300. How long does psychological treatment usually take?

A national research study found that 50 percent of psychotherapy clients had made improvement within eight sessions of therapy, and 75 percent showed improvement after six months of therapy. Of course, showing improvement is not the same as successfully completing treatment. Most psychologists will tell you that the length of treatment depends upon the nature of the problem, the severity of the problem, and the treatment goals selected. 

A vague response like this can be frustrating, but rest assured that most individuals complete psychological treatment within three to six months. When psychologists say that the nature of the problem affects the length of treatment, what they mean is the kind of problem being treated. For example, a serious depression requires more treatment than a mild stress response, or counseling to make a life decision. The severity of the problem also affects treatment length and intensity. (Intensity refers to whether sessions are scheduled twice weekly, weekly, or less frequently. The norm is once per week.) Chronic, long term depression requires longer and more intense treatment than a reactive depression. Finally, the treatment goals selected affect the length of treatment too. The treatment goal can be "to feel well enough to manage on my own," or it can be "to completely change the way I handle my life, including how I make decisions, set goals and relate to people," or anything in between. The first goal would indicate a desire for short term treatment to resolve a life crisis, without necessarily examining how the crisis developed or how to avoid similar problems in the future. The second goal would require long term psychological treatment, most likely in excess of one year, with sessions scheduled at least weekly. 

In general, adjustment problems tend to show significant improvement within eight to twelve sessions of therapy, and usually treatment can be completed within twenty sessions or less. The same is often true of marital adjustment problems, although serious couple conflict might require six months or more of treatment. Moderate problems or intermediate treatment goals are usually treated within sixteen to thirty sessions, but occasionally treatment lasts close to a full year. This is especially true if the problem is ongoing, or if additional complications arise. More serious problems, including recurring chronic depression, serious post traumatic stress responses, substance abuse, personality problems, and ongoing stress responses such as those related to caring for a chronically ill family member, often require treatment for one year or longer, depending upon the severity of the symptoms.