30 minutes comes from the total of 45 sessions.

I would definitely bring up your anxiety regarding the time constraints. I think you statement of "glazing over topics" is key to your situation. Some of your anxiety could be relative to sharing your life experience with a new person. There are variables that need to be addressed in therapy and you have to be the one to bring these up so that your therapist knows about them. If you don't, it will be you who ends it prematurely. I wonder how often that you find it difficult to communicate your feelings to others? Your therapist may not know how you are feeling and you have to enlighten him so that he can help you through these important topics.

 

[Peanut]

I am permitted 36 and probably have about 28 left. I wonder if it's legal to just pay the excess amount in cash on top of the usual billing and copay.

Typically I do not have trouble communicating my feeling to others as long as they don't pertain to intimacy. When intimacy comes into the picture I have extreme difficulty. But I was hoping that he could address that so I don't have to!! My natural inclination is to just not go there so I really can't see myself bringing it up! I would just sink right into that big white chair and die right then and there!

I also find it extremely difficult to communicate dissatisfaction TO someone directly, so that may be why I'm having such a hard time telling him too.

 

[Lost]

Toeless, I wish your grandmother better too.

Back to the original topic, my therapist does 50 minute sessions.

Altho I find the time always flies when with her, she has helped a lot. ?I've been seeing her for around 5 months now. ?And I also remember doubting in the beginning whether she was actually helping and accomplishing anything.

 

[Peanut]

Thanks Lost I appreciate that.

And apparently the consensus is that my therapist does the shortest sessions ever in the history of psychotherapy.

I can see it now, on Thursday after twenty minutes he'll say "Well, it sounds like you're really busy, are you anxious to get those things done now?...let me walk you out" Actually, he probably won't say anything because most of the time he just STANDS UP and says nothing! I'm going to try that when I have guests that are overstaying their welcome! It seems to work like a charm!

 

[Lost]

lol!