If a patient has taken medicines, I always get as much detail as possible: dose, duration, response. If a patient has been involved in psychotherapy, I try to learn what in the patient’s life has changed and through what means. People who demean and disparage the whole concept of psychotherapy claim it’s simply rent-a-friend. It can be, but ideally it should be much more.
Our goal as parents is to render ourselves obsolete. That’s also what I aim for when I’m a therapist: helping patients achieve the competence and confidence to kick off their “training wheels.” Even supportive psychotherapy should have an “end game.” Patients who seem to require the regular advice and encouragement of a professional can be coached on other sources of support: friends, interest groups, religious organizations. Symptom-based treatments or therapies designed to achieve behavior change should move progressively toward specific goals. Progress should be measurable. Endless therapy should be the exception.
When I take a patient’s history, and the patient has been in therapy, I hope to learn that therapy has provided a vehicle, that the patient and therapist have been on a journey—toward a destination. If therapy has just been a place to go and talk, if there has been no obvious progress, I raise questions.