"How long will this take?" is one of the most common questions people ask before starting therapy, and one of the most reasonable. You are planning time, money and energy. A therapist cannot give you an exact number at the start, but there is a good deal of research and experience to help set expectations.
What the research suggests
The American Psychological Association (APA) gives a few reference points. It notes that some people begin to feel better in about six to 12 sessions. It also cites a classic study in which half of psychotherapy patients improved after eight sessions and 75% improved after six months. And it notes that other people, for example those who have experienced serious trauma, have several problems at once, or are unclear about what is making them unhappy, may take a year or two to benefit.
The American Psychiatric Association puts the range simply: depending on severity, psychotherapy may take a few sessions over a week or two, or many sessions over years. These figures describe groups of people, not a promise for any one person. They are a reasonable frame for a first conversation with your therapist.
Why structured therapies quote a number
You may see specific session counts for some approaches. The NHS, for example, says a course of CBT is usually between 5 and 15 sessions depending on what it is for, with more sessions sometimes offered if symptoms have not improved. Structured, time-limited approaches like this often set a number in advance. Other approaches, including insight-oriented work, tend to set goals first and let the length follow. Neither is automatically better; they answer different needs. Dr. Lehmann's approach is insight-oriented and integrative. With her, some people come for a focused, shorter period and others prefer longer-term work, and you talk about pace and goals as you go.
What affects how long it takes
The APA lists several factors that shape length: the type of problem, your characteristics and history, your goals, what is going on in your life outside therapy, and how quickly you are able to make progress. In everyday terms:
- A single, recent problem, such as anxiety that began after a job change, often moves faster than a pattern that goes back decades
- Anxiety and depression together, or alongside grief, trauma or a major illness, usually take longer to untangle
- Narrow goals (sleeping better, getting back to driving on the freeway) are quicker to reach than broad ones (feeling less self-critical in every relationship)
- Ongoing stress, such as caregiving, a divorce or a demanding job, can slow things down
- Regular attendance and trying things between sessions tend to help
NIMH adds that finding the right treatment for anxiety or depression can take some trial and error, and that both therapy and medication can take time to work.
What the first months often look like
Most people start with regular, often weekly, sessions. The APA describes the first few sessions as a time to build understanding and a plan, and says that by then you should have a new sense of your problem and some hope. Many people feel some early relief simply from taking action. The middle stretch is usually where patterns are worked through, and it can feel uneven. The APA notes you may feel more angry, sad or confused at times as therapy goes deeper, and that this is not the same as standing still.
If you are starting from scratch, What Therapy for Anxiety Looks Like With a Psychologist and its companion on depression describe the work in more detail.
A simple way to track your own timeline
Before your first session, write down two or three things you would like to be different, in concrete terms: "fall asleep within half an hour most nights," "go to my sister's without dreading it for a week," "get through a workday without hiding in my car." Next to each, add a line about how often it happens now. Every month or so, look at the list again and note what has shifted. The list is only for you, but it makes a conversation about length much easier, and it shows change that is easy to forget.
How therapy ends
The APA says plainly that psychotherapy is not a lifetime commitment. You and your therapist decide together when you are ready to stop, often when the problem that brought you in no longer dominates your days or the goals you set have been met. Some people taper, meeting less often for a while before stopping. The APA also describes a follow-up a few weeks or a month later, and "booster" sessions down the road if a new situation stirs things up. Some people continue longer because they keep gaining from the work, which is a choice, not a failure to finish.
Planning for the cost of time
Because length varies, it helps to think in stages. Ask your therapist what they would expect to see by the eighth or tenth session, and plan to review then. Check how many sessions your insurance covers and at what cost; How Much Does Therapy Cost in Michigan? walks through the numbers. Dr. Lehmann's private-pay fee is $220 per clinical hour, she is in network with Blue Cross Blue Shield PPO, and reduced-fee spots are available on a limited basis.
Pace is something you can raise at any point. If weekly sessions are hard to keep up, ask whether a different rhythm could work. If progress has stalled, say so; How to Tell if Therapy Is Working has questions to bring. For how Dr. Lehmann works with low mood, see depression therapy.