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Lengthy wait lists to see a psychologist a problem? Attending therapy sessions a problem?

Lengthy wait lists to see a psychologist a problem? Attending therapy sessions a problem?

Here’s an option:
Chapman Marques Psychology is now offering Focused Acceptance and Commitment Therapy (FACT)1. This therapy developed from the “third wave of CBT” – Acceptance & Commitment Therapy (ACT). The FACT approach, within the brief therapy tradition, allows a psychologist to see more patients for a shorter time with outcomes comparable to lengthier therapy.

Debunking Five Myths Concerning Individual Psychological Therapy

Dr Kirk Strosahl, Dr Patricia Robinson and Thomas Gustavsson, in their 2012 text, Brief Interventions for Radical Change, debunked the assumption that therapy must take a lengthy period and demolish five commonly held myths concerning psychological therapy, offering an empirically validated rationale.

1. Patients want lots of therapy

Normally they don’t! Therapy is inconvenient for most patients. Not to mention too costly for many. The most common number of therapy sessions (the statistical mode), world-wide and across all therapies, for all categories of difficulty, that patients attend is … one! (cf. Brown & Jones, 2005; Talmon, 1990). A single session!

Most patients end their therapy quickly anyway – with or without the therapist’s agreement. Thirty to forty percent drop out of therapy without consulting their therapist (Olfson et al, 2009).
Only a small number of patients prefer long-term therapy (Strosahl et al, 2012). Most patients prefer brief therapy (Strosahl et al, 2012).

2. Degree of change is dependent on amount of time in therapy

It is a commonly held belief in the mental health community that the longer patients undertake therapy, the more benefits they gain. Howard et al. (1986) debunked this myth. They found that 15% of patients can have clinical improvements after booking an appointment even before the first session. Their study has been ignored. Baldwin et al. (2009) found that patients who engaged in brief treatments had relatively rapid rates of change compared to those in longer-term treatment.

3. The longer the therapy, the more powerful the effects

Not so! Molenaar et al (2011) showed that a long-term improvement in social functioning in depressed patients could be achieved in half the time. Similar results have been shown with anorexia (Lock et al, 2005); childhood conduct disorders (Smyrnios & Kirby, 1993); PTSD (Sijbrandij et al, 2007); panic disorder (Deacon a& Abramowitz, 2006); depression and a wide range of anxiety disorders (Cape et al, 2010). Strosahl et al, 2012) note that overall, research suggests brief treatments are just as effective for the same disorder as longer treatments. It could be said: the more effective the therapist, the shorter the therapy.

4. Brief Therapy is a superficial intervention with few long-term benefits

Research studies have demonstrated this is not correct (Baker et al, 2005; Bryan, Morrow & Appolonio, 2009). Strosahl, Robinson & Gustavsson (2012) comment that “the process of therapeutic change is not well understood and may in part be influenced by the subtle or not so subtle communications and expectations of the therapist”. If the patient hears a particular issue is going to take a long time to treat they may dutifully, if unconsciously, comply with that expectation.

5. Rapid, large clinical gains are rare in therapy

Again, research studies give the lie to this myth. Research by Doane, Feeney & Zoellner, (2010) and Tang, DeRubeis, Hollon, Amsterdam & Shelton (2007) estimated between 40% to 45% of patients can experience sudden, large gains in 2-4 treatment sessions. Similar gains have been noted in patients with PTSD (Doane et al, 2010, 52%); binge eating (Grilo, Masheb & Wilson, 2006, 62%); IBS (Lackner et al, 2010). Long term improvements in functioning as well as reductions in relapse rates were found in research by Crits-Christoph et al, 2001; Lutz, Stulz & Kock, 2009; Tang et al, (2007); and Renaud et, 1998). The evidence for rapid gains has also been established by a meta-analysis conducted by Aderka, Nickerson, Boe & Hoffman, (2012).

What can be concluded from this research?
Brief Focused Acceptance & Commitment Therapy can be:
o more accessible
o less time consuming
o less expensive
o just as effective as longer therapy
o more convenient for the patient
o less costly to the tax-paying public
o more effective for short attention focus teens
o less stressful for patients with focusing difficulties (e.g. ADHD).

FACT can be undertaken via telehealth where not contra-indicated.

Cost: $130 per 30-minute session. Medicare rebate on MHCP: $63.55. Out of pocket: $66.45 (Rates can change over time. Check current rates and rebates).

If you are interested, contact Chapman Marques Psychology at Belconnen Specialist Centre. 1 Some conditions may require longer single sessions or several sessions. FACT may be unsuitable for some patients and some presentations.