How Long Does Therapy Take?
How Long Does Therapy Take?
I've heard individuals share that they are concerned about starting therapy because there's a notion that once you start, you will be on the couch forever.
I would like to smash that stigma right here and right now. If you decide to go to therapy, for any reason, it does not mean that you;
Are a defeatist, a label junky or that you are weak (in fact it's quite the opposite. Therapy is empowering and a sign of strength)
Are becoming a "shrink-goer" for life
Will become overly dependent or addicted to therapy
Are entering into a “marriage” or long-term contract with your therapist
Will you lose your choice about when to end therapy at any point in time (this is always your choice. If it’s a long term relationship, it’s ideal to have a wrap up session, but that is still purely your choice!)
In reality, some people attend therapy for one session, three sessions, a few months or a few years.
Although I don’t typically recommend only one session, there have been some research developments about "single session" shifts that seem promising. According to a study published in 2006 in the Journal of Consulting and Clinical Psychology, 88% of those attending therapy expressed improvement even after only one session.
In 2001 the Journal of Counseling Psychology reported that clients rated significant emotional relief from attending 7-10 sessions.
The length of time it takes to achieve successful outcomes is not one-size-fits all. For some people, short term treatment is enough and for others who have more extensive treatment goals, choosing a longer plan of action is preferable.
What factors could impact the length and efficacy of my therapy treatment goals?
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 single session with you?" To which I often say, "It’s important to identify who the best therapist is for YOU.
Even if I have developed a strong therapeutic relationship with your friend, it’s important to explore if we are also a good fit for one another. It is critical to find just the right fit." All therapists have different specialties, skill sets, personalities and tendencies. If you're working with someone you don't jive well with, or who makes you uncomfortable, your therapy will keep stalling and you won't get any closer to achieving your goals. So be mindful and take your time choosing the “right fit therapist” for you (Luborsky, 1976).
The healing happens precisely within the context of the relationship, so choosing a therapist you can build trust with will impact your treatment’s efficacy.
Building an alliance and having a strong collaborative relationship has been proven to impact the successful outcomes of treatment (Ardito & Rabellino, 2011). Therapy is collaborative work and its success will depend on a solid connection.
2} Everyone Has Different Treatment Needs
Some issues are easier to identify, address and treat than others. A more simple life challenge can take a few sessions whereas more complex situations might require anywhere from 6 months to a number of years.
For example, if there are no underlying concerns, getting help to process a recent break up, to help figure out goals at a crossroad in life or resolving interpersonal conflict can be successful with shorter term support and goal-focused work in as few as 3 or 4 sessions to a few months.
Alternatively if there is a history of abuse, neglect or betrayal, the healing process may take longer if you want to experience lasting shifts and long-term relief. This is also true for more severe mental health diagnoses that respond best to ongoing, consistent treatment (Gabbard, Litowitz & Williams, 2012).
3} Your Level of Motivation & Drive
If you're choosing to begin therapy, you're definitely motivated enough to begin the process.... However, it's important to keep in mind that sometimes engaging in ongoing work can get exhausting. It takes grit, persistence and patience to work towards your goals and sometimes it gets hard. Really hard. Once we start to scratch the surface, layers of past challenges that you think you had dealt with already (albeit maladaptively) start to bubble and simmer. We might find old tendencies towards passivity, self-neglect, codependence, defiance or problematic relationship patterns that seem to be inhibiting further movement and change.
If you keep getting stuck or you 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). Just like the act of buying a gym membership won’t lead to health (unless you actually use it), mental health won’t progress without actually putting in the effort required to attain it. Just like you can’t pay the membership fee at the gym and expect that only using the hot tub and sauna will generate health, therapy can’t and shouldn’t feel like a day at the spa. Success will be dependent on ongoing and consistent effort.
Of course, when stagnation, old habits or blockages come up, like a personal trainer, your therapist will help you work through your blockages (help being the operative word), but that’s not where the change happens. It happens with you. With your commitment to homework and lifelong learning.
4} Acceptance of Humanity
The most beautiful parts of us are only beautiful because of what it took to get to that beauty - and I’m not talking about the Hollywood kind of plastic beauty. I’m talking about the marks that adversity leaves on our hearts, minds and souls. It’s hard to accept “in the moment” (so never say this to someone who is in active struggle), but when you meet someone who has gone through hell and back, they are usually the most thoughtful, balanced, well adjusted and kind people you will ever meet.
They had to work harder than others to become who they are and their battle scars are usually the parts that shaped them. The scars are a symbol of hope that they can rise up when they are down and those downs are just as much a part of their story and the ups.
Japanese Kintsugi artists repair broken pottery by gluing the pieces back together and filling the “scars” with precious materials like gold, silver and platinum. This method is founded on the philosophy that breakages and repairs are not only a part of the object’s history but an essential aspect of its beauty.
Scars should not be disguised, but transformed into something even more beautiful and precious.
The therapeutic process can sometimes feel like you have been broken and you are not even sure if it’s possible to be put back together. I can assure you that although it feels that way, you are not broken. It’s sort of like when you start to clean out your garage or attic and it looks way worse during the cleaning process, like you made a much bigger mess… and it’s even more overwhelming than it was when you started… but that mess is actually an essential part of the organizing process. Your mind and body has a lot stored up in it. It’s completely human for your problems to feel like they have been exacerbated before they get better.
Therapy can feel like accelerating at some moments, and other times like you’re a “barely moving turtle”
In therapy, sometimes you will feel like you've pressed on the accelerator and are implementing change with ease, and that will feel great! At other times, you might feel exhausted, drained, like you just climbed Mount Everest, or you might get frustrated with your progress, feeling like you're moving slower than a turtle-pace. It's all ok. In the end, the turtle beat the hare because “slow and steady wins the race.”
Stay steady to experience the exciting shifts and gains
As long as you're committed to your goals, you'll work through it all, including your pace frustrations, and you will keep moving forward in typical human fashion. I've never seen a perfect linear, smooth therapy process that flows perfectly. The therapy process is meant for humans and all the complexities that come along with that status.
And of course, if you have a question, ask your therapist who is the expert on getting to know you and would best answer in a personalized fashion for you!
If your’e in New York and are looking to engage in counseling for your anxiety, trauma, depression or relationship issues, reach out here. Our therapists are trained in advanced methods such as EMDR, somatic therapy (mind-body), art therapy and cognitive work.
Sources:
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