What's even more ridiculous about this...

I'm not a complex patient.

I've got multiple psychiatric diagnoses, but I don't have any PDs and my main mood disorder is largely under control with meds. "Studies show" that CBT helps with the remaining issue I want help.

I seem to have a high amount of "psychological mindedness." Some things that are referred to as CBT techniques are naturally part of my personality. I can talk about feelings without too much issue.

I'm not inclined to anything that would inconvenience the therapist. A lot of the conflicts or other issues that people describe in this forum are things that are non-applicable to my situation.

And yet, therapy has been useless for me. From what I can tell, all the ways therapy normally helps are things I was already doing before therapy.

I guess it mainly helps people who are in the middle?

ANYWAY, I was interested in further reading on this, which lead me to this paper on a complex patient referred to as Sonia. They had success with that patient through some "integrated" therapy model. It took eight years of active treatment and at least two more years of "maintenance" treatment. It was planned from the beginning to be long term. The providers also worked with her family members. The treatment was a coordinated effort between a psychologist psychotherapist, a psychiatrist, a therapeutic coach, and an "independent assessment team," with psychotherapy sessions being conducted in a variety of settings including private consultation offices, the patient's home, the patient's parents' home, the patient's son's school, and the patient's workplace. She also used medication. The patient had rich parents, and her mother financially supported her when necessary. I don't think the paper mentioned who paid for all her treatment, but I'm guessing it was her mother. There was an event in the patient's life several years into treatment which the paper's author talks about with, "the situation became very tense and nearly everything we had achieved was put at stake," but fortunately, it worked out.

The patient benefited from this treatment whereas she hadn't benefited from previous treatment, but this is a far cry from anything that ever gets a randomized controlled trial. I don't even think you could do an RTC on this. In fact, this patient wouldn't consent to most standardized assessment methods. I can't really imagine the government ever funding a program to provide people with something like this.