Intro

The question of how long does therapy take to work is a common and normal query to have before getting started. I believe people often ask this because of concerns around cost, time and uncertainty of commitment. After working as a Clinical Psychologist for 20 years, I’ve seen therapy work differently for a number of clients, meaning there isn’t a set number of sessions required. This guide explains what can affect therapy timelines, three different types of therapy journeys we talk about at Pear and how to tell if therapy is working or not. 

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Key Takeaways:

• Not all therapy journeys follow the same timeline, it depends what you want and need to get out of your sessions
• Some people find therapy starts ‘working’ after one or two sessions, because having a space to open up can bring a sense of relief and allows you to finally say out loud what you have been carrying
• At Pear, we talk about therapy as three different types of journeys based on what support you are looking for: Pit-stop, Short-haul, Long-haul
• Therapy feeling difficult or slower doesn’t mean it isn’t working and faster therapy doesn’t always mean better therapy. It is more important that therapy is effective regardless of the timeline
• The connection you have with your therapist can help determine its effectiveness, trust is needed to feel safe to open up
• At Pear, we pair you with therapists based on your specific needs and goals for therapy 

When to reach out sooner

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How long does therapy take to work?

In all honesty, therapy can start working straight away. There is often an initial first phase where simply having a space to share what’s going on and being able to articulate and understand why you are in therapy. This in itself is very liberating.

People talk about relief at having found someone and somewhere to ‘offload.’ This means that sometimes, after even a session or two, people report feeling ‘lighter’ and less overwhelmed.

In terms of a timeline for resolving what you came to therapy for, this can really vary. If you have come with a specific goal such as interview anxiety, therapy can be short-term. 

For struggles that are perhaps more entangled with different areas of your life, or have been causing you some difficulties for a long time, it is likely that the timeframe will be slightly longer.

But truthfully, there isn’t always a fixed timeline, it depends what you’re coming to therapy for and the type of therapist you’re working with. 

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How many sessions will I need?

Whenever you are dealing with real humans with real struggles, it’s actually quite hard to apply strict frameworks and guidelines, there isn’t a number of sessions that can be applied universally. It is better to think of therapy in terms of:

• Are you looking for a quick check in?
• Do you need support with a specific goal?
• Do you need deeper/explorative support?
  
  

At Pear we talk about the above as: Pit Stop, Short-haul and Long-haul therapy.

• A therapy Pit stop is a quick check-in and refresh. It’s for when someone doesn’t have the time or the finances to enter into deeper therapy. ‘Pit stops’ are there to get some much needed practical support, and send you on your way feeling less overwhelmed. It might be as simple as 1 or 2 sessions.
  
  
• Short-haul therapy is for specific goals and struggles that are quite clear and defined. Perhaps anxiety about public speaking or feeling overwhelmed about a confusing life decision. Short-haul therapy often has a clear timeframe and might range between 3 and 6 months. Both the client and the therapist should be clear on the goals they are working towards.
  
  
• Long-haul therapy is more exploratory, which enables more layers of change to take place. It could be connected to a past trauma, a long-standing belief or narrative that is causing current harm in your daily life. Long-haul therapy often works with struggles that are quite entangled across all areas of your life. It’s hard to put a timeline to it, though it could be anywhere from 9 months upwards. 

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What makes therapy work faster (or slower)

Effective therapy is all about trust, which also affects pace. If a client feels safe in therapy, they will feel able to share their struggles and talk about things that they might not have shared with anyone else before. It might be the first time they have ever said something aloud. They are only able to do this if they feel connected and comfortable with the therapist they are working with. 

Whether therapy goes ‘fast’ or ‘slow’ will ultimately be impacted by the fit between client and therapist, but also any good therapist will know what pace to support. It’s ok and normal for things to take time. That doesn’t make therapy less effective. 

Sometimes pace is the focus. Perhaps moving too fast won’t be helpful and it’s more about feeling safe enough to move forward, which becomes part of the work. 

Other times the pace is less important. What you need to make sure is the conditions are right in order to facilitate trust and change; this will depend on how ready the client feels and how safe the therapeutic relationship is.

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How to tell therapy is working

There is often a tension in therapy. You are likely to feel quite relieved and somewhat calmer the moment you have your first sessions. If you click with your therapist, you will start to feel safer to open up, which can feel quite liberating. It’s actually a wonderful place to be, to finally feel like things are going to change and you don’t have to continue like you are. 

The tension comes, however, when therapy also feels a little tricky. Sometimes talking about things you’re struggling with can bring forward emotions that you’re not always ready for. Some sessions feel challenging, and people then worry it’s not helping, when in fact it is usually the opposite. Tricky therapy sessions can be a really good sign. It means you are working through and releasing what has been stuck, and it is often this stuckness that causes struggle.

I like to compare it to exercise. When you are exercising, you can often feel strain and pain. In this scenario, there can be recovery tensions which take a couple of days to heal. Afterwards, your muscles are stronger and fitter. It is the same with therapy, a form of psychological strength training. At the time, it may feel painful or sore while you are in it, but afterwards you are wiser, calmer and more content. Also, remember your therapist is trained to create a space where you can lean on them, process and share the release. That is what they are there for.

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When it isn't working — is it the time, or the fit?

Therapy often has moments where someone might feel they want to stop or switch. My advice would be to continue a little and try to work out with your therapist if something needs to change or shift.

If it genuinely feels like something you can’t discuss, or your gut is telling you it might be something to do with your therapist, then I would suggest following that intuition as switching therapists might be what is needed. However, if this is a pattern that continues within your therapy journey, then I would imagine it is more about your struggle overcoming what is required to ‘push through’ rather than therapist fit. 

Sometimes as you work through some issues, other parts of your life come into focus. These might be better supported by another therapist who is trained in this area. You and your therapist can discuss this together and work out which type of therapist or approach might support you in your next therapy chapter.

Overall, I don’t believe there is an ideal number of sessions for therapy to ‘work’. It really depends on your therapist, what you’re looking for support with and what you feel you would need to change or feel different to feel like therapy is working for you.

If you’re concerned about how long therapy will take or how many sessions you need to have, it might be worth thinking about what is actually driving that worry. Is it budget and only feeling able to afford a certain number of sessions? Does the idea of longer-term therapy feel a little scary? It’s a good idea to talk to your therapist about the origins of your concerns.

When you complete our therapist pairing form, we ask you about the above to ensure we have a better understanding of what you need at this moment and so we can find you a therapist you’ll click with. Click HERE to start your pairing today.

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