How long is Therapy?

This is probably the question I get asked the most, other than “What is Hypnosis like?” It’s a great question as it allows you to plan and budget for therapy. Let’s look at the research first before jumping into my thoughts about it.  According to a 2010 study published in the American Journal of Psychiatry, 42 percent of people in psychotherapy use 3 to 10 visits for treatment, while 1 in 9 have more than 20 sessions. Other studies find about the same length of treatment.

My own Practice Statistics

When I track how many sessions people do in my practice, I find about the same amount. About half are done in 3 to 10 visits.

Hypnosis – When someone comes in for something specific, it ranges anywhere from 1 – 7 sessions, sometimes extending to 8-10 session but that’s usually if someone is also working on multiple problems. The vast majority of hypnosis cases are done in 3-5 sessions in my practice. Hypnosis for IBS is a 7 session protocol. Smoking Cessation is 3-5 sessions. Headaches and Migraines is about 6 sessions.  Hypnosis for Insomnia is 1-3 Sessions. Even Chronic Pain and Chronic physical disorders generally come in, learn skills to decrease and manage pain and disability better, and are done pretty quickly. Those are only a couple of the areas that I do Hypnosis for. Change is fast!

Couples Counseling –  When there’s not a personality disordered partner, couples are generally done in 8-12 sessions. If there has been an affair, then it can go longer than that but in general, couples counseling is pretty fast.

Anxiety and Panic Disorder treatment in my practice in Broward really varies. If it’s moderate, we’re generally done within 8-10 weeks. If it’s more severe, then the treatment is longer as we work on skills to handle anxiety and panic disorder step by step. People are always amazed to hear it’s only a couple of months. They often say they tried seeing a therapist and they didn’t get better. When I ask whether they did any structured worksheets or handouts, the answer is generally, “No.” And that is why I believe it didn’t help them.

Using structured handouts and worksheets and Cognitive Behavior Therapy (CBT) combined with hypnosis, which is what I do in my practice, helps people with panic attacks and anxiety get better quickly!

Post-partum anxiety and depression moms are generally feeling better and on their way in a month or two of therapy. That’s 4-8 sessions. Prenatal anxiety and depression counseling can extend a little longer, lasting through a pregnancy and several months after a birth.

Who goes More than 15-20 sessions?

Let’s look at the clients going more than 15 – 20 sessions in my practice. I want to be clear here that I’m only talking about the clients that I generally treat.  Of course there are specialties that I don’t handle that I don’t address in this article. This is what I see in my own practice. They fall into a couple of categories.

(1) They have moderate to severe  depression, anxiety, overeating, or Obsessive Compulsive Disorder (OCD). This includes picking, hair pulling, severe phobias that include rituals afterwards (hand washing, cleaning, checking, etc.).

(2) They enjoy or need depth therapy, processing trauma and/or abuse that is affecting their daily lives. I included the word “enjoy,” because some people really enjoy the process of therapy, bouncing ideas off of someone else, getting direct feedback, and doing some exploration of how either childhood events and/or trauma or events and trauma in adulthood affect their present lives.

(3) Some clients need support to function on a daily basis. Borderline Personality Disorders often need years of therapy due to deficits in emotional regulation, knowing what’s real and what’s not real (and needing to check it out with someone), and skills in handling the nuances of relationships. Learning emotional regulation takes time. There’s just no way around it.

(4) Addiction. Many, many addicts in recovery need on-going therapy. Most of them fall into the above three categories and the addiction is a way of coping with those events or problems. Therapy in this instance is address (1), (2), and/or (3) as well as the process of staying sober.

(5) Heartbreak. This may be an unexpected category for a lot of readers, but my clinical experience is that heartbreak is a much longer process than people expect, ranging from 1-2 years for full recovery. “Recovery” means you are not pining over the person, obsessing about them, online stalking them and they’re not in your daily thoughts. This can also include someone in a marriage that’s not a healthy or satisfying marriage. That’s a form of heartbreak!

Every other Week vs. Weekly Therapy

Sometimes people ask if they can start with every other week due to financial concerns or their schedule. When you do every other week therapy, your treatment slows way down. I almost never start with every other week because it takes time to get to know someone, what they’re facing, to build trust, and to start working on what they came in for. Every other week therapy at the beginning feels more like taking half an antibiotic. The work is slower so the progress is slower, which affects motivation. Weekly sessions keep you changing and motivated as well as provide a consistent, safe space.

Depending on how you grew up and whether a lot of chaos was present, it may be the first time in your life that someone holds a consistent, safe space for you. You can read more about this in this wonderful article by therapist Jodie Gale on “Why Counsellors & Psychotherapists Recommend Weekly Therapy.”

I generally recommend that people start with weekly therapy (and sometimes twice a week). Once someone is feeling better and on their way to functioning well, we either end treatment or do a couple of session of every other week therapy until we end treatment. If someone wants to move into more depth work which takes more time and is more of “on-going” therapy, then we discuss that.

I hope this helps you understand the length of treatment. Yes, it depends on what you’re coming in for. Regardless of length of treatment, it’s always an investment in yourself and in your family and loved ones. The healthier you are, the less it affects them.

Regardless of who you’re seeing for therapy, it should always be a discussion between you and your therapist about how therapy is going, whether your goals are being met, and where you are in your therapy. Don’t be afraid to bring it up to your therapist if you have questions. We love to talk about it!

I specialize in hypnosis for anxiety and chronic conditions in Broward county and the Fort Lauderdale area. To see if we’re a good fit to work together, schedule your free consultation at 954-309-9071.

Yours in health,
Dr. Liz