How many sessions does therapy take?

It is the first question almost everybody asks me, usually before they have even told me what is wrong. And it makes sense: nobody wants to get into something without knowing when it ends.

Let me answer up front and then explain why.

In my practice, most courses of treatment resolve in around five sessions, spread over some three months.

That is not five weeks in a row: it is five spaced-out meetings, with time in between for things to actually happen.

Why so few

Here is the most common misunderstanding. People assume a short therapy is a shallow therapy, or that the psychologist is in a hurry. That is not it.

I work with models that were designed to be brief. It is not that I speed them up: they were born that way.

Solution-focused therapy, strategic therapy, systemic therapy and narrative therapy share an idea that sets them apart from classical psychoanalysis: to resolve a problem you do not need to understand where it came from. You need to understand what is keeping it alive today.

That is an enormous difference. Reconstructing your childhood can take years. Identifying what you are doing right now, without realising it, that keeps the problem from resolving, takes one or two sessions. And from there the work is a different kind: try, check, adjust.

That is why I am less interested in your past than in what you have already tried. Almost always, what keeps a problem going is not its origin but the wrong solution that has been applied for years with all the good intentions in the world.

Why the sessions are spaced out

At the beginning we meet more often. After that, less and less.

It is not for convenience or scheduling: it is part of the treatment. What changes things does not happen in my consulting room, it happens in your life between one session and the next. If we met every week for months, you would never have time to test anything.

Spacing them out also serves a purpose that matters a great deal to me: that you find out you can manage on your own. If you need me less each time, we are on the right track. If you end up needing to come forever, we have done something wrong.

My stated goal is that you stop needing me as soon as possible. I do not believe in therapy without end.

When the obstacle stops being outside

There is a question I ask a lot in session: when was the last time you really tried? Very often the answer is “years ago”. And behind that there is a good deal more than discouragement: there are fifty years of research that explain it.

It is called learned helplessness, and Martin Seligman described it in the nineteen-sixties. When someone tries to solve something several times and fails, they stop trying. And they carry on not trying even when the conditions have changed and now they could. The obstacle stopped being outside and moved into the expectation.

I see this in session constantly. Perfectly capable people convinced their problem has no solution — not because it has none, but because they tried with the tools they had at the time and it did not work.

A good part of my work is exactly that: separating the obstacles that are still there from the ones that only remain in the expectation.

When more sessions are needed

I am not going to sell you the idea that everything gets sorted in five sessions, because it is not true.

There are situations that call for longer treatment: severe disorders, conditions that have been in place for a long time, situations involving risk, or cases that need coordination with psychiatry. There are also people who, having resolved what brought them, decide to keep working on something else. That is a legitimate decision, not a relapse.

What I can tell you is that you will know soon. Within the first two sessions you will have a clear idea of what we are doing, how long it might take and whether this is any use to you. If after two sessions you do not know that, you have every right to ask. And if the answer does not convince you, you have every right to leave.

What it means in money

It is worth doing the whole sum, because almost nobody does.

A course of therapy costs the price of a session multiplied by the number of sessions. Comparing per-session prices without looking at how many will be needed is like comparing ticket prices without looking at where they go.

A five-session course at one hundred euros is five hundred euros in total. A therapy that is cheaper per session but stretches to twenty or thirty sessions costs considerably more, and consumes far more of your time and your patience.

Always ask for the estimated total, not the price of a session. Ask any psychologist, not just me.

How to tell whether you are progressing

Three signs, and they work with any therapist:

• You notice changes outside the consulting room. Leaving the session feeling understood is not enough: something has to be different in your week.
• You know what you are doing and why. If you do not understand the plan, either there is no plan or nobody has explained it to you.
• You need it less and less. A therapy that works fades out by itself.

If you want to start

I work online and I personally handle every case: there is no rotating team and nobody is going to assign you to someone else.

Before a first session we talk on the phone for a few minutes, at no cost. In that call I explain how I work and you tell me what you want to achieve, so I can be sure I am the right person to help with it. If I think I am not, I will say so and point you towards someone who is.