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How Long Does Therapy Take?

Photo by Fleur on Unsplash

It’s reasonable to wonder how long you can expect therapy to take. Of course, I can’t give you an exact length of time. After I’ve met with you and I have an understanding of what your goals and your challenges are, I can give you an estimate. But the first thing that pops into my mind at that question is another question, “How long is a piece of string?”

You hear about some people who are in therapy multiple times of week for years. Those people are probably in psychoanalysis. You’ve likely heard about many others who are in therapy weekly for a year or two. That could be any number of kinds of therapy. And you’ve might have heard how therapy, particularly CBT, can be done in 12 sessions. Or that insurance will only approve 12 sessions initially, indicating that most problems should be sufficiently addressed in 12 sessions. All of that can be true, which makes it all the more confusing. After all, if you could reasonably expect to get the results you wanted in 12 sessions, why would you want to be investing the time and the money into weekly therapy for a year or more? You might wonder if people who are in therapy for that long are being taken advantage of by their therapists.

I believe the goal is a crucial component in the length of time therapy may require to be effective and lasting. Specifically, are you interested in symptom reduction or in change deep inside, such as the beliefs you have about yourself or how you relate to others? Symptom reduction may not take as long. It is not likely to address the deeper, foundational issues but it might be enough to get you by. (And that, by the way, is all that insurance is generally interested in: the minimal amount of therapy for you to limp along. As a rule, they are not interested in deeper work on the foundation of your self). But if you want to work on issues like your perfectionism, that’s likely to take longer. And, to be clear, I’m not looking down at symptom reduction. Sometimes that’s all that is needed. I absolutely love helping people with their insomnia, for example. That’s generally only 5 or 6 sessions and our goal is symptom reduction. It happens quickly and my clients are happy because that was the goal they started with.

Okay, so this is all well and good but if you are interested in the deep, profound work of changing your inner self, what can you expect? You can read this article for all the specifics or you can make do with my very short summary to detailed information. The authors of this piece showed how three different measures of therapy yielded very similar time frames as far as length of therapy. One was a Consumer Reports survey of more than 4,000 people who had had therapy within the past three years. This study found that the longer people stayed in therapy, the better they did. Specifically, the study found that meaningful change began occurring at about six months. At a year people reported substantially more improvements and at two years even more. Deep, significant changes take time.

A second, different, study asked a group of almost 300 very experienced therapists (they had an average of 18 years of experience as therapists) to answer questions about their last completed therapies “in which patient and therapist agreed that the outcome was reasonably successful.” Therapists of all different orientations were included in this study, so it included those who might lean toward briefer therapies as well as those who think of therapy in terms of years. The median length of time reported (median means half of the answers were below this number and half were above) was between 52 weeks (for panic) to 75 weeks (for depression). That’s a year to 18 months.

And, finally, researchers used a scientific tool which measures therapeutic progress to see how long therapy that yielded results takes. In this study, a nationwide sample of 10,000 clients filled out this questionnaire after every therapy session. This tool looked for changes in three areas: symptoms, relationships, and the quality of life and work. What researchers found was that achieving “clinically significant change), as opposed to clients getting achieving full results, took 21 weekly sessions (about 5 months of therapy) for half of the clients to report clinically significant change. It more than 40 weekly sessions for 75% of the clients to report clinically significant change. In research, “clinically significant change” means that when change occurs there is reasonable assurance that it wasn’t by chance. In other words, that the therapy itself led to the change rather than, for example, the simple passage of time.

These studies bring up another point: frequency of therapy matters. The standard for therapy is weekly. There is research indicating that at least for some issues, such as depression, more frequent therapy leads to quicker and better results. There’s a good likelihood that sessions every-other week aren’t going to be as effective. In other words, if 21 weekly sessions can lead to significant change for half of people, we can’t assume that for clients going every-other week that 21 sessions every-other week will have the same results. And that is one reason some therapists will not accept clients who will not commit to weekly sessions.

So this was a lot of writing about how long therapy can be expected to take. It has a lot to do with the client’s goals. And just like you can’t turn an aircraft carrier on a dime, making changes to your inner self after a lifetime of believing or acting or feeling certain ways takes time. Additionally, there is a trust that must develop between the therapist and the client. The client is not likely to share the really scary stuff, the stuff I call the monsters in the basement, until they are sure they can rely on the therapist to be nonjudgmental and to listen and to care. That usually happens through a series of confidences which start as more superficial and, as trust is earned, become more substantial until monster-filled basements are reached.

Only you know how deep your goals are. Is a reduction in your symptoms enough for you right now (you can always return at another time for additional work) or is your issue something that deals with the core of who you are?

Clearly, the decision to start therapy is a significant one. That’s why I offer a free 30-minute consultation at my Belton office. Call or text (816) 226-4678 to arrange for either a session or a consultation.

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