How long does it take for therapy to work?

Key Takeaway:

∎How long it takes for your therapy to work starts with finding the right therapist for you. ∎ There are a couple of important models to consider when looking at the length of therapy. Ultimately, this decision should be left up to you. ∎There are a number of signs to look for to let you know your therapy is working. Feeling better, seeing signs of change, and feeling supported by your therapist is what is important.

Sarah is going to therapy for her anxiety. It’s become overwhelming lately, and she’s noticed it’s starting to interfere with her day-to-day living situation. The ongoing struggle of ruminating about what she has or hasn’t done, what she needs to do next, is causing her a consistent amount of dread even thinking about where to start. Naturally, this has caused her to begin to worry, and lately, it’s been affecting her sleep. It was time to seek help. She found a therapist she got along with, someone she could trust, however; the cost of therapy was also a little steep, and insurance can only go so far! Of course, Sarah wondered, “How long will this take before it starts working?” “How many sessions before I start to feel better?” “Am I going to be able to afford this?”

Sarah’s story is a story that many of us who have gone through the therapy process ask ourselves. A frequently asked question drives the question; “How long is it going to take for therapy to work?”

Determining how long it takes for therapy to work sometimes means asking if we need treatment in the first place:

For many of us, the challenge with going to therapy is wondering if we need to go in the first place. Given the cost and time investment involved in therapeutic intervention, it’s easy to guess whether you’re making the right decision. This is an entirely normal response! There was a time when seeking a therapist was quite stigmatized. Fortunately, that stigma is starting to disappear with time. The question, however, remains – when is it a good time to seek a therapist?

The American Psychological Association has two main guidelines when it comes to determining if you need therapy:

1. Is the problem distressing?
2. Is the problem interfering with my day-to-day life?

To determine if the problem is distressing – you can ask yourself:

1. Do I spend time ruminating over the problem every week?
2. Is the problem itself causing me an embarrassment to the point where I want to keep it away from others?
3. Has the problem created a space interfering with my quality of life?

When considering the level of interference the problem is creating in your life; the APA suggests asking yourself:

1. Does this problem take up considerable time in my daily routine? Is there an hour or more each day where I am handling the problem?
2. Is the problem interfering with my work or educational ambitions?
3. Are you accommodating the problem by making adjustments to your lifestyle?

A “yes” to these questions may indicate it’s time to seek help. Nonetheless, the decision to go into therapy is deeply personal and only a decision you can make. More importantly, you should also note that it’s essential to choose a scientifically proven treatment to be effective. There are several treatments and styles of therapies that have been proven to be effective for a variety of disorders. Taking the time to learn about specific therapies may be helpful regarding what you’re dealing with. More importantly, ensuring you and your therapist are a good fit is also a good call.

How long therapy will take may also come down to finding the right therapist:

Determining how long therapy is going to take may also be a matter of finding the right therapist. Knowing when therapy is not working will save you time and frustration. Seeking the proper treatment is an essential first step in the therapy decision-making process for your particular disorder; however, ensuring you have a good relationship with your therapist is also essential. An incredible amount of research indicates that a good “therapeutic alliance” is essential for psychotherapy to impact your overall welfare positively.

Before going into therapy, there are some fundamental questions to consider when you’re attempting to find the right therapist:

1. What is your therapeutic philosophy?
   • Therapists have treatment philosophies that inform their therapeutic interventions. It’s essential to discover if your therapist’s philosophies on therapy will be a good fit for you overall.
2. How long have your been providing therapy?
   • Knowing how long your therapist has been providing therapy is often an excellent pre-text to understanding the quality of treatment you will receive in their practice.
3. What kinds of therapy do you recommend for me?
   • There are many kinds of therapy. Ensuring your therapist has a promising therapy modality that will fit your needs is vital to the healing process.
4. How long is each session?
   • Some clients need a more extended amount of time with their therapist. Most therapy sessions are around 50 minutes in length. Some therapists offer longer sessions.
5. Can you refer me to someone who specializes in what I’m dealing with?
   • This is an important question, especially if you notice the therapy is not working. Ensuring that your therapist has good connections within your city is vital, especially if treatment is ineffective with that therapist.
6. What will therapy sessions be like?
   • Some therapists have highly structured therapy sessions. However, not everyone is comfortable with this process. If you prefer a more “go with the flow” style of therapy, it might be time to consider other options.
7. How long will therapy last?
   • If your therapist is experienced, they should be able to provide you with a general time frame. However, some conditions are hard to predict. Some brief therapies can take six weeks; another treatment measure may require up to 20 weeks or more.

Finding the right therapist can be a bit of a balancing act. However, once you have found someone you feel you’ll jive with, the treatment process usually proves much more effective in the long term. Don’t take the interview process for granted! If you’re looking to narrow down your treatment window, you must find someone you can connect with that, most importantly, is there to serve you.

The time commitment involved in therapy:

Once you’ve found a good therapist that you feel will meet your treatment goals, determining how long therapy is going to take comes down to several factors. However, a general guideline from the APA is therapy can take up to three months or 15-20 sessions before a patient starts feeling better. The research on the topic, however, indicates that there are different models to consider when looking at treatment lengths in individuals –

The dose-effect treatment model: The treatment as dose model was first published in 1989 by Kenneth Howard in the Journal; “American Psychologist.” The model suggests that the number of doses impacts the outcome of wellness the patient experiences. In particular, psychotherapy followed a treatment course, not unlike medication, where the returns experienced by the patient decreased rapidly with higher dose rates. What was found was that 14% of patients improved before attending the first sessions, 53% improved following the 8th session, 75% improved following 26 sessions, and 83% improved following the 52nd session. This effectively examines the number of therapy sessions on the patient and then measures clinical improvement after the treatment period.

The “Good-enough” model – Interestingly, there is another model known as the “good enough model” of therapy intervention. This model is highly patient-dependent and states that different patients will require different levels of treatment. The theory addresses that some patients will determine the number of therapy sessions based on their feelings. Some patients will require as little as four sessions, while others require many more.

Overall, both models suggest that many factors affect how long therapy must last before it becomes clinically effective. As a result, many studies warn against providing universal numbers to patients regarding how many sessions it will take before clinically significant developments occur within your overall welfare.

Signs your therapy is working:

Determining whether or not your therapy is working will be a conversation between yourself and your therapist. Deciding on treatment goals and the direction of therapy is something that you should be discussing with your therapist throughout the therapeutic relationship. There are, however, several indicators that should tell you whether or not the treatment is working:

1. You start to feel better – the issues that you went into therapy for in the first place is starting to diminish, and you notice that it is interfering with your life less significantly than before.
2. You’re learning about unhealthy coping mechanisms and taking steps to resolve them.
3. Your relationships are beginning to improve with those around you.
4. You begin seeing patterns in your previous behavior and how it impacts your current behavior, so you can make behaviors that will not have the same effect they did on you.
5. You feel a high level of support from your therapist.

How will I know when therapy is “finished”?

One of the critical signs of a good therapist is ensuring a safe space for you to tell them, “It’s time to end therapy.” There are many signs that it’s time to end therapy which include:

1. You feel better. The goal you came into therapy for has been achieved, and you’re not concerned with what was bothering you before coming into treatment in the first place.
2. Your needs have changed throughout therapy, and your therapist is no longer the right person for the job. This happens! Don’t worry – your therapist should have several connections available through other therapists that they can refer you to!
3. You don’t have anything left to talk about. Talk therapy requires exactly that, talk. There is no longer a need for intervention from your therapist. It’s perfectly ok to say this and move on!
4. You and your therapist agree that it’s time to graduate! If you both have come to the end of the session and you have a new understanding of yourself and your problems – pat yourself on the back – you’ve done some heavy lifting, and it’s time to move on.

We understand there are challenges when letting go of a therapist who supports you throughout your healing journey. You’ve found someone you work well with, they’ve helped you significantly in your overall results, and you’re feeling much better than you were before. It’s time to move on, yet you still think that you’re about to lose a meaningful relationship. That’s perfectly natural! Don’t let it stop you from enjoying your life! Most importantly, don’t hesitate to reach out occasionally to your therapist. There may come a time when you need more assistance down the line.