How Long Therapy Takes and How Often to Go

The length of therapy is not fixed in advance. It depends on what you want to work on, the approach you choose, and how things go along the way. Sessions are typically held once every 1-2 weeks for about 30 to 50 minutes, but the total number of sessions is something you and your therapist decide together. Some people come for a few sessions to work through a specific problem; others stay for many months or longer. There is no rule that says you must commit to a set number of sessions before you start, and no therapist can promise how many you will need.

How often should you go to therapy?

Sessions are typically held once every 1-2 weeks, so some people go weekly and others every other week. The right frequency depends on what you are dealing with, your schedule, and what your therapist recommends. Early on, meeting more often can help build momentum and get to know each other. Later, you might space sessions out as things improve. The decision is yours to make with your therapist, and it can change over time.

How long is a therapy session?

A typical session lasts about 30 to 50 minutes. Some therapists offer longer sessions, especially for certain types of therapy or for couples or family work, and practices set their own session lengths, so ask how long yours will be. The first session may be a little different: it often includes paperwork, a discussion of what brings you in, and questions about your background. For a fuller picture of that first meeting, see your first therapy session: what to expect.

Short-term vs long-term therapy

Some approaches are designed to be short-term, while others are open-ended. The table below compares common examples.

This is a general guide, not a rule. A therapist may combine approaches, and the length of therapy can be adjusted as you go. For more on these and other approaches, see types of therapy explained: CBT, DBT, EMDR and more.

Reviewing progress together

Goals of treatment, and how long and how often to meet, are discussed by you and your therapist together. It helps to check in regularly: Are you making progress toward what you wanted? Is the approach working for you? If therapy has gone on for what feels like a reasonable time without improvement, talk to your therapist. It may make sense to explore other professionals or approaches. The National Institute of Mental Health (NIMH) suggests that rapport and trust are essential, and that you should feel comfortable with your therapist. If something feels off, you can raise it. For signs that it might be time to switch, see therapist red flags and when to switch therapists.

When to stop therapy

There is no fixed rule for when to stop. You might decide to stop when you have met your goals, when you feel more stable, or when the cost or time commitment no longer fits your life. Ending therapy well usually means talking it over with your therapist, reviewing what you have learned, and planning how to maintain progress. Some people taper off by reducing session frequency before stopping. It is also common to take a break and come back later if new issues arise or if you want a refresher. Therapy can be used instead of or alongside medication and other treatment; choosing a treatment plan should happen with a mental health professional.

What if therapy is not working?

If you have been in therapy for a while and do not see the changes you hoped for, bring it up with your therapist. They may suggest adjusting the approach, trying a different type of therapy, or referring you to someone else. NIMH notes that it may make sense to explore other professionals or approaches. It is not a failure to switch; finding the right fit can take time.

Common mistakes and misconceptions

• Expecting a fixed number of sessions. No one can promise how long therapy will take. It is a process that unfolds.
• Not discussing goals early. Without clear goals, it is hard to know if therapy is helping. Talk about what you want to achieve.
• Staying with a therapist who is not a good fit. Rapport matters. If you do not feel comfortable, it is okay to look for someone else.
• Thinking you must be “bad enough” for therapy. Therapy is for anyone who wants support, not just for people in crisis.
• Ignoring practical limits. Cost, insurance, and scheduling can affect how often you go. It is okay to discuss these with your therapist.

The first session and beyond

The first session is a chance to get to know your therapist and for them to learn about you. You can ask about their credentials, experience, and approach. NIMH suggests asking about the goals of therapy, whether a time frame or number of sessions is recommended, how progress will be assessed, and fees and insurance. You can also ask about confidentiality and its limits. Psychologists must inform clients as early as feasible about the nature and expected course of therapy, fees, and the limits of confidentiality (APA Ethics Code 10.01).

Online therapy and state lines

Online therapy, or telehealth, is the use of communications technologies to provide health care from a distance, including mental health counseling. Whether a provider may treat you in another state depends on state law. A full license from a state board permits practice in that state; other routes include temporary practice laws, reciprocity, licensure compacts, and telehealth registration where a state offers them. Providers should verify your location before an appointment. For example, in California a therapist must hold a current California license or registration to treat clients located in California, including by telehealth. If you are considering online therapy, ask the provider which state license they hold and whether they can work with someone in your state.

Privacy and confidentiality

Confidentiality has limits. A psychologist may disclose without consent only where the law requires it or permits it for a valid purpose, such as protecting the client or others from harm (APA Ethics Code 4.05). Social workers may disclose to prevent serious, foreseeable, and imminent harm, and then only the minimum necessary (NASW Code 1.07). Mental health professionals are mandated reporters of child abuse and neglect in many states; rules vary by state. It is a good idea to ask your therapist about confidentiality at the outset.

Paying for therapy and insurance

Cost can affect how often you go and how long you stay in therapy. If you have insurance, check with your plan about coverage for mental health services. Under the Affordable Care Act, mental health and substance use disorder services are one of the ten essential health benefits that individual and small-group plans must cover; all Marketplace plans cover them, including behavioral health treatment such as psychotherapy and counseling. The Mental Health Parity and Addiction Equity Act (MHPAEA) generally requires that, where a covered plan offers mental health benefits, their copays, deductibles, and visit limits not be more restrictive than for medical and surgical benefits, but it does not require a plan to cover mental health at all, and it does not apply to small employers’ group plans, retiree-only plans or Medicare. For questions about your employer plan, contact the Department of Labor’s Employee Benefits Security Administration (EBSA).

If you are uninsured or not using insurance, you have the right to a Good Faith Estimate of the cost when you schedule care at least 3 business days in advance, or when you ask for one. For recurring care such as counseling, one estimate can cover the expected sessions for up to 12 months. If the bill is $400 or more above the estimate, you can dispute it; the bill must be dated within the last 120 calendar days, and there is a $25 administrative fee.

Crisis help

If you are in crisis or having thoughts of suicide, in the US call or text 988 (the 988 Suicide & Crisis Lifeline) or call 911 in an emergency. The 988 Lifeline is available 24/7, free, and confidential. It is for anyone who is struggling, not only for suicidal thoughts.