Evaluating psychological treatment progress
How
many sessions are needed?
There
are many factors affecting whether a person will experience a
psychological “disorder”, how they will experience it, over what
duration and whether they will require some form of professional
intervention to get better. There are also a number of factors that
will influence how long it will take a person to get better, and
whether or not they will make a full recovery. These factors include:
- Type
of problem - diagnosis
- Severity
- Time since
symptoms first treated
- Support
networks – family, social, work
- Personality
- Motivation
to get better – are there secondary gain issues?
- Physical
health problems – e.g. drugs and alcohol, other significant
health problems
- Other
psychological health problems - pre-existing psychological injuries
- Pain levels
- Type and
appropriateness of treatment
- Skills
of therapist – over 80% of variance in treatment outcomes
- Rapport with
therapist
Despite
the many variables that can and WILL affect treatment outcomes, it is
possible to make some approximate estimates of how many sessions will
be needed or should be approved. With most psychological treatment it
is advisable that a maximum
of ten sessions is approved at a time and that a progress review
occurs after 5 or 6 sessions.
Frequency
of sessions is another issue worthy of comment. Most injured workers
requiring sessions at least weekly to second weekly at the beginning
of their therapy to reduce subjective distress and for the concepts
being taught to be reviewed, applied and monitored. As therapy
progresses sessions can be gradually decreased in frequency until
they can be eventually phased out all together. There may be times
however when further sessions are necessary – such as after a major
setback occurs due to re-injury, or when the person is suicidal. For
the majority of time however, it is important that the injured worker
is taught skills to be independent and to manage the residual
symptoms of their physical or psychological injuries through use of
their own support networks.
