How Much Therapy Will I Need?

Counselling sessions are usually in 50-minute or 90-minute slots, most often as weekly sessions though sometimes it can be helpful and appropriate to meet more than once each week for a time.   Therapy groups are usually 2-hours per weekly session or are over two or three consecutive days of around 7-hours per day.

It is probably impossible to say for sure how long it might take to achieve any given therapeutic goal, as it is affected by so many variables.  However, to guide you, the following is what I have found to be a realistic minimum, that is, you are unlikely to achieve much in less than the time I describe below.

Individuals and Couples

A review of my practice over the period 2008 - 2010 suggests that even in complex issues, motivated clients can often achieve their initial goals within seven sessions.

Note that I have said initial goals.  Longer-term and more complex goals will usually take more time.  However, when working with individuals and couples, my experience has been that seven counselling sessions can be very effective and make an apparently disproportionate contribution to recovery and wellbeing.  This can be true even when the difficulties a person or couple is experiencing are greater than can be resolved in such short-term working - the short intervention can help to allow the person or couple to go on to resolve their difficulty on their own.

What Leads to Longer Term Work?

In a relatively small number of cases - say around 15 per cent - longer-term and/or more intensive work can be helpful. The outcome from an abusive or traumatic beginning in life, traumatic or complex bereavement, a history of complex and difficult family dynamics and the exploration of living life with a challenging illness would be typical of these longer term cases.  Even in such cases, the rule of thumb noted above (taking a break after three months), is a good one to follow.

When working in longer-term therapy, my experience encompasses working over extended timeframes and with clients that need more than one counselling session per week to achieve their therapeutic goals.   Though not common, there are times when this more intense work is desirable.   However, even in such cases, it is not usual to continue with such frequent therapy for more than a few weeks before reverting to the more typical weekly sessions.

Although many therapists will offer what is termed 'open-ended' therapy, in most cases I would be surprised if we needed to meet more than 30 times and our regular reviews should tell us whether the work should be drawing to a close.  In the very few cases where working over extended timeframes - even for several years - can be desirable, it is likely that the client/s already know that very long term working is likely to be helpful due to their previous experience of therapeutic support and intervention.

Families

When working with families, my personal experience is that three sessions is a realistic minimum to achieve something meaningful.  Depending on the number of family members involved in the therapy, more time is often required simply because there are more people to be heard and a more complex interraction to explore and understand.  I have worked with families where even apparently challenging dynamics have improved enough for the therapy to end after six sessions.

Regular Reviews

In most cases, if you are seeing a therapist for the first time, I suggest that we plan to review progress on or before appointment eight.  At this time, it can sometimes be helpful to take a break to allow you to review progress away from the therapy room.  And, even if you feel it is working, after three months it can be a good idea to consider taking a break of a month to see what you have gained before starting further sessions.

Groups

Most groups take some time to reach the point where the participants can make use of what the group can offer and for that reason, I seldom run groups of less than ten weekly sessions or two full days.  Therapy groups, however, are almost always run as a set number of sessions on set dates - typically ten weekly sessions or two or three full days.

Weekend Anger Groups are usually run as a Friday evening followed by all day Saturday and all day Sunday.

What is Counselling? What is Psychotherapy?

Considering this is a simple question, I find it curiously difficult to answer without becoming too technical and discussing the theoretical models and the research that explains why it works.  The BACP's definition What To Expect From Therapy might be helpful.

Psychotherapy has been described as exploring the underlying nature of troubles and possibly changing these through experiencing and recognising unrecognised forces in yourself.

It is true that therapeutic work can be demanding, even hard and painful sometimes.  Every so often, it can bring to your attention something you may be doing without noticing and it can be hardest of all if that is something you don't like.  Paradoxically, these can be the most empowering moments in all the work you do.

If you are wondering how much therapy you might need, I have included a guide   based on my experience as a therapist, further down in the right-hand column.

The distinction between 'counsellor' and 'psychotherapist' is largely technical, with psychotherapy tending to have more emphasis on experience and knowledge of working with people struggling with psychiatric disorders and chronic or long-term mental health issues and where a more active therapist offering guidance and sometimes containment can be helpful.

Additional Site Navigation: