by Sidney Mullen

How long effective psychotherapy will take depends on numerous factors and the length of treatment from one person to the next may vary considerably.

Different Issues, Treatments, and Payment Conditions

If you are seeking counseling or psychotherapy in order to resolve a relatively straightforward issue, psychotherapy may be successfully concluded in as few as 5-20, one-hour sessions. However, if you’re suffering from numerous or extremely complex, long-standing issues, psychotherapy can easily take a year or more to be effective.

In addition to the types of difficulties you’re looking to address, different therapy treatments will take varying lengths of time to achieve their objectives. Solution-focused counseling may help you to overcome some problems in a matter of weeks. Psychodynamic therapies may require years in order to help you move beyond embedded personality issues that are negatively impacting your personal and professional relationships and your day-to-day ability to function effectively.

Practically speaking, the number of sessions you attend may be limited by your health insurance provider or your ability to pay for these services out of your own pocket.

Why Does Therapy Sometimes Take So Long?

It is important to discuss the expected length of your treatment with any prospective therapist prior to beginning therapy. Doing so will help you prioritize your goals and frame your expectations accordingly. We are all unique and complicated beings. It is not uncommon for therapy to be undertaken to address one or two problems only to have other issues rise to the surface once the work has begun.

Less Time

Some problems — such as stress due to a temporary situation, adjusting to a career transition, phobias, and social and sexual anxieties — lend themselves to short-term work and can often be addressed successfully in 10-15 sessions (one session per week for 10-15 weeks). While 10-15 weeks may seem like a long time — especially if compared to a 15-minute appointment with your physician — when looked at on an hourly basis it’s about equivalent to a weekend seminar… A rather small investment to make considering the positive change you can create in your life during that time!

More Time

If you’re experiencing ongoing or recurring relationship difficulties, low self-esteem, difficulty trusting others, or you have a history of anxiety or depression you’re more likely to benefit from in-depth psychotherapy. This is also true if you have issues related to growing up in a dysfunctional family or experienced trauma, abuse, or neglect in childhood. In these circumstances, it is more likely that the coping strategies you developed as a child will have become embedded parts of your personality that affect your thoughts, feelings, beliefs, and behaviors.

If this is the case, you will not only need some time to develop a working relationship and a sense of trust with your therapist, you will also need time to explore your current life experiences, what’s working and what’s not working, and develop new coping strategies in order to create the changes you desire. What cannot be rushed is the developing trust between you and your therapist.

Evaluating Your Progress

Psychotherapy is an ongoing process that requires your commitment, determination, and hard work to be effective. In effective treatment you will notice incremental learning and progress throughout the course of therapy as opposed to achieving goals in a target number of sessions. While you may be able to overcome some problems relatively quickly, other issues that seemed relatively straightforward may turn out to be much more complex than you imagined.

When something does seem to be more complex, it’s good to discuss with your therapist how revising your goals will likely affect the length of your treatment.

How Will You Know If Therapy Is Working?

Positive Feelings:

In the first 10-20 sessions you can expect to see positive changes. When evaluating your therapy, look for movement towards your goals and positive patterns of growth and change, even little things that can be signs of profound changes. If you don’t see some signs, you may want to consider another therapist or alternate treatments.

Still, creating lasting change isn’t an easy process, and it is not realistic to expect to be a new person overnight. The first step is building a working relationship with your therapist. This working relationship is central to your ability to get through the painful memories, frustrating experiences, or disturbing feelings that may need to be worked through. When you can pass through these experiences together, without losing the connection between you, and find the meaning in them, you will know that your therapy is working. If so, you’ll likely feel more connected to other people, better able to handle a crisis that would have overwhelmed you in the past, or you may find yourself enjoying a more positive outlook on life.

“Negative” Feelings:

The uncomfortable feelings you may experience in therapy can test your ability to trust the therapist. This is often what takes so much time. This is a normal part of therapy. During these sometimes very trying times, do make every effort to communicate how you’re feeling about your therapist to her or him. You need to have confidence that your therapist will take your feelings seriously and not merely get defensive. The therapist’s job is to try to understand what your negative feelings might mean for you.

If therapy results in a greater capacity for tolerating “negative” feelings about life’s slings and arrows, therapy is working. Greater tolerance for the negative also means richer experiences of positive feelings. Therapy is working when you experience yourself as a fuller, deeper, more stable person.

Sidney Mullen is a therapist in Berkeley, where she specializes in providing Jungian psychotherapy.

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