Aside from “how long does therapy take?”, which was discussed last week, another common question is “how often should I be seeing my therapist?”

Again, it depends. So let’s talk about that.

What follows applies to those who are coming in for individual, family, couples, child or adolescent therapy.

In the Beginning

We recommend doing weekly sessions for 4-6 weeks regardless of whether you are being proactive or working on a specific challenge. If you are in crisis, you may need multiple sessions a week in order to stabilize the situation.

We recommend having those first 4-6 weekly sessions because two important things are happening.

One is you are getting to know your therapist, seeing how they work and how comfortable you feel working with them. You are sorting out if you can trust the guidance and insights that your therapist brings forward, if you find their responses and way of working helpful to you. If that trust is not there, you are not going to get the return on investment.

Second, your therapist is finding out all about you and what is bringing you to therapy. Your therapist is gathering information about your history, your family, your health, your support network and your current coping strategies through what you say and what you don’t say. Give your therapist the opportunity to do that because they are going to be WAY more effective that way.

Once you have some trust and good rapport built up and your therapist has a solid picture of what is going on with you, you guys can decide together what is going to be best in terms of session frequency.

Weekly Sessions

Weekly sessions are super helpful in the following situations:

• you are working on building skills (coping, communication, social, mindfulness skills)
• you are working through a specific challenge that is actively showing up in your daily life (anxiety, relationship difficulties including divorce, grief, behavioral issues, depression, trauma).
• you are breaking old patterns and reprogramming thinking as well as behaviors because this requires repetition and a neutral party who can consistently support you in seeing how this is showing up in your life as well as how to shift.

Of course, there are other reasons, those are just some basic ones. Weekly sessions are most definitely an investment of your time and resources. And, doing this from the start will actually get you where you want to go faster. Doing biweekly sessions might actually fatigue you and feel like therapy is not working because progress may take longer or just might be more difficult. Better to fully invest and get your work in.

Biweekly Sessions

This is a good option when:

• You have been in therapy some time and you are seeing progress like less anxiety, alleviated depression, decreased overwhelm, being able to practice the skills you are learning in session out in the real world.
• You are being proactive about coming to therapy so there is nothing urgent, but you are doing some inner work on yourself and you are doing work between sessions that your therapist suggests or that you find supportive like meditation, journaling, establishing a fitness routine, etc.

As Needed Sessions

This is helpful at the following times:

• You are a therapy veteran! You have been in therapy for a long time and your therapist knows you well so when something comes up and you schedule a session, your therapist knows how to support you through it. Sometimes people come in for one session, sometimes it’s a series of sessions to deal with a specific challenge.
• You have an established relationship with a therapist that you created while being proactive. Your therapist is familiar with your history and goals and can be there for you when stuff comes up.

Multiple Sessions in One Week

This is usually indicated when:

• You are in crisis, which means that your safety is in question or daily functioning is impaired (can’t stop crying, concerns about self harm, can’t go to work or school, etc).
• You are in the middle of making a big decision or big transition in your life and you need support through that to stay healthy and afloat.

This is by no means a comprehensive list, just something to give you an idea of what to expect as you embark on or during your journey in therapy.

Know that this is an important conversation to bring up periodically with your therapist. We want to be mindful of your time and resources AND we want to make sure that your experience in therapy is effective and productive. Not something that drags on. Or conversely, doesn’t sufficiently address your goals, which then makes therapy less than effective.

Engage in making the decision about how often you come in for sessions together with your therapist, as their clinical recommendation is important to consider.