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December 14th, 2021

How Long Does Therapy Last?

By Dr Rumina Taylor (Chief Clinical Officer)

  • Therapy
  • Trauma/PTSD
  • Anxiety
  • Depression

When deciding if you should undergo therapy, you might be wondering how long therapy lasts and what type of time commitment you’ll need to give. One of the first questions many people ask when they consider therapy is: “how long will it take to get better?”

Of course, the duration of any course of therapy varies depending on a number of factors including diagnosis, treatment plan, delivery method and objectives. However, as therapeutic treatment is a typically standardised practice delivered by highly qualified clinical psychologists, we can give some clear indicators about how long therapy lasts.

One key thing to note is that general counselling has no defined timeframe - it may last as long as you and your counsellor want it to. Psychotherapy, with a focus on goal-driven treatment, has more defined lengths in terms of number of sessions and session timings.

How your circumstances affect timings

When working with a new client, a clinical psychologist will take into account the presenting problem, the duration of the problem and whether or not there are life events exacerbating the difficulty when determining what type of therapy best suits them, and how long the treatment will take.

They will have a treatment plan in mind which should give you an idea of total number of sessions and session length, but this will depend on the conditions you present with and your interaction with your therapist.

Clinical psychologist and director at HelloSelf, Dr Lucy Stirling, highlights the importance of a give-and-take relationship between the client and the therapist, and how this impacts the overall therapeutic experience including the treatment duration, she explains: “Therapy uses a relationship (between the client and the therapist) and knowledge (the client’s knowledge about themselves and the therapist’s knowledge about the evolution of the mind, human behaviour, relationships and psychological models of learning) to bring about a positive change in the client’s experience of themselves, others and the world and a corresponding reduction in suffering.

“This relationship is dependent on the two people in it and therefore every therapeutic relationship and therapy process will be slightly different.”

So, as Dr Stirling says, the length of any therapeutic treatment plan may be dictated by the clinician, but ultimately it is your problems, situation and circumstances that allow the therapist to work collaboratively with you to determine the duration of treatment required.

How long will it take therapy to work?

Along with the question of: “how long will it take?” is somewhat of a sub-concern of how long it will take to work, or get better. We could answer the former by saying that the average length of CBT treatment under the NHS is between 5 and 20 sessions. However, understanding how long therapy takes to work is not necessarily the same thing.

When it comes to therapy, taking CBT for example, the progress that you make relies heavily on your own input. Sessions delivered by a clinician are clearly structured and you may be given tasks to complete at home, for example keeping an activity diary. Whether you choose to complete this “homework” is ultimately up to you, but the more you participate in the CBT process, the better the impact and the sooner you will start to feel better.

So, keep in mind that it’s not just your clinician and the treatment plan that dictates how long therapy will take to work, but your own engagement and input as well.

Dr Stirling adds: “Therapy isn’t just the conversation in the room but is also the process of developing knowledge, awareness and skills, all of which can be taken with you to improve your quality of life and relationships between sessions and beyond the ending of formal therapy sessions.”

How is therapy structured?

While therapy varies person-to-person, the structure of a treatment plan is relatively fixed. Firstly, your clinician will carry out an assessment and formulate a treatment plan - this could last anywhere between 1-4 sessions depending on the complexity, severity and enduring nature of the presenting difficulty.

Next, the active treatment phase will last between 3-20+ sessions, followed by maintenance and follow-up, which may be between 3-6+ sessions spread out over a longer period.

So, while this may give you a vague idea about the duration of therapy treatment, Dr Duncan Precious, a clinical psychologist at HelloSelf, discusses each stage in more detail: “Therapy can be better thought of as episodes of treatment.

“Therapy is about: the establishment of a relationship, development of collaborative understanding/application of psychological theory/evidence, provision of treatment, consolidation/maintenance of progress/review and then ending.

“Active treatment is about applying psychological theory/evidence/techniques to achieve symptom reduction, improvements in quality of life and wellbeing and progress towards therapy goals.”

Now, let’s look more closely at common presentations and how long therapy may take for each.

For anxiety

Many of us experience anxiety at some time in our lives, especially during stressful events like starting a new job, getting married or having a child. However, for some people, anxiety becomes a dominating force in their life and something that affects them on a day-to-day basis. Symptoms of anxiety include panic attacks, intrusive thoughts, inability to sleep, over-eating or under-eating and heart palpitations among many others. Although anxiety is a mental health concern, it does have many common physical symptoms.

As with all difficulties, the length of therapy required to treat anxiety is largely dependent on the type of therapy prescribed, the severity of the presentation and any life events that may be exacerbating your anxiety.

Typically, people with anxiety benefit from CBT as it is a clearly structured treatment plan with a clear pathway of steps and places a focus on identifying and managing the triggers that lead to anxiety. The client may experience anxiety during certain social situations or they may be triggered by a past experience, all of this is taken into account when developing a treatment plan for the patient.

A typical course of CBT is between 5 and 20 sessions and the sessions usually last 50-60 minutes each.

For depression

Like anxiety, many of us experience periods of low mood and maybe even depression throughout our lives. However, for some people, depression becomes an overarching problem in their life, affecting their job, relationships and even their own health.

Depending on the presentation, complexity and severity of the client’s depression, they may be prescribed a different treatment plan - be it a course of CBT, acceptance and commitment therapy (ACT), compassion-focused therapy (CFT) or an integrative therapy combining two or more of those approaches.

In terms of treatment duration, again this is up to the discretion of your clinician but we do know that a range of 6-24 sessions is typical.

For PTSD and trauma

PTSD and trauma are typically more complex presentations that require longer treatment plans. Since PTSD and trauma are very unique presentations, there are multiple different treatment methods and, therefore, lengths of treatment. Eye Movement Desensitisation and Reprocessing (EMDR) is a psychotherapy treatment used most commonly in trauma and PTSD, and treatment with this model of therapy can often be briefer than a more personalised and integrative approach.

For such a personal condition, you’ll have to trust in your therapist and work together to ascertain the right length of treatment time.

How long does each session last?

A therapy session usually lasts for 50 minutes, although couples and trauma-focused therapy sessions may last 90 minutes. The format and structure of the session will vary depending on the model of treatment being used.

For example, an ACT session structure might be:

  1. An update on significant events during the week
  2. Feedback and discussion on any between-session activities that were set in the previous session and undertaken during the week
  3. Conversations to identify ways in which situations and current behaviour takes the client away from what is important and brings about suffering (difficult thoughts and feelings),
  4. Identifying and developing skills aimed at moving the client towards mindful, valued, willing and effective action, may include some experiential exercises e.g. an introduction to mindfulness practice
  5. Agreeing on a between-session activity to practice and build on skills.

How long is long enough?

Your clinician will work with you to create a treatment plan to suit your presentation, so you don’t need to worry about deciding what is “enough.” At the start of treatment, your clinician will assess your difficulties and give you an estimate for how long the therapy will last, this will become more specific over the next few sessions as you get to know each other and start to progress.

How do you track your progress?

On that note… how do you track progress? And how do you know therapy has worked? Your therapist may suggest keeping a diary throughout, so you can track progress made. For example, if you experience social anxiety, your notes will highlight big milestones like attending a social event or speaking in a work meeting.

Once your treatment plan is complete, your therapist will give you the tools you need to continue self-improvement in your own time, so you can harness the tools and skills you’ve developed to support you through forthcoming situations and life events. This is where the two-sided approach to therapy really shines - if you dedicate time, energy and attention to learning from your therapy and developing coping techniques that you can continue to use throughout the rest of your life.

Ready to start therapy or keen to find out more about finding the right treatment for you? Get in touch with HelloSelf today to start your online therapy journey.

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