The time-expanded commitment
The time-expanded commitment has been defined as an agreement, between client and practitioner, to meet, at least once a week, for up to four to five years, with regular reviews and with a clear understanding that at least two months will be needed to come to a mutually agreed conclusion (see Table 1). On both sides, this is a somewhat momentous commitment, although the implications are not always fully discussed at the beginning. The preliminary sessions of the mini-commitment offer practitioners an opportunity to think ahead as far as possible. Are they likely to be practising in the same place, or within the same agency, for the next few years? What verbal agreements need to be put in place with regard to absences, holidays and cancellations? How realistic and durable are the financial obligations entered into? These clients are engaging in a therapeutic engagement which may outlast the practitioner’s present employment in an agency, or which may be affected by increases in private practice fees. In considering carefully these pragmatic resource constraints on an offer of time-expanded engagement, practitioners may find themselves reshaping their offer of psychological therapy into an offer to work in a time-extended format.