6 Factors That Can Determine How Long Therapy Will Last
Key takeaways:
Therapy can last for just a few sessions or can go on for several years.
Many different factors can affect the length of therapy, including your symptoms and treatment goals.
Termination is the process of ending therapy after your symptoms have improved, your treatment goals have been reached, and you are likely to maintain stability without regular professional support.
Table of contents
When starting therapy, one of things clients wonder is how long it will take. They want to know what to expect and how much time they will have to invest in it. Answering this question is tricky, though, because there is not a straightforward answer.
There are many different types of therapy for a variety of symptoms and diagnoses. Each therapy approach differs in a number of ways. One distinguishing feature is whether a therapy approach is intended for a specific number of sessions or is open-ended.
So let’s take a look at what can impact how long mental health therapy might last.
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How long should therapy last?
Therapy should last as long as it takes for you to notice improvements and feel better. There is no standard length of therapy. It could take several weeks, months, or even years, depending on the person and type of therapy.
Studies have found that, on average, around 50% of clients experience improvements after 15 to 20 sessions. Some clients choose to continue therapy even after they feel better to work on new goals or to make sure that they can maintain their progress.
Several factors can play a role in how long therapy typically lasts.
1. Type of therapy
The type of therapy is a critical factor in the length of treatment. Some therapies are designed to last a specific length of time, while others are open-ended.
Examples of therapies that are often shorter in length include:
Cognitive behavioral therapy (CBT): 6 to 14 sessions.
Cognitive processing therapy
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Other types of therapy are open-ended. This means they aren’t designed to have a fixed timeframe. Examples of open-ended therapies are:
Psychodynamic therapy
2. Your treatment goals
Your specific goals for therapy will play a big part in the length of your treatment. If you have many goals or add to your goals over time, then your therapy will take longer. Also, if your goals are broad, rather than specific, it will probably take you longer to reach them.
3. Your symptoms and diagnosis
The severity of your symptoms can also affect the length of therapy. If your symptoms are severe and chronic, then it will most likely take longer for therapy to work.
Conditions that often take longer than 6 months to a year to improve in therapy include:
Serious mental illnesses like schizophrenia
Complex traumas
Co-occurring mental health and substance use disorders
Personality disorders such as borderline personality disorder (BPD)
It should be noted that these are general guidelines. Everyone is different, and even people with the same mental health condition may have different rates of progress.
4. The rate that you make progress
Some clients will make progress faster than others. Clients who progress at a slower rate may need longer to experience the benefits of therapy. Clients who improve quickly may choose to end therapy when they start to feel better. Others may continue even after their symptoms go away.
It’s important to know that therapy is not a race. For some people it may take a few months, while for others it may take years to improve. If it’s taking longer than expected, talk to your therapist about how you’re feeling. Maybe you could benefit from a different treatment approach, or maybe you just need more time.
5. Your investment in the process
Your investment in the therapy process is an important part of how long therapy lasts. The more motivated and engaged you are, the more you will get out of therapy.
There are several ways that you can invest in the therapy process, such as:
Attending your appointments consistently
Coming to sessions ready to work
Completing homework assignments
Being receptive to feedback from your therapist
Thinking about what is discussed during therapy in between sessions
It’s OK if you’re not feeling motivated for therapy or have times when you feel unmotivated. Many clients struggle with this. If you’re having a hard time getting invested, talk to your therapist about what you’re feeling. Your therapist can help you work through this.
6. How you pay for therapy
Therapy should be affordable to everyone who needs it for as long as they need it. But sometimes financial issues may mean you need to end therapy. This often happens when you use your health insurance plan to pay for therapy.
When you use insurance to pay, health plans require that clients continue to meet medical necessity for therapy. What an insurance company considers medically necessary may be very different than what you feel is most helpful for your mental health. If your insurance coverage declines to pay for additional coverage, it may be difficult to pay out of pocket to continue treatment.
In addition, some insurance coverage has limits on how many sessions you can have per year or per issue. And if you change insurance companies or your therapist no longer accepts your insurance, you may also need to stop therapy due to financial reasons.
If your financial situation makes therapy difficult to continue, speak with your therapist. Therapists may offer sliding scale or reduced rate spots for clients who are having a hard time paying for treatment. They may also be able to refer you to a therapist who accepts your health plan or offers low-cost services.
How do you know if therapy is working?
Generally, you’ll know that therapy is working once you start to feel better. This could mean that your symptoms improve or you’re better able to function in different areas of your life. Around 75% of clients experience some benefits from therapy.
Because therapy is a process, you may not see results right away. Some people actually feel worse in the beginning as they open up about difficult thoughts, feelings, and experiences. This is normal and should improve over time.
Signs that therapy is working include:
You are better able to cope with your symptoms.
You have greater self-confidence.
Your relationships have improved.
You’ve changed ineffective behaviors.
The past no longer feels like it’s holding you back.
You have goals for the future.
You feel motivated.
You’re better able to solve problems and take on challenges.
You can cope with uncomfortable emotions like anger and grief.
How do you know when it’s time to stop therapy?
Therapy is not necessarily meant to last forever. The goal of therapy is for the client to feel better and meet all of their treatment goals. When this happens, therapy is ready to come to an end.
Signs that you are ready to stop therapy include:
You no longer experience the symptoms that originally brought you to therapy for at least 2 months.
You’ve developed new skills to help you cope with your symptoms.
You feel confident that your new skills will continue to serve you in the future.
You’re better able to function, take care of yourself, and meet responsibilities.
You’ve experienced improvements in other areas of your life.
How to break up with your therapist and stop therapy
If you think that you’re ready to end therapy, bring this up with your therapist. You and your therapist can then discuss whether you are ready for termination and begin making a plan.
Termination is the process of ending therapy. It starts when the therapist and client agree that you have met your goals. A date is set as the final session. You use the remaining time to reflect on your progress and prepare for the end of therapy.
It can feel awkward to “break up” with your therapist. But discussing termination and working on it together is one of the most important parts of therapy. A discussion about termination should be done in session and not by email or text message. This gives you the valuable experience of reflecting on your work and saying goodbye to your therapist.
If you have had difficulty with ending relationships in the past, you may find this process to be especially challenging. It may seem strange to spend several weeks or even months saying goodbye. But termination can serve as a corrective emotional experience. This lets you see what it’s like to end a relationship in a healthy way.
In some cases, it may not be necessary to go through the entire termination process, such as if your therapist isn’t a good fit for you. It can be helpful to talk to your therapist about this. A good therapist will be open to what you have to say and not become defensive or judgemental. They may benefit from learning why you’d like to end, especially if it’s something they could work on, too.
The bottom line
Therapy can last for different lengths of time depending on the type of therapy, your symptoms, and how invested you are in the process.
Some types of theraps, such as cognitive processing therapy, are designed to last for a shorter number of sessions. Longer-term therapies are designed to be open-ended and do not have a set end date.
You and your therapist should talk about what approach is best for you and prepare for the ending of therapy together.
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References
American Psychological Association. (2017). How long will it take for treatment to work?
American Psychological Association. (2018). Definition of termination.
American Psychological Association. (2023). Understanding psychotherapy and how it works.
American Psychiatric Association. (2023). What is psychotherapy?.
Castonguay, L. G., et al. (2012). Corrective experiences in psychotherapy: An introduction. Transformation in psychotherapy: Corrective experiences across cognitive behavioral, humanistic, and psychodynamic approaches.
Jakobsons, L. J., et al. (2007). When are clients ready to terminate? Cognitive and Behavioral Practice.
Mental Health America. (n.d.). Therapy.
Rapfogel, N. (2022). The behavioral health care affordability problem. Center for American Progress.
Ryan, R. M., et al. (2011). Motivation and autonomy in counseling, psychotherapy, and behavior change: A look at theory and practice. The Counseling Psychologist.
U.S. Department of Veterans Affairs. (2023). Evidence-based therapy.
Yao, L., et al. (2023). Person-centered therapy (Rogerian therapy). StatPearls.
Yontef, G., et al. (2005). Gestalt therapy. Current Psychotherapies.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
