Abstract
Limited capacity and high demand for mental health care drive efforts to improve the efficiency of treatment and increasingly result in predetermined time limits for treatment, even in government-covered treatment in welfare systems. How do clients experience having predetermined time limits for psychotherapy? We analyzed the transcripts of interviews with 18 participants who had completed a return to work (RTW) intervention based on emotion-focused therapy (EFT) that had predetermined time limits. The analysis identified four experiential trajectories through therapy with predetermined time limits, representing four narrative themes: Trajectory A: It is ok to stop here—Not wanting more therapy; Trajectory B: Seeing the benefits of continued therapy, but ready to give life a go without treatment; Trajectory C: Being on one’s own too early—Economic obstacles hindering the continuation of therapy; and Trajectory D: I need more than this—Securing continued therapy. Having the therapist communicate the timeframes for therapy clearly, while leaving room for individual tailoring of therapy, was experienced as very important by clients receiving psychotherapy with predetermined time limits.
Highlights
Mental health problems are a common and global challenge (Alonso et al, 2004; Steel et al, 2014) and create human suffering and reduce the life quality of those afflicted by them, as well as their families
Our analysis resulted in the construction of four different trajectories, or narrative themes: A: It is ok to stop here—Not wanting more therapy; B: Seeing the benefits of continued therapy, but ready to give life a go without treatment; C: Being on one’s own too early—Economic obstacles hindering the continuation of therapy; and D: I need more than this—Securing continued therapy
To highlight how the experiences shared by several participants could be associated with different trajectories for different participants, each trajectory is presented as a detailed narrative of the participants’ journeys through therapy and the way predetermined time limits influenced this, with sufficient contextual information to allow the reader to get a picture of the complexity of the experiences at the core of the four trajectories
Summary
Mental health problems are a common and global challenge (Alonso et al, 2004; Steel et al, 2014) and create human suffering and reduce the life quality of those afflicted by them, as well as their families. While research has shown that work ability, social support in the workplace, socioeconomic status, and positive expectations of returning to work facilitate RTW (Gragnano et al, 2018; Victor et al, 2017), mental health problems, themselves, have been found to pose a barrier for transitioning back to work (Gragnano et al, 2018), which indicates the potential of psychotherapy as an RTW intervention This notion is supported by recent research that showed a positive association (β .482) between the duration of time before initiating psychotherapy and the duration of sick leave in a large sample of persons diagnosed with anxiety and mood disorders (Alonso et al, 2018)
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