In truth, this is a difficult info piece to write, and a sensitive thing to comment on. How long does therapy take? It’s entirely dependent on your circumstances. The ‘size’ of the problem you seek to work on impacts how much work might need to be done. Length of treatment is to be determined between you and your therapist. Further, your own preparedness for the necessary psychological change is another factor. Therefore, I cannot possibly provide you with a definitive answer in a generic piece of writing. Beware easy answers and big promises on questions about your mental wellbeing!
What I try to do here is briefly discuss some factors of therapy that impact treatment length. These may enrich your understanding a little further. In Denmark, publicly subsidised therapy is offered for blocks of 12 or 24 weeks depending on the issue, which may be more than enough for your circumstances. The length of private therapy is entirely at your discretion. I comment briefly on each of these factors as a pluralistic therapist, to own my perspective on them.
Reasons for coming to therapy
As a pluralistic therapist, I am trained to think about your ‘goals’ for therapy. You can alternatively think of them as hopes, needs, desired outcomes, targets, purpose… whatever word or phrase makes sense to you. For some clients, they arrive with something clear and tangible. Consider Client A. They want help developing strategies to manage two challenging work relationships, and associated work stress. These are clear, delineated ‘goals,’ right from a first consultation.
Compare with Client B, who seeks therapy to address this general, aching feeling. They want change, yet don’t know where to start. They feel like they’ve “kinda lost touch” with who they “used to be” and don’t know how to reconnect (or, even, where to start). All they know is work has been crazy, and being a new parent proves beyond exhausting. And life has become “a bit grey.” Their therapy process therefore starts without much direction, which itself might take weeks to find and put words to. We need a lot of exploration first, to make sense of what’s happening. We dig about to find clues on where the roots of these problems might lie, then identify helpful therapeutic tasks to undertake.
So, how long does therapy take? A first factor is your level of clarity on your needs. Pluralistic therapy is attuned to routine check-in with goals and needs as therapy progresses. This ensures we retain purposeful focus in and across our work together.
The type of therapy you are engaging with
Different therapy types follow different methods, according to the techniques a therapist has trained in. Some have fixed treatment pathways, fixed steps you follow. Cognitive Behavioural Therapy (CBT), a common type, is adaptable and can be quite short, perhaps just six sessions. Acceptance and Commitment Therapy (ACT) may take about 16 sessions to progress through its stages. Such styles generally restrict therapy to a fixed length of reasonable prediction. Client A, from my above example, is likely to benefit from this kind of style. A specific focus on the here and now of their workplace is likely all they need.
Depth psychotherapies tend to be more open-ended. They can ‘take as long as it takes’ to get to the heart of the matter. You might stay with them as long as you feel you need to, in order to see life changes. Think about Client B. There is so much unknown. With depth psychological change, this is a person looking to change how they feel, think, and understand themselves. Depth psychotherapy tests out new ways of thinking about and talking about their sense of self. It’s a type of exploration — through a unique close relationship with another person, your therapist.
Again, how long does therapy take? Our second consideration is the type of therapy you commit to. Pluralistic therapy is flexible, it adjusts and responds to your precise goals and needs.
Level of therapeutic support required
There are many different ways of understanding what therapy is all about. One preferred personal understanding is a simplified one: we seek therapeutic support when we get ‘stuck.’ Sometimes, life throws the unexpected at us. As examples, think of bereavement, sudden ruptures with people close to us, job loss, or economic hardships. Client A’s organisation went through a sudden restructure, and they ended up with a challenging new manager and co-worker. Other times, we get stuck on a problem in life that we notice keeps repeating. Over time, it grows so big we can’t take our mind off it. Rumination, distraction, a lack of joy set in. Client B’s feeling grew more and more pervasive. It became something there with them morning, noon and night.
Whatever way it breaks, many people seeking therapy might resonate with this sense of ‘stuckness.’ And in this view, the aim of therapy is simply to get ‘unstuck’ enough. In other words, free enough to get on with life. Therapy doesn’t need to go on forever, just long enough to get ‘free enough.’ This is my professional and ethical position. What you need to become unstuck will vary, depending on your relevant skills, cultural resources, and level of social support elsewhere in your life. If you get ‘free enough’ but want to stay in therapy and work on aspects of personal development, that’s okay too!
A caveat…
This is a very general interpretation, and obviously everything depends on your unique, personal circumstances. For example, clinically diagnosed mental health problems like personality or mood disorders are different. My ‘stuck/unstuck’ way of understanding doesn’t quite apply to them. The personal changes required to move beyond associated life problems run much deeper. It may be necessary to learn completely new ways of relating to others, of understanding the self. New skills, like stronger emotional regulation, or reality-testing thought habits, these take time to develop. In a different vein, discovery of neurodivergence would be about ‘adapting,’ not becoming unstuck.
Please remember, I am offering a very general perspective here! Metaphors always have their breaking points.
Possible therapy lengths for our imaginary clients
Client A mostly likely only needs an initial consultation, and then 2-3 sessions to ‘work it out.’ Their therapy functions as a bit of a ‘problem-solving’ space, somewhere they can be unguarded, speak and think freely, in confidence. In contrast, Client B may take much longer to work through their problems, months rather than weeks. The first phase of the work is to create some emotional safety, to allow them to get in direct touch with those pervasive feelings. This helps find words for what they “kinda lost touch” with about themselves. Once those words clarify, what they want to do next comes into focus. Likely length of therapy may, or may not, become clearer. It’s also possible that Client B notices after a few weeks that they’ve been feeling much better. And, funnily enough, they’ve been sleeping much better too! So, therapy ends. The door is open to come back if those pervasive feelings return.
Single Session Therapy
Single Session Therapy (SST) is an approach that aims to provide you with a targeted form of psychological support in just one session. This is a bit different from standard therapy practice. It attempts to keep a sharp, restricted focus on one single problem in your life, and on what you can do about it. You could also think of this as focused on solutions, on action planning, or on problem solving. This may be a helpful way of addressing a current problem in your life, if you feel that you do not want to delve too deeply into your past. It may also be useful for just focusing on one part of your life, for example, just work, nothing personal. From my example above, Client A may get some benefit out of this streamlined approach. A principle of SST is to try provide clients with one clear takeaway skill, action plan, or shift in psychological perspective that they can apply to their ongoing problem.
Remember, you’re in charge
I want to sign off this piece by speaking to your sense of agency. Unless your therapy is part of a mandated program of treatment, you remain in charge of how long it lasts. It can pause or stop when you say so. There is a bit of a dilemma inherent here, though, worth highlighting:
(a) The ‘work’ of therapy can be painful, disruptive, disorienting… hard, uncomfortable work.
(b) Your therapist is likely correct that perseverance through the toughest times reaps reward.
Both (a) and (b) are true. But, often, you’ve done the hardest part by actually getting to the therapy room. This alone is a significant step towards change. You’ve acknowledged you want to do something to deal with a problem in living. Whatever happens, just hold onto your sense of autonomy and control over what is happening. You are a free participant in your therapy process. Ethically-aligned therapists will always promote your agency, autonomy, and control in therapy.
