How long does therapy take? It depends on what you’re working on and what you want to be different. A well-known 1986 research review found that about half of people were measurably improved by around 8 sessions, and about 3 in 4 by around 26 sessions. Feeling better is one goal. Changing the patterns underneath is another, and that often takes longer. Here’s how I think about it.
I’m Connor McClenahan, a licensed psychologist and director of Here Counseling. We see clients at Suite 629 in the Playhouse District in Pasadena, and by video anywhere in California. Most people come to therapy because something is pressing on them: a loss, a breakup, money strain, trouble at work or a conflict with someone close that is feeding depression or anxiety. If you’d like help finding someone to work with, you can meet our Pasadena therapists.
How many therapy sessions do most people need?
If you’re asking how many therapy sessions you need, there’s no single number, because everyone is different. In the 1986 review, about 50% of people showed measurable improvement by around 8 sessions, and about 75% by around 26 sessions. Improvement means symptoms got better, not that everything was fixed. Many people keep going after that to work on the road that got them to the bump, not just the bump itself.
The study is Howard, Kopta, Krause and Orlinsky (1986), “The dose-effect relationship in psychotherapy,” in American Psychologist. It counted sessions, not weeks. I translate it into months only because most people come once a week.
| Sessions (1986 review) | About how many improved | If you come weekly |
|---|---|---|
| Around 8 sessions | About half | Roughly two months |
| Around 26 sessions | About 3 in 4 | Roughly six months |
3 ways you can expect growth over time
Dealing with one bump in the road of life is one thing. Dealing with the road that got you to that bump is another. And setting yourself up for a clear path into your future is another still. That’s why I think about therapy in three lengths.
Short term therapy
Short term therapy is for when something is pressing on you, or you’re going through a hard season. A handful of sessions is more like mini therapy: you’re getting to know your therapist, naming one core issue and picking up a tool or two to cope. With a few months of steady work, you can look at one part of your life, notice where you’ve been avoiding things, and understand why you react and feel the way you do. It also lays groundwork if you ever come back.
Most of all, it gives you time to build a trusting relationship with your therapist. Research keeps finding that the quality of that relationship is one of the most reliable predictors of how therapy turns out.
Long term therapy
Long term therapy lasts until you feel secure enough to carry what you’ve learned into your life without regular sessions. You can always come back. Here we look at your family of origin, past trauma and core personality traits. That helps you see the patterns, beliefs and reactions that may no longer serve you, and build kinder ways to see yourself and others.
Life-long therapy
Life-long therapy means coming back to therapy at different points across your life. At each stage, your values and perspectives shift. Coming back over the years supports self-knowledge each step of the way, and gives you room to work through old pain and grow more self-compassion.
Why don’t I feel better after my first session?
If you’re wondering how long therapy takes to work, or how long until it starts to help, the honest answer starts here. The first session or two can feel like you’re just sitting in your problem. You’re talking about it and feeling things that are uncomfortable. That’s normal. Those early sessions are doing real work, even when it doesn’t feel like you’re getting anywhere yet.
Depression, anxiety, trauma and panic usually run on well-worn patterns in your mind and body. The more you practice something, the more built in it becomes. Changing how your body or mind naturally wants to respond is one of the hardest things a person can do. It takes effort over time, and that’s okay.
Can therapy help before my symptoms go away?
Yes. I break healing into two things. One is healing: your anger, panic or low mood actually easing. The other is support: feeling like it’s going to be okay, that you’re on the right path and have the help you need. Support can bring relief early, even while deeper patterns are still changing.
Think about breaking your leg. The minute you get into the back of the ambulance, some of the pain eases. Nothing has changed in the leg yet. You just know you’re being helped. Setting the leg and wearing the cast is the second kind of healing. It takes a while, but you know you’re in the right place.
| Support (the ambulance) | Healing (the cast) | |
|---|---|---|
| What it feels like | “I’m in the right place. This is going to be okay.” | Symptoms ease and old reactions change |
| When you may notice it | Often early | Over many sessions |
| What helps it | A therapist who really gets you | Steady work, session after session |
What happens in the first few therapy sessions?
The first session or two are usually about defining the problem and setting a realistic goal together. That can feel like, okay, come on, I want to get going. But you’d be surprised how much saying the problem out loud to a skilled therapist sheds light on it. When someone sits down with me, I’ll ask them to talk about the problem, and then ask questions like these:
- How long has this been going on?
- When did it start?
- When has it been at its worst?
- When has it been at its easiest?
- Has it ever gone away on its own, or have you done something that helped?
Those questions give texture to what you’re feeling and help us understand what the symptom is doing for you. Then we set a realistic goal together: what you actually want to be different at the end of all this.
How long does therapy take for anxiety, depression or trauma?
There’s no set timeline for any of these, and the same diagnosis can look very different from one person to the next. What shapes it most is how long the problem has been around, what support you have now and what you want to be different. A recent, focused problem often needs fewer sessions than patterns that have been building for years.
Anxiety
Many people notice some relief once they understand what their anxiety is doing and have a few tools to work with. Changing the deeper habits of worry and avoidance usually takes longer, because they’ve had a lot of practice.
Depression
Low mood can make it hard to believe anything will help. That’s where support matters early. As sessions go on, we look at what keeps the heaviness in place and what small changes help you feel more like yourself.
Childhood trauma
Healing from childhood trauma often takes longer, because the patterns started early and have had years to settle in. It depends on what happened, what support you have now and your goals. I wrote more about this in how long it can take to heal from childhood trauma.
Frequently asked questions
How many therapy sessions do most people need?
It varies. In a 1986 review, about half of people were measurably improved by around 8 sessions, and about 3 in 4 by around 26 sessions. Your number depends on what you’re working on and your goals.
How do I know when I’m ready to end therapy?
A good sign is that you’ve reached the goals you set together and you feel able to handle setbacks on your own. Talk it through with your therapist and plan the ending together rather than stopping suddenly. You can always come back.
Where is Here Counseling?
Our office is at 595 E Colorado Blvd, Suite 629, Pasadena, CA 91101, in the Playhouse District. We also offer therapy by video anywhere in California.
Find the right therapist for you
Whatever time it takes, therapy can bring you closer to yourself. The change you’re working toward is big, so find a therapist who makes it worth it. You can browse our therapists or book a free 15-minute consult. Come see us at Suite 629 in the Playhouse District in Pasadena, or meet by video from anywhere in California. There are good things on the other side of this.
Dr. Connor McClenahan
References
Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41(2), 159-164. DOI: 10.1037/0003-066X.41.2.159
Ardito, R. B., & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: Historical excursus, measurements, and prospects for research. Frontiers in Psychology, 2, 270. DOI: 10.3389/fpsyg.2011.00270