Shirah Vollmer MD

The Musings of Dr. Vollmer

Psychotherapy Package

Posted by Dr. Vollmer on May 9, 2010

     Ernest, thirty-three, has seen me over the past ten years, in spurts. He has a marital crisis; he comes in for a few sessions. He has panic attacks; the pattern repeats. He has problems with his daughter; the pattern repeats yet again. Recently, Ernest decided to “handle things” on his own. He went to his primary care doctor, received prescriptions for Restoril to help him sleep and Xanax to calm his nerves. Within about two months, Ernest could not sleep at all and he was “anxious all the time.” He called me in a panic; he needed to come in right away. It was Sunday. I saw him Monday. I gave him some medication to counteract the effects of  the Restoril and Xanax. He began to feel better. “You know what I am going to do,” he says. I am going to pay you ahead of time for twenty visits, so that I don’t “flake out this time.” “I am cheap,” he says, “so I know if I pay you in advance, then I will definitely come. ”

      I thought about Ernest’s amazing  initiative. I called it  “the psychotherapy package” similar to a package for a personal trainer, which both helps the person commit himself to his work-out and it gives the trainer some financial security. I was impressed with Ernest’s creative thinking to help himself. I was inspired by his determination to overcome his previous crisis oriented approach to psychotherapy; I was impressed by his wish  to create a deeper, more long-lasting experience. I wondered what would have happened if I suggested the package, rather than Ernest coming up with the idea on his own. I wondered if I should suggest this “package” to other patients. Of course, I also wondered what would happen if I blogged about this. Ernest gave me a lot to think about.

2 Responses to “Psychotherapy Package”

  1. Shelly said

    What medication counteracts the effects of Restoril and Xanax?

    My sense is that if you suggested the “Psychotherapy Package” to other patients, it might be seen as a marketing ploy and perhaps would not be well-received (unless there is some financial gain in it for your patients). Just trying to consider the financial difficulties that many people are in currently due to the economy and joblessness, people might consider psychotherapy as “luxuries”, whereas if they see you during crises, your sessions would be necessities.

    What do you think?

  2. I used Seroquel, an antipsychotic which helped him come off of the Restoril and Xanax.

    I think it is a tough call. Having a package means there is a one-time “hit” but then the financial issue is removed from the work, at least temporarily.

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