How Long Should Psychotherapy Last?
It depends on the point of therapy.
Posted Sep 14, 2017
One of the things I’ve heard said is that some psychotherapies take too long.
If you have a choice between two therapies that produce the same result, it makes sense to choose the one that has been shown to be faster.
But while that seems sensible, it doesn’t mean that longer term therapies are never helpful.
If there is a clearly defined result to aim for, it may be possible to make choices about which therapy to opt for based on research findings about which is fastest. But people looking for longer-term psychotherapy may want something different.
Often people come into therapy looking for help with issues that can’t be clearly defined. People often come to psychotherapy wanting to understand themselves better, talk through difficult issues, and find ways to live a more authentic life. There is no clearly defined end goal except for that decided on by the client.
Carl Rogers in his 1963 paper on the concept of the fully functioning person asked, what is the hypothetical endpoint of therapy?
"I think of the commonly held notion that the person who has completed therapy will be adjusted to society. But what society? Any society, no matter what its characteristics? I cannot accept this. I think of the concept, implicit in much psychological writing, that successful therapy means that a person will have moved from a diagnostic category considered pathological to one considered normal. But the evidence is accumulating that there is so little agreement on diagnostic categories as to make them practically meaningless as scientific concepts. And even if a person becomes “normal,” is that a suitable outcome of therapy?" (Rogers, 1963, p. 17).
For Rogers, the hypothetical end point of therapy was personal growth and becoming more fully functioning. By fully functioning he meant optimal psychological maturity and complete openness to experience. It was seen more as an ideal to strive for, one that few of us ever reach. Seen this way, becoming as fully functioning as one can is a lifelong journey, maybe with the help of some therapy at times along the way when things seem too difficult.
There may be considerable benefit in a few sessions of therapy, but for most people the task of personal growth requires commitment over a longer period.
Psychotherapy of this kind involves clients dismantling their existing ways of looking at themselves and the world and, bit by bit, rebuilding a new sense of themselves and their place in the world. Such changes can be difficult to make. It involves honest self-reflection and the ability to let go of old ways of looking at oneself and the world that have become deeply entrenched. Everyone has their own speed at which they can do this. It can be difficult to let go of who we are in order to become who we can be.
A good psychotherapist won’t try to push people to go faster than they can. To do so can feel threatening and, paradoxically, lead people to become more entrenched in their previous positions. The psychotherapist will know that they don’t have the answers for how their client should change their life; their job is to help the client feel safe enough that they can look within themselves and work out what is best. Building the depth of trust needed for this can take time. But the primary agent of therapeutic change is always the client.
Not everybody wants this from therapy, but for those that do, it is important to recognize that deep seated changes may not come about in a few sessions.
Rogers, C. R. (1963). The concept of the fully functioning person. Psychotherapy: Theory, Research & Practice, 1(1), 17.