Questions

Q: How long does the process of therapy take? What does it involve?

A: Psychotherapy can last for just a few sessions or for many years, depending on the type of therapy and the client's goals.

One of the shortest types of therapy is called solution-focused brief therapy (SFBT). In solution-focused therapy — which often lasts for just three or four sessions — the focus is entirely on finding solutions to the client's challenges. Very little time is spent analyzing problems or discussing past history. Instead, therapist and client focus on what works, and begin to build on that.

Another moderately short-term type of therapy is cognitive-behavioral therapy. If the client has one specific issue that she wishes to work on, a typical length of therapy might be six to twelve sessions. During that time, the therapist works with the client to help her make positive changes and develop tools that she can use in her life. One of the goals in cognitive therapy is to help clients "become their own therapists" by developing practical, usable strategies and approaches.

On the other end of the scale, one of the longest forms of therapy is classical psychoanalysis. It's typical for a client to spend many years of weekly sessions seeing a psychoanalyst, during which time the client might discuss a variety of past experiences. Newer psychodynamic forms of therapy, which stem from the psychoanalytical tradition, are often longer-term as well. Six months to several years of sessions would not be uncommon for this type of depth-oriented therapy.

It is, of course, entirely up to the client to decide how long he or she wishes to work with a therapist. Some clients may prefer a long-term, broader approach. Others may choose to come for a dozen sessions to work on specific issues, and then return for a "follow-up" if and when it is needed. I encourage clients to discuss the time-frame with a prospective therapist before beginning therapy.

What Does Therapy Involve?

What is required of the client in therapy? This, too, depends on the form of therapy and the client's goals. In cognitive therapy, the client works actively with her therapist to make changes in his life. During the therapy sessions, the client develops tools and approaches that she uses throughout the week. As she tries out these approaches, she then works with the therapist to refine and improve the techniques.

By contrast, other forms of therapy do not require the client to actively work outside of the therapy sessions. Instead, the client is encouraged to talk within the sessions about his past experiences, his current relationships, his thoughts and feelings, and other aspects of his life. Psychodynamic and client-centered therapy approaches are more oriented toward this type of approach. (For an overview of these, you can visit our Types of therapy Q&A).

Different therapy approaches will appeal to different people. I encourage you to ask any prospective therapist about his or her orientation and approach, to see if there is a fit.

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