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Length of Psychological Therapy

While the outcome of psychological therapy can not be guaranteed, I use several rules of thumb to guide how long therapy may take.

Psychologist - length of psychotherapy
  • People who are more distressed usually need longer work.

  • For those people who have experienced trauma, counselling is usually shorter if:

    • You were functioning ok before the trauma, and
    • You are safe now, and
    • What happened was bad, but not extremely severe


  • People who have experienced severe trauma, or who still are not safe, or who weren’t travelling that great before the trauma can expect therapy to take longer.



It also depends on you want to achieve. Deeper psychological work may take longer, and in my opinion lasting change is unlikely with fewer than 12-16 sessions. But there is no rule that says all psychological work must be completed in one go. Your goal may reflect what is realistic for now - such a return to good enough functioning. It is important to discuss what you would like to achieve with your therapist at the beginning of therapy, and at each time you pause to review the work.


That said, research indicates that some psychological change often happens within the first 6 sessions (see Duncan, Miller, Wampold, & Hubble 2010), and if no change (however small) is occurring for you after 6 months then it is important to discuss the reasons for this with your therapist. One possible reason is that events external to the counselling – such as domestic violence, drug addiction, or other life events – are important to attend to.


Another reason might be that what has happened in your life is so severe that fast change is unlikely. Another reason may be that the therapy itself needs adjusting to a method that suits you better. Or you may have the wrong therapist. This may not be that the therapist is not competent, but instead that the match between you and the therapist may not be right.



Frequency of counselling

How often to attend counselling can be a balance between an individual's emotional need and the financial cost of counselling (or other practical limitations). Also important is that effective psychological therapy often requires continuity - if there are too many gaps between sessions it can feel like starting again each time, and gains can be lost.

Here are my suggesttions about how frequently to meet for counselling:

  • If your need is strong, and your distress is very high  then I recommend attending counselling at least weekly.
  • Weekly therapy is also often used by people engaged in long term personal growth work.
  • Fortnightly counselling is useful when you would like to regularly work away at the psychological issues that concern you. Fortnightly sessions may take longer to achieve the same results as weekly, but not necessarily twice as long. What is learnt in counselling needs time to take in, digest, and feed into your own change, so fortnightly sessions can work well.
  • Montlhly counselling is "top-up" or maintenance counselling. This can be useful for people who have achieved significant change in their lives, and just want to keep on top of things psychologically. I do not recommend monthly counselling for people starting therapy as I believe that the length of time between sessions is too long to start change happening.