TALK IT OUT

Therapists say very few people need to see them for more than a few months

The best kind of therapy isn’t just talking aimlessly about feelings. It’s a structured time where therapists work with patients to solve their problems until they can do it on their own. In most cases, the goal is reaching that end point—and it isn’t always years away.

The research is indicating that you don’t need extended, long-term therapy for most kinds of problems,” said Bruce Wampold, a psychologist specializing in counseling at the University of Wisconsin-Madison. Though some patients may seek therapy to help manage chronic conditions like depression, many seek treatment for problems that can be overcome relatively easily, like conflicts at work or in relationships. Therapy should be like seeing any other kind of doctor: You make an appointment, work to gain the tools you need to manage your problems, and eventually discontinue your time together.

A lot of good therapy can be done in a dozen sessions,” said Joe Parks, a senior medical advisor with the National Council for Behavioral Sciences. A study published in the American Journal of Psychiatry found that in 2007, patients seeking psychotherapy had about eight sessions on average.

The most prevalent short term-treatment is known as cognitive behavioral therapy (CBT). CBT focuses on correcting thought patterns, and has been proven effective for problems ranging from anxiety and depression to substance abuse and post-traumatic stress disorder. Therapists can also combine CBT with other types of therapy for best results. Getting to the root of some problems may take a lot longer, said Christy Beck, a therapist based in State College, Pennsylvania, who uses a combination of CBT and psychodynamic therapy to examine past events from patients’ childhoods. She said she sees patients for just a few sessions if they have a situational problem or for multiple years if they’re dealing with something more complicated, like an eating disorder.

According to Wampold, the most effective therapists are those who display good interpersonal skills (pdf)—qualities like being empathetic, listening well, and effectively communicating the treatment plan to the patient. Early stages of therapy may be hard. “If it’s good therapy, you’re going to discuss some things that are uncomfortable and difficult,” said Wampond. But despite feelings of discomfort, you should start to feel better after a few sessions.

If you don’t, it’s imperative to bring it up with your therapist. “Therapists are people too; they make mistakes,” said Parks. This is why, he continued, it’s good to have a common goal to come back to, like sleeping better, feeling motivated to tackle daily tasks, or being content with the quality of your relationships. When one strategy doesn’t work, another may.

Usually, Beck said, both parties will reach a consensus about when it’s time to part ways. “Every termination I have had has been mutual,” she said. “I don’t personally keep people in therapy longer [than they need to be], but for me also I think it needs to come for them.”

Some patients, though, may want to stay in therapy even after they’ve resolved their immediate problems. This is fine, Beck said, as long as patients aren’t feeling worse. “Some people feel like therapy is great for for self-awareness and growth,” she said. “It’s a personal decision.”

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