How long will my therapy take?
I've heard individuals share that they are concerned about starting therapy because there's a notion that once you start therapy, you will be on the couch forever. If you should decide to go to therapy, for any reason, it does not mean that you are becoming a "shrink-goer" for life. You always have the choice to end therapy at any point in time. Some attend for one session, three sessions, a few months or a few years.
There has been some research on "single session" shifts. For example, according to a study published in 2006 by the Journal of Consulting and Clinical Psychology, 88 percent of those attending therapy expressed improvement even after one session. In 2001 the Journal of Counseling Psychology proved that clients rated emotional relief from attending 7-10 sessions. Now, for some, short term treatment is enough and for others, achieving their treatment goals will require attending significantly more sessions than a few.
To help you feel more clear on the next steps in seeking therapy, read on.
3 pointers that will impact the length of treatment:
1. Collaboration between therapist and client.
Many times a client will call and say "I heard you're the best, or you came highly recommended, can I book a session with you." To which I often say, "You need the best therapist for you. We can explore if we are a good fit for one another, as that will be the first step." It's important to choose a therapist with proper skill set for your needs, AND for the therapist and you to get along. If you're working with someone you don't jive well with, your therapy will keep stalling and you won't get towards your goals. So be mindful and take your time in choosing the right fit therapist for you (Luborsky, 1976).
Therapy isn't like a science project. The healing happens within the context of the relationship, so choosing a therapist you can build trust with will impact your treatment. Building an alliance and having a strong collaborative relationship have been proven to impact the success and outcomes of treatment (e.g., Ardito & Rabellino, 2011). In your therapy, both you and your therapist will be working hard at the goal of getting you feeling better. Your therapy will move you at a steady and healthy pace when you're both genuinely engaged in this collaborative work.
2. Treatment needs
Some issues are simpler to identify, address and treat, and yet other complex issues may take anywhere from 6 months to a number of years. For example, processing a recent break up, getting "unstuck", resolving interpersonal conflict or making a big decision can be acquired through shorter term support, and insight, goal-focused work that can can take as short as a few sessions to a few months.
However, if you have history of abuse, neglect or have experienced betrayal, the healing process may take longer for you to experience lasting shifts and relief you seek. This is also true for more severe mental health diagnoses that respond best to ongoing, consistent treatment (Gabbard, Litowitz & Williams, 2012).
3. Your willingness and motivation
If you're choosing to begin therapy, you're definitely motivated enough to begin the process. However, sometimes engaging in the ongoing work can get tiring. It takes grit, persistence and patience to work towards your goals and sometimes it gets hard. There may be some old tendencies towards passivity, self-neglect, codependence, defiance or problematic relationship patterns that may come in the way of movement and change. If you keep getting stuck or are hoping that your therapist will do the work for you, your therapy will take a whole lot longer (Krupnick, Sotsky, Simmons, Moyer, Elkin & Watkins, 1996).
Of course, when stagnation, old habits or blockages come up, your therapist will help you work through it. I've never seen a perfect linear, smooth therapy that's always flowing perfectly. The human therapy process needs flexibility. What you may find is that, at times, you'll feel like you've pressed on the accelerator and are implementing change with ease, and that will feel great! At other times, you may feel exhausted, like your climbing a himalaya mountain, or like you're moving at turtle-pace. It's all ok. As long as you're committed to your goals, you'll work through the pace changes and keep moving through.
With all that in mind, it's hard to predict an exact time frame for therapy. Sometimes issues resolve very quickly and you experience relief sooner than expected. Other times, something new may unravel or come up that may extend the treatment for a bit. The goal of therapy is for you to feel strong enough to eventually end therapy and continue on your life's journey without your therapist's help.
At the end of the day, I see comprehensive, long lasting healing as a journey that isn't meant to be rushed. You're training for the marathon, not running a sprint. You want to practice skills, implement life changes and offer healing that you'll have with you way beyond your time in therapy. I encourage you to focus more on the quality of the therapeutic work and less on the clock, or calendar, on the wall, .
Once you are engaged in therapy and have a trusting therapy relationship, you will be discussing your treatment goals, how therapy is going and tracking your progress over time. With transparency, openness and clarity, the two, together, will come up with a time that feels right to wrap up the work you've done together.
At the end of treatment, you'll identify the goals you've reached, celebrate your healing and growth, and identify ways for you to continue the progress you've achieved. Most therapists are happy to have you come back at a later point in time or "check-in" if needed, for support with an occasional stressor or if you need therapy again later down the road.
My wish is for you to engage in therapy with a sense of confidence, ease and upward growth.
Ardito & Rabellino (2011). "Therapeutic Alliance and Outcome of Psychotherapy": Historical Excursus, Measurements, and Prospects for Research.
Gabbard, Litowitz & Williams (2012). Textbook of Psychoanalysis 2nd Edition
Luborsky L. (1976). “Helping alliances in psychotherapy: the groundwork for a study of their relationship to its outcome,” in Successful Psychotherapy, ed. Cleghorn J. L., editor. (New York: Brunner/Mazel; ), 92–116
Krupnick J. L., Sotsky S. M., Simmons S., Moyer J., Elkin L., Watkins J. T. (1996). The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Programme. J. Consult. Clin. Psychol. 64, 532–53910.1037/0022-006X.64.3.532