Why do clients stop seeing their therapist when they need help?
Franco Greco • November 5, 2019
The Productivity Commission (the Commission) estimates that there are 3.9 million people with mental illness in Australia. 2.9 million people access mental health care services.
One in five people will experience mental ill-health (diagnosable mental illness and mental health problems) in any year. Over their life time, one in two people will experience mental ill-health.
1 in 8 visits to GPs are related to mental health issues.
About 1.2 million people access Medicare-subsidised psychological therapy through the Better Access program.
However, one in three only attend one or two sessions, dropping out due to the out-of-pocket cost or difficulty finding a suitable provider.
Most clients - while are not constrained by the service limit - do not receive sufficient psychological therapy to achieve a significant and sustained improvement in their condition.
Many just get one or two sessions before they drop out. Aboriginal and Torres Strait Islander people were more likely than the overall population to have only one session (22% compared with 17%) (Commission estimates). On average, consumers received 4.5 sessions of individual therapy in 2018.
People cease therapy before they are better for several reasons.
I have provided a few reasons below and some suggestions for clients and therapists to adopt to minimise the risk of ceasing therapy:
4. Client fear and resistance to change -
if a client comes in with concerns about treatment or is unsure what is going to happen in therapy, then the therapist can seek to provide that client with some education to help him or her feel more comfortable. If a client is feeling anxious about sharing some of his or her feelings, then the therapist can work hard to foster the therapeutic alliance and to increase that client's motivation for treatment. Putting strategies in place early on in treatment before the dropout actually happens.
If you have any questions on this article or the Draft Mental Health Review or wish to schedule a free initial consultation you can contact me at Your Psychologist at the following link:
https://www.yourpsychologist.net.au/appointment-request
One in five people will experience mental ill-health (diagnosable mental illness and mental health problems) in any year. Over their life time, one in two people will experience mental ill-health.
1 in 8 visits to GPs are related to mental health issues.
About 1.2 million people access Medicare-subsidised psychological therapy through the Better Access program.
However, one in three only attend one or two sessions, dropping out due to the out-of-pocket cost or difficulty finding a suitable provider.
Most clients - while are not constrained by the service limit - do not receive sufficient psychological therapy to achieve a significant and sustained improvement in their condition.
Many just get one or two sessions before they drop out. Aboriginal and Torres Strait Islander people were more likely than the overall population to have only one session (22% compared with 17%) (Commission estimates). On average, consumers received 4.5 sessions of individual therapy in 2018.
People cease therapy before they are better for several reasons.
I have provided a few reasons below and some suggestions for clients and therapists to adopt to minimise the risk of ceasing therapy:
1. Cost of therapy -
Therapy can impose a significant burden on the clients. There will be times when a client will not be able to afford therapy. This is often experienced as shame, and embarrassment by the client. The role of the therapist in this context is to create an environment where an issue like this can be discussed. In fact, this issue may be an opportunity to build the necessary level of trust required for successful treatment. The opportunity to discuss – and where appropriate negotiate - the cost and payment for treatment could remove this barrier associated shame and embarrassment and build trust.
2. The therapist -
some clients do not establish the necessary therapeutic rapport with the therapist to which they are referred, and then drop out. Yet we know from the research that half of the treatment effectiveness is due to the therapist factors (such as building a safe, trusting and learning environment). Less than 3% of those who received MBS rebated psychological therapy in 2018 went to more than one provider (Commission). Increased client choice of therapist would better sustain a strong ‘therapeutic alliance’. Therapist also needs to be open and attentive and to this issue and the potential barrier to a client's treatment and ask the client about how they are 'feeling about the sessions?
3. Not seeing the benefit from therapy -
Some clients may feel they are not getting benefit from treatment. Therapists could do more to demonstrate the benefit of therapy, for example by regularly measuring client outcomes and sharing these with clients. Therapist can also engage with the client on the process of treatment, the aims in the approach they are taking ... this provides valuable insights to the client and encourages a learning mindset and framework for the client to use beyond the treatment sessions. Also by talking about the process of therapy, it promotes the expectation that eventually 'we will be able to address these problems and take care of things.' It gives the client a goal to work toward right from the beginning. It reminds them that in maybe six months or a year they may be done.
If you have any questions on this article or the Draft Mental Health Review or wish to schedule a free initial consultation you can contact me at Your Psychologist at the following link:
https://www.yourpsychologist.net.au/appointment-request
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