How Long Is Therapy? Understanding The Therapy Process

Over 41.7 million US adults saw a therapist in 2021, and that number continues to grow. However, some people have misconceptions about mental health treatment. Understanding the therapy process, how long it can last, and how to set treatment goals may be helpful for deciding whether to reach out for support. 

Note that anyone can receive therapeutic services, regardless of diagnostic status. That is, you do not have to have a mental illness or suspected condition to receive guidance. Many people seek therapy for stress, relationships, life advice, and other topics. Keep reading to learn more about the therapeutic process, including what to expect and how long therapy can last. 

How does therapy work? 

Therapy is an umbrella term encompassing over 400 therapeutic modalities designed to treat symptoms of mental illness, support individuals with stress, address relationship challenges, or offer life advice. Therapy is psychologically based and may focus on how mental health impacts all areas of life, including professional, educational, and personal issues. 

Although therapy sessions may vary in subject matter and technique depending on the modality used by the therapist, many take place in an office or online setting. Therapy can take place in individual, couples, family, or group formats, depending on the client's needs and the therapist's specialty. 

How long are therapy sessions? 

Each therapist can set their own time requirements for sessions. However, the average therapy session in the United States is 30 to 60 minutes, and the ICD-11 (a diagnostic manual used by therapists) allows therapists to code 30 to 60 minutes for billing purposes. The cost of therapy may vary depending on the length of the session. 

How many sessions a month should you have? 

How many therapy sessions you have can depend on your treatment plan and preferences. Some people attend therapy once a month, while others attend once or twice weekly. Your therapist can talk to you about their standard policies for session numbers, and you can switch your plan if necessary. 

If you have a health insurance plan, the insurance company may limit how many therapy sessions you can attend per week or month. You may be required to pay out of pocket if you have more sessions, so you might want to check with your insurance company before making appointments. 

How many sessions of therapy can occur before the end of services? 

There may not be a limit to the number of therapy sessions one can have. You can go to therapy for as long as you want to if your therapist is available and if you find it helpful. However, many people come to treatment with one or more specific goals in mind, and a therapist might have an idea of how many sessions are needed to meet those goals.  

Some therapeutic modalities also work under a specific number of sessions. Short-term forms of therapy might only require two to ten sessions, whereas longer forms might take 20 to 60 sessions. In some cases, people stay in therapy for years to work on long-term concerns such as a severe mental illness or past trauma, for example. They might also use therapy to talk to someone about daily events and receive compassionate advice and professional guidance. 

To get an idea of how long you might be in therapy, you can talk to your therapist at the start of treatment and ask them what they think may be most helpful in your case.  

How to set treatment goals with your therapist

Often, the number of sessions you have and the time you're in therapy can depend on your treatment goals and the plan you and your therapist devise when you start therapy. Treatment plans may be linear, or your therapist might check in with you throughout your therapeutic journey to see if you're meeting your goals. 

List of goals that you can set with therapists

Your goals can depend on your motivation for seeking treatment, but may include the following: 

• Being able to work through symptoms at home independently 
• Ending an unhealthy habit 
• Quitting a substance 
• Finding a method that treats your mental illness or helps you manage symptoms
• Solving a significant life challenge 
• Making a difficult decision with your therapist's support 
• Resolving conflict in your relationship
• Coping with divorce or a breakup 
• Reducing stress 
• Improving communication 
• Understanding yourself on a more profound level 
• Finding resources to improve your life such as housing, food, or inpatient treatment 
• Feeling validated and supported after an adverse event or trauma
• Finishing a court-ordered round of therapy 
• Learning a new skill 

How long is therapy in dialectical behavior therapy (DBT)?

Some therapeutic modalities have specific timelines or goals for clients. One such module is dialectic behavior therapy (DBT). Although DBT can be long-term, it is a structured form of counseling that often ends in graduation from services after clients have worked through the entire workbook and mastered the DBT skills. It is often offered in a group format but can also be delivered via individual or couples therapy. In this case, the treatment goal is to master certain skills.

If you are struggling with substance use, you can contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

How do you know when you don't need therapy anymore? 

Many clients may feel like they have been in therapy for a long time and want to know when to stop. The following signs might signify that you are ready to move forward from therapy. However, you can come back to therapy at any time if you find that you need it again in the future. Some therapists may even keep session slots open for past clients in case they want to return. 

Your therapist recommends ending services

If your therapist tells you that it could be beneficial to end services due to your improvements, it could be a sign that you're ready to practice your new skills independently. Your therapist might recommend this option if you often come to therapy without anything to talk about or haven't reported any new or worsening symptoms for several weeks or months. 

If you disagree with your therapist's assessment, let them know why. If you've been holding back your thoughts and feelings in sessions, for instance, you can talk about these challenges together and develop a new plan to help you start being more open. Your therapist is there to help you, so it can be important to be as honest as possible. 

You've met all or most of your treatment goals

Sometimes, people find that they've met all the goals they came to therapy to achieve. If you have met all your goals and don't have any new goals for therapy, you might consider letting your therapist know you'd like to end sessions. In addition, if you are living with a mental illness and your symptoms are now fully managed, you may be at a point where further treatment may not be beneficial. 

You want a break from therapy

People may go through periods where they need a break from therapy or have temporarily experienced a lapse in symptoms. If you think you might still find value in therapy in the future but need a break to focus on other aspects of your life, let your therapist know you'd like to stop sessions temporarily. They may be able to accept you back when you're ready. You can also consider attending fewer sessions per month or visiting your therapist on an as-needed basis. 

You are successfully managing your symptoms independently

You might be ready to stop services if you've noticed you're successfully managing your symptoms and concerns at home independently. If you have learned coping skills in therapy and feel confident about implementing them, you may feel ready to manage your mental health on your own. 

Your therapist isn't a match

Some people end therapy with a specific provider because their modality, approach, or personality isn't a match. In these cases, you might try reaching out to a different therapist or exploring a new modality that may be more effective for you. You may not want to give up on therapy due to a few poor experiences. There are thousands of therapists in the US and many ways to receive support. Everyone needs something different, and it may take some time to find the right provider or treatment approach for you.

How long is "too long" to be in therapy? 

Attending therapy long-term may feel shameful or embarrassing for some clients. However, there is no specific time limit for therapy.

Flexible counseling options for individuals with mental health concerns

For some individuals, meeting with an in-person therapist can be challenging due to the time commitment, cost, and distance of many providers. In these cases, online therapy through a platform like BetterHelp may offer flexibility and convenience. With an online platform, you can end services anytime for any reason and switch therapists until you find the right match. These options can allow you more control over how and when you receive care. In addition, you can attend as many or as few sessions as you want each month, which may allow you to work therapy into your busy schedule more easily. 

The efficacy of online counseling

In one study, researchers looked at the effectiveness of online counseling compared to in-person therapy for adults experiencing depression. They determined that 71% of participants found online therapy more effective than in-person counseling. Specifically, these individuals reported that online therapy was 90% easier to attain, 100% more convenient, and 80% more affordable. Further, 93% of participants reported that if they needed therapy in the future, they’d choose online counseling.