On The Cost Of Therapy And The Subjective Assessment Of Its Effectiveness

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Lately I've been thinking a lot about the cost of therapy, its effectiveness and subjective assessment.

I was in a situation when therapy cost little for me, when it cost a lot, clients came to me for whom my price was low and those for whom my price was high. And I'm not talking about some objective yardstick here, but rather about the client's subjective assessment and its impact on therapy.

I noticed that when therapy was cheap for me, I treated it with a slight negligence - I could chat about interesting, but not very important, I could cancel the session at the last moment because I was tired or I didn't want to. And the payment for the missed session in this case did not bother me much. "Well, I'll pay, what problems."

The low cost of therapy is half the trouble. Well, a person works a little more relaxed, well, he resists himself wherever he wants, well, he treats therapy a little superficially, like entertainment. He is a client, he has every right.

The situation is much worse when therapy is too expensive. Inside the head, every person has an “internal accountant” who measures “expenses” and “incomes”. If, according to this accountant, therapy is “expensive,” then great results are expected from it.

Here, a “savior effect” is possible, when a client comes to therapy and thinks “okay, I’ve found a professional, now he will set my brains right and everything will be fine with me”. It is clear that the client in this case is in a passive position, that the therapist is not able to change his life, and after a while the client observes the lack of results, becomes enraged, and either devalues the entire therapy or a particular therapist “I thought you were a magician, but you deceiver”. And such clients go and look for the next most omnipotent therapist … The attitude “I'll pay you a lot of money, and you will do it cool without my participation” does not work in therapy, just as the idea of sacrificing to the god of therapy “I will spend 10,000 dollars and my life will be better” …

There may be another option - the therapy costs the same, but the client's financial situation has changed for the worse (or the therapist has raised the price). Subjectively, therapy starts to cost more. Then the ratio of satisfaction = effect / cost changes.

if earlier the effect was 10, and the therapy cost 10, then satisfaction was = 1.

If therapy now costs 12, then satisfaction becomes 10/12 = 0.83. Although the process of therapy itself and its quality are conditionally unchanged. And the client says “something my therapy is ineffective”, “I don’t feel any changes”, “I think you are not working well with me”.

There is also a third option - this is the option of competing needs. We are seething with different needs, and the resources of money, time and effort are usually limited. And then we compare how much benefit or pleasure we will get if I spend the same amount on psychotherapy, or on a cafe with friends, or on a new gadget.

And it also happens - therapy or new boots, instead of the current ones, therapy or aikido for a child, therapy or finally getting a filling at the dentist. It seems to me that therapy will be assessed as necessary and effective when the client has closed those needs that are basic for him and are in the list of needs lower than psychotherapy or self-development.

Actually, everything in life changes and often at the same time - both the quality of the therapist's work, and the client's involvement, and the client's ability to implement changes in his life, and the financial component … It seems to me important to understand all these factors and take them into account when analyzing dissatisfaction.

Sometimes it seems paradoxical - the person was with an experienced, expensive professional, left him for someone who was a beginner and unknown and is satisfied. Does this mean that an experienced professional is bad and a beginner is a genius? Not at all. The ratio of satisfaction = effect / cost has simply changed.

Sometimes it is important to notice a change in your financial capabilities and take a break to cover your basic needs. With current boots or a hole in a tooth, the need to regularly pay a significant amount for “talking” will be so irritating that it can ruin the whole therapy. And there will be devaluation, accusations and grievances instead of an adequate pause or a change of specialist.

And sometimes it is important to pay more so that the money given away feels like something valuable, so that in return the “internal accountant” requires effect and changes and pushes you to take real steps, and not just pleasantly talk to an interesting person.