People come to therapy to alleviate a disorder or symptoms and treatment lasts as long as those unpleasant symptoms exist, from a few weeks to a few years. If you are symptom free and that's all you wanted out of therapy, you're all done. In the wellness model, going to therapy is like going to the gym.
Long-term psychotherapy is typically referred to as psychotherapy that exceeds the normal parameters of time allotted for the treatment of most psychological disorders.
The number of recommended sessions varies by condition and treatment type, however, the majority of psychotherapy clients report feeling better after 3 months; those with depression and anxiety experience significant improvement after short and longer time frames, 1-2 months & 3-4.
If you are looking for more of a quick solution for a specific problem, short-term therapies can be beneficial, whereas if you would rather have space and time to explore multiple problems or an issue and its potential roots in-depth, long-term therapy may be the right choice for you.
But It Doesn't Have to Last for the Rest of Your Life
People often don't commit to therapy because they fear they will be stuck there until they die. There's nothing wrong with continuing therapy for the rest of your life, but you don't have to.
Recent research indicates that on average 15 to 20 sessions are required for 50 percent of patients to recover as indicated by self-reported symptom measures.
In fact, therapy can be harmful, with research showing that, on average, approximately 10 per cent of clients actually get worse after starting therapy. Yet belief in the innocuousness of psychotherapy remains persistent and prevalent.
Therapy has been found to be most productive when incorporated into a client's lifestyle for approximately 12-16 sessions, most typically delivered in once weekly sessions for 45 minutes each. For most folks that turns out to be about 3-4 months of once weekly sessions.
Therapy often takes longer than first-time patients anticipate. Sometimes this is because they enter treatment for a concrete problem, only to discover deeper, more chronic difficulties. And, as we will see, there is a reason why difficulties become chronic.
I myself have often felt sad, even grief, when a long-term client has terminated, and a longing to know what has happened to them later on. I occasionally will receive a phone call, email or letter after they have terminated, letting me know how they are doing, and I always feel grateful to them for the communication.
We walk a fine line of being on your side but making sure that you are grounded and can maintain proper boundaries. So yes, we as therapists do talk about our clients (clinically) and we do miss our clients because we have entered into this field because we remain hopeful for others.
But for most people, there will come a time when therapy no longer feels necessary or progress has stalled. In most cases, the client will choose to end therapy; there are also situations in which a therapist decides to end sessions and refer a client elsewhere. Formally, ending therapy is called “termination.”
Yes. We care. If you feel genuinely cared for by your therapist, it's real. It's too hard to fake that.
The authors note some reasons why patients drop out: They are unwilling to open up about themselves; they cannot agree with the therapist about what the problem is; they just don't get along with or feel confidence in the therapist; they believe they are not improving quickly enough; they have unrealistic expectations.
A therapist can hug a client if they think it may be productive to the treatment. A therapist initiating a hug in therapy depends on your therapist's ethics, values, and assessment of whether an individual client feels it will help them.
They point to a theme I often hear from therapists: We want clients to be as invested in the process as we are. We like it when they're motivated to work in and out of the session, ready to try new things and willing to look deep inside. When these ideal elements are in place, therapy tends to progress nicely.
Therapists most often reported feeling sad while crying, and grief was most often the topic of discussion. In 55% of these experiences, therapists thought that clients were aware of the crying, and those therapists who discussed their crying with their clients reported improved rapport as a result of the crying.
Planned client termination may be one of the hardest aspects of clinical work. Although planned termination is often a great opportunity for both the client and therapist to gain additional insights, it can lead to a variety of thoughts and emotions that can be unpleasant for all involved.
Done supportively, silence can exert some positive pressure on the client to stop and reflect. Non-verbal signals of patience and empathy by the therapist can encourage the client to express thoughts and feelings that would otherwise be covered up by too much anxious talk. Sympathetic silence can signal empathy.
It's natural to want a quick fix, and our society specializes in quick. Unfortunately, it's more difficult to do that with therapy than with other things. That said, trauma therapy used to take many years, and with more modern and powerful therapies, it usually doesn't.
You also know therapy is working if you're using the skills you learned in session, outside of session. For example, are you better able to set boundaries with others, prioritize your own needs and demands, and effectively deal with situations without spiraling into a panic attack? These are great signs of progress.