<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>magicalhippo</author><text>&amp;gt; If a therapist isn&amp;#x27;t willing to work with you in the first couple of sessions to create a specific, measurable, achievable, relevant and time-bound plan for your therapy, you should be very wary.&lt;p&gt;I have a friend who&amp;#x27;s been in therapy for over a decade, due to debilitating anxiety from childhood trauma.&lt;p&gt;Went many years to first before switching to second, same story. I asked &amp;quot;well have you gotten any tasks or tools to help you deal with it?&amp;quot; multiple times, always same answer: &amp;quot;No&amp;quot;.&lt;p&gt;Third time lucky it seems. Now seeing a therapist which comes with concrete suggestions and tasks. Things have improved. It&amp;#x27;s not a trivial problem to solve, but at least there&amp;#x27;s change now.&lt;p&gt;edit: You may ask, why stay with the therapists that didn&amp;#x27;t help? Anxiety... didn&amp;#x27;t want to upset the therapists by suggesting it wasn&amp;#x27;t helping.</text><parent_chain><item><author>jdietrich</author><text>Nearly all of the clinical benefits of psychotherapy are delivered in the first few sessions. Some studies suggest an &lt;i&gt;inverse&lt;/i&gt; correlation between duration and effect size - people in long-term therapy may have worse outcomes than people who complete a short course of therapy.&lt;p&gt;Psychotherapy is an effective treatment for most common mental health problems, but if you&amp;#x27;re going to therapy for more than 12-18 weeks, you&amp;#x27;re doing something other than treating a mental illness. You&amp;#x27;re likely getting something out of it otherwise you&amp;#x27;d stop going, but that thing isn&amp;#x27;t improving your mental health in any meaningful way and may be actively causing harm.&lt;p&gt;I&amp;#x27;d strongly encourage people to try psychotherapy if they&amp;#x27;re experiencing psychological distress, but I&amp;#x27;d also strongly advise them to go in with a clear sense of what they&amp;#x27;d like to achieve. If a therapist isn&amp;#x27;t willing to work with you in the first couple of sessions to create a specific, measurable, achievable, relevant and time-bound plan for your therapy, you should be very wary. Therapists who advocate an open-ended approach that eschews goal-setting and objective outcomes in favour of a nebulous sense of &amp;quot;insight&amp;quot; or &amp;quot;growth&amp;quot; aren&amp;#x27;t delivering evidence-based care and aren&amp;#x27;t acting in the interests of their clients.&lt;p&gt;&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.cambridge.org&amp;#x2F;core&amp;#x2F;journals&amp;#x2F;the-british-journal-of-psychiatry&amp;#x2F;article&amp;#x2F;duration-of-psychotherapy-has-little-association-with-outcome&amp;#x2F;CD51BB442A15328952834A5B1FCE7DD0&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.cambridge.org&amp;#x2F;core&amp;#x2F;journals&amp;#x2F;the-british-journal-...&lt;/a&gt;</text></item><item><author>foxfired</author><text>I hesitate to comment on these threads, because no one wants to take the risk of saying anything adverse. &amp;quot;What if I say something bad about therapy? would this cause someone else not to see a therapist and end up dying?&amp;quot;&lt;p&gt;But I will say this. As people are becoming more lonely in a crowd, as they can&amp;#x27;t silence the noise in an empty home, as they can&amp;#x27;t find someone to listen to them even when they surrender, therapy will be the only outlet. You often see the cases in japan where people rent friends.&lt;p&gt;It&amp;#x27;s not that therapy is bad (it&amp;#x27;s pure luck if you find the right therapist), it&amp;#x27;s that there was a solution for the problems it is trying to solve. A community. And the friends that come with it.</text></item></parent_chain></comment><story><title>Therapy as a way of aligning with your subconscious</title><url>https://ava.substack.com/p/therapy-as-a-way-of-aligning-with</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>ramraj07</author><text>Good therapists don’t schedule constant weekly checkins for folks who don’t need it. I’ve had times when my therapist said check in after 4 months to see if things are fine.&lt;p&gt;Therapy works for people who need a lot of help to barely get to normal. It also helps a lot for people who would typically be classified as just fine, but they still want to become better people.  I’m in that category. I hope none of us believe we are already the best we can ever be, there’s always room for improvement. If that’s the case, why wouldn’t you want to continue working with a professional to try and figure out how that can happen?</text><parent_chain><item><author>jdietrich</author><text>Nearly all of the clinical benefits of psychotherapy are delivered in the first few sessions. Some studies suggest an &lt;i&gt;inverse&lt;/i&gt; correlation between duration and effect size - people in long-term therapy may have worse outcomes than people who complete a short course of therapy.&lt;p&gt;Psychotherapy is an effective treatment for most common mental health problems, but if you&amp;#x27;re going to therapy for more than 12-18 weeks, you&amp;#x27;re doing something other than treating a mental illness. You&amp;#x27;re likely getting something out of it otherwise you&amp;#x27;d stop going, but that thing isn&amp;#x27;t improving your mental health in any meaningful way and may be actively causing harm.&lt;p&gt;I&amp;#x27;d strongly encourage people to try psychotherapy if they&amp;#x27;re experiencing psychological distress, but I&amp;#x27;d also strongly advise them to go in with a clear sense of what they&amp;#x27;d like to achieve. If a therapist isn&amp;#x27;t willing to work with you in the first couple of sessions to create a specific, measurable, achievable, relevant and time-bound plan for your therapy, you should be very wary. Therapists who advocate an open-ended approach that eschews goal-setting and objective outcomes in favour of a nebulous sense of &amp;quot;insight&amp;quot; or &amp;quot;growth&amp;quot; aren&amp;#x27;t delivering evidence-based care and aren&amp;#x27;t acting in the interests of their clients.&lt;p&gt;&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.cambridge.org&amp;#x2F;core&amp;#x2F;journals&amp;#x2F;the-british-journal-of-psychiatry&amp;#x2F;article&amp;#x2F;duration-of-psychotherapy-has-little-association-with-outcome&amp;#x2F;CD51BB442A15328952834A5B1FCE7DD0&quot; rel=&quot;nofollow noreferrer&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.cambridge.org&amp;#x2F;core&amp;#x2F;journals&amp;#x2F;the-british-journal-...&lt;/a&gt;</text></item><item><author>foxfired</author><text>I hesitate to comment on these threads, because no one wants to take the risk of saying anything adverse. &amp;quot;What if I say something bad about therapy? would this cause someone else not to see a therapist and end up dying?&amp;quot;&lt;p&gt;But I will say this. As people are becoming more lonely in a crowd, as they can&amp;#x27;t silence the noise in an empty home, as they can&amp;#x27;t find someone to listen to them even when they surrender, therapy will be the only outlet. You often see the cases in japan where people rent friends.&lt;p&gt;It&amp;#x27;s not that therapy is bad (it&amp;#x27;s pure luck if you find the right therapist), it&amp;#x27;s that there was a solution for the problems it is trying to solve. A community. And the friends that come with it.</text></item></parent_chain></comment><story><title>Therapy as a way of aligning with your subconscious</title><url>https://ava.substack.com/p/therapy-as-a-way-of-aligning-with</url></story>