Should Therapy Last Forever?
Are you contemplating starting therapy, in the middle of therapy, or considering stopping therapy and wondering how long therapy should last? Well, the answer to this question is—it depends! The therapy modality, practice setting, insurance, treatment goal(s), client, and therapist all influence the duration of therapy.
Some therapy modalities (i.e. styles of doing therapy) like solution-focused brief therapy, cognitive processing therapy, and trauma-focused cognitive behavioral therapy have guidelines/manuals for completing therapy in a set number of sessions, typically 12. There are specific topics and goals for each session, and within 10-14 sessions with your therapist, you’ll hopefully have met at least your initial treatment goals. Other therapy modalities may have looser timeframes or none at all, and use other metrics to track progress towards treatment goals.
Where you get therapy also affects how long it lasts. In a community mental health practice, they are more likely to use modalities with shorter, defined durations and have outcome-based performance measures that push for therapeutic progress as quickly as possible. In an acute/time limited practice setting, treatment could be limited to the duration of your stay or program. For example, crisis stabilization units (CSUs), typically have group and individual therapy daily for three to five days, with recommendations to follow up with a residential program, partial hospitalization program (PHP), intensive outpatient program (IOP), or standard outpatient provider where duration varies from six weeks to six months on average.
If you’re using insurance, a mental health voucher program, or an Employee Assistance Program (EAP), they typically impose limits on how often and how long you have therapy. You may have a certain number of units (15 minute increments) or sessions that are allowed by your insurance before additional requirements and paperwork are needed to document medical necessity. Insurance companies typically like to see progress towards your goals within six months and some require a new treatment plan addressing barriers to change and new methods to reach those goals to continue past six months. Mental health programs may have a specific number of sessions they’re willing to pay/reimburse for. Typically clients have about six sessions through their EAP, or up to 12 sessions from voucher programs like the Loveland Foundation.
Therapy is when a therapist and client(s) collaborate to meet the client’s treatment goals using different evidence-based interventions. Treatment goals are different for each client and include but are not limited to: adding additional problem solving skills, building self-concept, strengthening client relationships and social support system, and reducing specific mental health symptoms that are getting in the client's way of living the life they want. Because of this personalization of treatment, sufficient progress towards a goal may be reached in two sessions, or two years, or two decades.
Therapy also often ends early for reasons other than successful termination; where a therapist and client agree the client has reached their treatment goals. Therapy can end due to financial barriers, loss or change of insurance coverage, therapists moving or quitting practices, clients moving to new states, referral to a better fit therapist, and other expected or unexpected adjustments in the lives of the therapist and/or client.
TLDR: Brief therapy is typically about 12 sessions, with standard treatment plans lasting six months to one year. The duration of therapy varies based on the style of therapy, where you’re getting therapy, how you’re paying for therapy, what you’re going to therapy for and the circumstances that the therapist and client experience throughout therapy.
As a solo therapist in private practice that does not take insurance but offers sliding scale prices, a benefit to beginning mental health services with me is the lack of most barriers that stop therapy early. Clients collaborate on their goals and treatment plan, know exactly what cost will be and have the option for their fee to ebb and flow as their income does, and they have the consistency of knowing they can have the same therapist for as long as they need to progress towards their goals.
