[gohat]

I've written a lot of articles in the health field (around 200), and, iirc, the efficacy data for therapy of psychoanalysis and CBT is similar, actually, again, now that I think about it, iirc, any psychological type of therapy (within reason) is roughly as effective as the other.

As such, from the insurer's side, which is preferable: one that lasts something like 12 weeks and has limited amount of sessions, or one that lasts years and can have 4 sessions a week?

People need to feel listened to, cared for, important - in one form or another.

[jdietrich]

This. CBT works as well as any other talking therapy, but is orders of magnitude cheaper.

As the article states, most talking therapies show the same efficacy, whether they involve six one-hour sessions or a decade of intensive analysis. To me, this is a clear indicator that nobody has beaten placebo and we really need a different model.

If we practiced surgery the same way we practice psychiatry, we would be routinely trepanning people if they seemed 'resistant to conventional treatment'. There is no sense in psychiatry that it is unethical to administer unproven treatments without clear informed consent. This has to stop. Psychotherapy needs to develop a firm framework to prevent patients from being subjected to pseudoscience, or it should be abolished and reformed from scratch.

To be blunt, psychoanalysts are vampires, extracting huge fees from vulnerable clients with absolutely no evidence justifying the time and expense. I see them as no different to psychics or faith healers. They obfuscate the argument by debating the merits of various therapies with no basis in neuroscience and no strong evidence of efficacy. We look back at the history of psychiatry and are horrified at what we see. I fully expect that our descendants will be horrified at how we practice psychiatry.

[j_baker]

If we practiced surgery the same way we practice psychiatry, we would be routinely trepanning people if they seemed 'resistant to conventional treatment'.

And if we practiced psychiatry the same way we practiced surgery, we'd give people MRIs, CAT scans, and plenty of other expensive tests every time they said they felt a bit sad.

[steve-howard]

4 sessions a week is always excessive. It's not that people don't need the help -- it's just that you need more time to process information.

[gnosis]

I don't know about that. It's not like people aren't "processing information" either during or after the therapy sessions.

And is 4 sessions a week really "excessive"?

Remember that most therapy sessions are only 1 hour long (sometimes as little as 45 minutes, or even 30 minutes long).

It can feel very rushed to have to cram a description of and then a discussion of everything significant that's happened to you in the course of a full week in to just 1 hour of therapy, especially if you are going through a very rough time where there's a lot going on (both external and internal).

That's why many therapists prefer "intensive therapy" (ie. more frequent or perhaps longer sessions) for people going through a crisis, and then advise less frequent sessions as their lives stabilize.

That said, I think 1 hour per week is the norm in most types of therapy. 4 hours per week is relatively unusual.

[steve-howard]

Not to tell too much about my life and the lives of those close to me, but two hours a week is the crisis setting. If a therapist tells you anything of value about the way you think or behave, it takes some time to think about what that can mean for your life.