Treatment Length

Therapy in Indianapolis, Zionsville, and Carmel, IN

Everyone wants a quick fix. I certainly understand. I like a quick fix myself. Sometimes psychotherapy can make it happen. However, quick fixes are more the exception than the rule. How long will treatment take?  Well, the answer to that question, like the answer to many other questions, is, "It depends." Effective psychotherapy can take anywhere from one session to years of sessions.

If the problem is very specific and has just come up, the course of therapy will probably be brief, a session or perhaps ten, depending on the complexity and number of people affected. The length of treatment is very dependent on the breadth, intensity, number, complexity, and duration of problems. Treatment will take longer: the more areas of life the problems impact, the longer the problems have been operating, the more intense their impact on self and others, the more problems there are, and the more complex are their interactions.

Yes, quick fixes that require little time and  effort are great when they can happen, but psychotherapy usually demands persistence and working through. Sometimes medications work without much effort from patient and therapist; however, they can have limitations even when they do help. After comparing medication and psychotherapy, Tryon (2016) concluded, "While psychotherapeutic effects may take longer to emerge, they may be more enduring because learning-based synaptic changes are structural whereas pharmacological modifications are often not" (p. 280).

Recently, Shedler and Gnaulati (2020) did an extensive review of the literature related to length of psychotherapy. They had asked, "How long does effective therapy really take" (p. 26)?  Unlike many evidenced-based reviewers, they did not rely solely on symptom reduction to measure effectiveness. Instead, they also looked at what patients and therapists defined as important. The patients had varied characteristics, and the therapists were almost equally psychodynamic, cognitive behavioral, and eclectic in their theoretical orientations. Interestingly, there was much agreement between patients and therapists. Both groups valued such goals as more self-acceptance, a stronger sense of identity, better relationships, more appropriate self-assertiveness, and increased self-understanding. Symptom relief was lower on the list than these more meaningful changes.

Shedler and Gnaulati (2020)  findings echoed those of a 25 year old systematic study done by Consumer Reports: "Meaningful change began at about the six-month mark, and clients who stayed in therapy for a year did substantially better. Those who stayed for two years improved still more" (p. 26). They concluded that therapy takes time It may be said that sometimes the longer, the better.

No matter the treatment length, successful psychotherapy can be the gift that keeps on giving. The American Psychological Association's 2013 resolution stated that those who find psychotherapy has been effective report that the benefits last after psychotherapy concludes and improvements continue to be made long after the termination of therapy.



American Psychological Association. (2013). Recognition of psychotherapy effectiveness. Psychotherapy, 50(1), 102-109. doi: 10.1037/a0030276

Shedler, J., & Gnaulati, E. (2020). The tyranny of time: How long does effective therapy really take? Psychotherapy Networker, 44(2), 26-31 & 52.

Tryon, W. W. (2016) Transtheoretic transdiagnostic psychotherapy Journal of Psychotherapy Integration. 26(3), 273-287.

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