No quick fixes in intensive therapy

While we appreciate Jonathan Alpert’s effort to assist people in making good choices about therapy [On the Mind: “In Therapy? Here’s How to Assess Effectiveness,” March 26], we think he has oversimplified the matter and offered something of a cookie-cutter approach. For example, not all modalities of therapy involve homework: psychoanalysis and psychodynamic treatment usually do not.

Also, expecting results in a few weeks may make sense if one is experiencing mild anxiety or minor depression, but with chronic illnesses such as bipolar disorder, borderline personality or childhood post-traumatic stress disorder, more time is often necessary. Just establishing rapport and a therapeutic alliance can take several sessions.

Alpert’s statement that talk therapy isn’t necessarily helpful is also not quite accurate. There is a great deal of evidence that it works well with a broad section of the population, particularly with patients who seek out help for themselves.

His worst piece of advice may have been this: “If you try therapy and don’t feel comfortable, chances are it’s not a good fit.” We cannot think of a more counterproductive attitude to suggest to new patients. Discomfort is often the first sign that therapy is working. Feeling comfortable in a process of deep healing and awakening is next to impossible. Patients who flee at the first challenging feelings will never get better.

When dealing with the human mind and heart, there are no quick fixes.

DANIEL BREZENOFF

FERNANDO BURGOS

Signal Hill

Brezenoff is a licensed clinical social worker and Burgos is an intern in marriage and family therapy.