Understanding Unconventional Therapy Sessions: Is A 4-Hour Session Normal?

As someone who often finds themselves in deep therapeutic sessions, the concept of a 4-hour therapy session initially seems out of the ordinary. However, when a close friend begins experiencing such extensive therapy time with their new therapist, the question inevitably arises: is this normal?

What Constitutes Normality in Therapy?

The idea of normal in therapy is quite subjective, depending largely on the dynamics between the therapist and the client. Given that your friend's therapist allows as long a session as needed, while charging for just one hour, this arrangement may initially sound unconventional. Yet, such boundaries can be crossed without necessarily being violated.

Context Matters: Boundary-Crossing vs. Boundary-Violation

A boundary-crossing does not necessarily equate to a boundary-violation. Clients require different interventions at different times, and what might seem extreme in one context can be beneficial in another. For example, having a therapist attend a medical appointment can be both supportive and appropriate for some clients, just as it might be inappropriate for others.

Examples of Appropriate Boundary-Crossings

Many therapists, like myself, have clients who require medical attention as part of their therapy. For instance, supporting LGBTQ clients with HIV treatment adherence or transition-related care involves addressing both medical and psychological needs in real-time. These contexts justify a boundary-crossing that is both ethical and essential for the client's well-being.

Inappropriate Boundary-Crossing

On the other hand, driving a client to a medical appointment out of personal convenience or anxiety might feel helpful but could harm the client's self-efficacy. While it might bring temporary calm, it lacks the professional integrity and intent that make a boundary-crossing essential for therapy.

Client-Driven Therapy Sessions

Your friend's extended therapy sessions may be aimed at addressing specific therapeutic goals. Therapists who provide long sessions often do so because they believe it is necessary for the client's progress. This approach can be beneficial if it aligns with the client's needs and therapeutic goals.

Important Considerations

When a therapist deviates from standard practices, it is important to consider the equity and sustainability of their approach. Questions such as 'how did they learn to conduct these sessions' and 'what clinical justification is there for scheduling sessions of varying lengths' should be addressed.

Client-Centered Dialogue

Discussing these concerns with the therapist is crucial. Your friend should ask why such extensive sessions are conducted and what purpose they serve. It is important for the client to determine whether this approach aligns with their goals and whether it will be helpful or counterproductive.

Exploring Alternative Therapy Options

If your friend is uncertain about the therapy sessions, they might consider scheduling an appointment with a different therapist. This can provide additional insights and may lead to finding a more suitable therapist who aligns better with their needs. Locally practicing therapists can offer specialized knowledge and a deeper understanding of the local regulatory environment.

Conclusion

While a 4-hour therapy session may seem unconventional, it can be perfectly normal in certain therapeutic contexts. It is essential for clients to communicate openly with their therapists to ensure the approach aligns with their therapeutic goals. If not, the flexibility to explore alternative options remains a valuable tool in finding the right fit.