It’s been a lifetime: let’s talk about long term therapy

By Felix Frain, Provisional Psychologist and Practice Manager

Mental health care policies vary greatly around the world, with about half of the global population having access to mental health support programs. Here in Australia, our Medicare system means that we’re included in that 50%, with mental health care plans providing government funding to support access to psychological therapy, amongst many other wonderful mental health support programs. 

As with all government policy and funding, certain limits are set, which means that the mental health care plan model in Australia allows access particular evidence-based psychological therapies, such as cognitive behavioural therapy (CBT), interpersonal therapy (IPT) and eye-movement desensitisation reprocessing (EMDR). One thing that these therapeutic models share is their time-limited and effective short-term outcomes. Much research has been conducted on the outcomes of these therapies, which are often beneficial over a set number of sessions, such as the Clark and Wells CBT model for social anxiety disorder, which states that 16 sessions are sufficient for effective treatment (Leigh & Clark, 2018)

Interestingly, the founding models of modern day psychological therapy emphasised the importance of the long-term to address the underlying psychological structures that are developed over the course of our lives, and subsequently influence our mental health. This emphasis on long-term therapy is supported by recent research, with Leuzinger-Bohleber and colleagues (2019) finding sustained improvement for those with long-standing depression following three years of psychoanalytic therapy (a long-term therapy model) when compared to equivalent short-term therapies. Similar outcomes have been found when psychodynamic (another longer-term therapy model) for conditions such as personality vulnerabilities and repeated experiences of trauma (D’Andrea & Pole, 2012; Fonagy, 2015). These longer-term therapies provide a space for individuals to deeply explore their intrapsychic world and the experiences in life that have brought them to where they are today. This can be a powerful and deeply healing process for individuals who engage in this type of therapy. 

Thinking about long-term therapy in the context of the Medicare system in Australia, a mental health care plan currently provides funding support for up to 10 sessions in a calendar year, which may pose a financial limitation for some in accessing longer-term therapy. Thankfully, the many available evidence-based shorter-term therapies through Medicare are highly effective in addressing psychological distress. There is, however, much benefit in long-term therapy as highlighted in this post, which may be worth exploring with a psychologist if this is of interest to you. Long-term therapy can provide you with the opportunity to develop new ways of coping with difficulties in life that may have been present from a young age all the way through to adulthood. By exploring these difficulties at a deeper level, you may find what has and has not been helpful in the ways you have engaged with different aspects of your life to date. By understanding yourself in this way, you may be better able to understand others, and given that humans are social creatures, we know this is definitely a huge benefit that can be seen as a result of therapy. 

At Excel Psychology, we have both behavioural and psychodynamic psychologists that can offer a wide range of treatment options, including long-term therapy. If you’d like to know more, go to our contact page and touch base, we’re here to help. 

D'Andrea, W., & Pole, N. (2012). A naturalistic study of the relation of psychotherapy process to changes in symptoms, information processing, and physiological activity in complex trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 4(4), 438–446. https://doi.org/10.1037/a0025067

Fonagy, P. (2015), The effectiveness of psychodynamic psychotherapies: An update. World Psychiatry, 14: 137-150. https://doi.org/10.1002/wps.20235

Leigh, E., Clark, D.M. Understanding Social Anxiety Disorder in Adolescents and Improving Treatment Outcomes: Applying the Cognitive Model of Clark and Wells (1995). Clin Child Fam Psychol Rev 21, 388–414 (2018). https://doi.org/10.1007/s10567-018-0258-5

Leuzinger-Bohleber, M., Hautzinger, M., Fiedler, G., Keller, W., Bahrke, U., Kallenbach, L., ... & Beutel, M. (2019). Outcome of psychoanalytic and cognitive-behavioural long-term therapy with chronically depressed patients: a controlled trial with preferential and randomized allocation. The Canadian Journal of Psychiatry, 64(1), 47-58.