I sometimes recommend Dr David Burns' Feeling Good podcast[1], and he is big on measuring and testing and stop points. Instead of 'tell me about your mother' his style of Cognitive Behavioural Therapy (CBT) is called TEAMS in which the T stands for Testing, and it involves:
- Patient choosing a specific mood problem/feeling they want to work on.
- A mood survey, where the patient rates their own level of e.g. anxiety, depression, fear, hopelessness. (e.g. out of 5 or 10).
- Therapy session, following his TEAMS CBT structure. Including patient choosing how much fear they'd like to feel (e.g. they want to keep a little bit of fear so they don't endanger themselves, but don't want to be overwhelmed by fear, 5% or 20%, say).
- A repeat of the mood survey, where the patient re-assesses themselves to see if anything has improved. There's no units on the measures because it's self-reported, the patient knows if the fear is unchanged, a little less, a lot less, almost gone, completely gone, and that's what matters.
That gives them feedback; if there is improvement within a session they know something in the session helped, if several sessions go by with no improvement they know it and can change things up and move away from those unhelpful approaches in future with other patients, and if there is good improvement - patient is self-reporting that they are no longer hopeless about their relationship status, or afraid of social situations, or depressed, to the level they want, then therapy can stop.
He's adamant that a single 2hr session is enough to make a significant change in many common mood disorders[2], and this "therapy needs to take 10 years" is a bad pattern and therapists who don't take mood surveys and before and after every session are flying blind. With feedback on every session and decades of experience, he has identified a lot of techniques and ways to use them which actually do help people's moods change. I liken it to the invention of test cases and debuggers (and looking at the output from them).
I agree some therapists are starting to come around on this, but even what you describe is somewhat flawed due to placebo effects, eg. some always feel better from any kind of talk, probably as a result of someone paying attention to their problems.
You might be able to overcome this effect by quantitatively tracking this across many sessions to some degree, but I think it's still always the patient that has to walk away, and never the therapist who says, "you're good, go on now".
- Patient choosing a specific mood problem/feeling they want to work on.
- A mood survey, where the patient rates their own level of e.g. anxiety, depression, fear, hopelessness. (e.g. out of 5 or 10).
- Therapy session, following his TEAMS CBT structure. Including patient choosing how much fear they'd like to feel (e.g. they want to keep a little bit of fear so they don't endanger themselves, but don't want to be overwhelmed by fear, 5% or 20%, say).
- A repeat of the mood survey, where the patient re-assesses themselves to see if anything has improved. There's no units on the measures because it's self-reported, the patient knows if the fear is unchanged, a little less, a lot less, almost gone, completely gone, and that's what matters.
That gives them feedback; if there is improvement within a session they know something in the session helped, if several sessions go by with no improvement they know it and can change things up and move away from those unhelpful approaches in future with other patients, and if there is good improvement - patient is self-reporting that they are no longer hopeless about their relationship status, or afraid of social situations, or depressed, to the level they want, then therapy can stop.
He's adamant that a single 2hr session is enough to make a significant change in many common mood disorders[2], and this "therapy needs to take 10 years" is a bad pattern and therapists who don't take mood surveys and before and after every session are flying blind. With feedback on every session and decades of experience, he has identified a lot of techniques and ways to use them which actually do help people's moods change. I liken it to the invention of test cases and debuggers (and looking at the output from them).
[1] Quick list: https://feelinggood.com/list-of-feeling-good-podcasts/ more detailed database: https://feelinggood.com/podcast-database/
[2] no, internet cynic, obviously not everything and presumably not whatever it is you have.