In defense of long-term treatment: on the vanishing holding environment

There are compelling similarities in the caregiving functions of good clinicians and good parents. Both clinicians and parents function best in a supportive environment. Yet many clinicians do not feel supported. They are under relentless pressure to find ever-briefer forms of treatment for all individuals, regardless of the individual's symptoms or circumstances. This pressure is especially distressing for the clinical social worker who, by tradition, has provided therapeutic services for the most-troubled individuals. This article is intended as a supportive gesture for the clinician who is struggling with questions about long-term treatment. Health care trends and contraindications for short-term therapy are addressed. A clinical case is presented.