“I saw my last therapist every week for three years, but just moved here and am looking for a new therapist.  I’ve had anxiety for years.”

Every week for three years?  And you’re still in need of therapy?  Let’s pause here: This blog isn’t to offend – this is to educate.  I often hear statements like this from new patients who contact me or who are attending their first session with me.  When I started practicing as a therapist almost 10 years ago, I was surprised to hear it, but the more often I do, the less this is news to me (however, it is absurd to me when I learn that their previous therapist did nothing to help them manage or reduce their mood symptoms).  The positive part is that it is then exciting for me to share that I can likely help the patient reduce (or possibly eliminate) their mood symptoms in a rather short period of time.

Let me explain further: The idea of being in therapy for years on end is rather outdated.  With many effective, evidence-based therapies available, it is possible to treat mood difficulties and see results rather quickly.  These therapies are often focused on teaching the patient how to apply psychological skills to deal with, manage, and improve their thoughts, emotions, and behaviors in ways that are more functional and rewarding.  These effective therapies are what we call short-term psychotherapy.

Statistics on Effective Length of Therapy

Studies have shown that being in therapy for prolonged periods of time actually leads to less effective treatment and poorer results.  There seems to be a sweet spot where substantial progress can be made before the positive benefits of being in therapy begin to decline due to remaining in therapy for too long.

Specifically, the Journal of Counseling Psychology (2001) reported that most patients experienced significant improvements between their seventh and tenth sessions.  Another 2006 study, published in the Journal of Consulting and Clinical Psychology, found that 88% of the 2,000 study participants improved after only one therapy session, but that this rate dropped to 62% after 12 sessions.  This means that the rate of improvement declined when participants stayed in therapy for too long.

If you are seeking therapy to work on circumstantial, transitory, or episodic problems or mood symptoms, look for a therapist whose philosophy is geared towards short-term psychotherapy.  Even if you have been struggling with problems for some time, in most cases short-term psychotherapy aimed at giving you skills for dealing with life problems is still the most effective (and cost-effective) form of therapy.

So What is the Deal with Talk Therapy?

Talk therapy that is focused on depth, gaining insight, and understanding one’s self can be incredibly helpful, and admittedly, it is a fair amount of my clinical work with patients.  However, along with “talking,” (which isn’t as simple as it sounds) I usually employ one of the evidence-based therapies so that the patient develops skills to manage problems on their own outside of the therapy sessions.  It is my experience that a combination of learning psychological skills and being able to come to therapy to discuss recent experiences or insights is the most effective form of therapy.

Disappointingly, however, many therapists simply practice “talk therapy” without any actual depth or analysis that would lead to enhanced insight.  And in most cases, it is patients who are engaging in talk therapy exclusively who remain in therapy the longest.

If you feel like you are just having a conversation with your therapist (one stripped of any deeper insight), you probably are.  This often equates to ongoing therapy sessions for years, which is symptomatic of ineffective therapy.  On the other hand, if believe your therapist has helped you to gain new insights and/or they are also teaching you skills, and perhaps giving you “homework,” this is an indication you are engaged in a therapy approach with the goal of fostering better coping and mood management skills.

To be clear, there is nothing wrong with talk therapy if you believe you are getting something out of it.  Talk therapy, if done correctly and with its intended purpose, can be very beneficial at enhancing insight, making cognitive and emotional connections, exploring repressed memories/thoughts/emotions, and promoting positive change in your life.  The key is knowing the difference between therapeutic depth and surface-level conversation.

When Your Therapist Just Listens, That’s Not Effective Therapy

If you spend the entire session talking, while your therapist nods their head and says an occasional “yeah,” that is probably not effective therapy.  The whole reason you are coming to therapy in the first place is likely for results – not for a “friend” that listens to you talk (if that’s what you want, there are many other avenues you can go).  Your therapist should be using their psychological education, training, experience, and knowledge to help you.

If this is your experience, speak up and ask your therapist for more therapy – meaning more analysis, conceptualization, feedback, skills, etc.  It might feel good to be heard and you may even walk away from your sessions feeling better, but there is a big difference between temporarily feeling good and making real changes in your life.

Sometimes Long-Term Therapy is Necessitated

This blog is not to say that some people don’t benefit from ongoing therapy and having a neutral, unbiased person (i.e., a therapist) to speak with routinely to process through thoughts, emotions, and current problems.  However, there is a difference between this type of therapy, which is more insight and coping focused, and therapy aimed at reducing depression, anxiety, or other mood difficulties.  There are also more chronic mental illnesses, such as Bipolar Disorder, that absolutely benefit from ongoing mental health treatment to manage symptoms and coping.  Every patient is unique, which means unique considerations must be made.

Generally speaking, however, most higher-functioning individuals and those without chronic mental illnesses can benefit most from short-term psychotherapy and evidence-based treatments.  In my experience, most people seek therapy for treatable difficulties, which means it doesn’t take years of therapy to resolve those types of problems. For some of my patients, it doesn’t even take a whole session.

Tampa Therapy’s Approach

In my practice, I often explain my philosophy about therapy to new patients: that I typically don’t believe in people being in therapy for forever.  This is based on the idea of therapy focusing on goals and outcomes (which can be achieved) and which means that patients can “graduate” to live their lives without being in therapy forever.

In some cases, I do see clients for longer periods of time, but this is rare, as most people can make pretty substantial changes rather quickly (e.g., anywhere from 4 to 12 sessions).  In my practice, the people who spent years in therapy before coming to me were able to face their fears, calm their anxieties, improve their mood, and reach life goals quickly — often within weeks.  Therapy is about making change, not about talking endlessly about your childhood and having a listening ear.  We’d love to help you, so give us a call if you are ready to make important changes, and fairly quickly.

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