I want to answer this for those of you who might be wondering “am I wasting my time?” or “why aren’t I feeling better yet?”. I want to validate experiences that brought up those questions while also providing realistic expectations to the therapeutic process so you know a little on what you might expect for your specific situation. We all want to feel better in the least amount of time it takes because time is money and therapy can be an investment. There are so many different types of therapy as well as different types of people and different types of needs so what therapy looks like for someone else may look drastically different from how it looks for you. Therapy is not a “one size fits all” so how long it takes depends on your specific needs, what you’re working through, and goals for therapy. 

The Truth of “It Depends”

There are several factors on determining how long therapy will take: what you’re working on specifically in therapy, how long it’s been there in your life, the type of therapy (CBT, EMDR, IFS, somatic, etc.), the frequency and consistency in which you attend therapy, and your environment outside of therapy. Let’s break these down even further. 

What You’re Working Through and How Long It’s Been There

Depending on if it’s acute stress (something that happened within the past month) or complex trauma (pervasive over the course of your life) will inform you in addition to what specific thing you’re working on to how much therapy you might need/want from six months to years to even decades. For example, an acute stressor might be a minor car accident or a recent large conflict with your spouse to work through and process in six months or less while someone working through complex trauma would need to build more trust using more time to feel more safe before the unpacking and processing of that complex trauma in therapy takes place. 

The Type of Therapy

The type of therapy usually depends on what you’re working on. With the acute stress example of the minor car accident, that might require EMDR to target the specific memory of the car accident. Complex trauma might require more varied types of therapy depending on the topic at a certain point such as EMDR specifically for complex trauma, IFS to reparent parts of yourself, or somatic therapy to connect mind to body to release trapped stress and/or trauma held in the body. 

Frequency, Consistency, and Your Environment

The more consistent you are and the more frequent you attend therapy, the faster therapy will be facilitated and the faster healing and growth will take place. For example, if someone goes to therapy once a month for a year, that’s only 12 times versus someone who goes to therapy once a week for a year, that’s 52 times. The person who goes once a week gets more out of therapy because they’re attending more, receiving more therapeutic support, gaining more insight, and actively working on what they want to work on more often. 

In addition to frequency and consistency in therapy, your environment outside of therapy plays a huge role. If you are wanting to work on family relationships yet still have to live with the same family members that are causing the stress, it will be a lot harder and will take more time to heal from inside the house versus someone wanting to work on family relationships who lives in an emotionally safe environment away from those family members. Ongoing stressors in daily life also can slow down progress due to needing to work on the “event of the week” rather than long-term goals that were the original intention in the beginning of therapy. 

What “Working” Actually Looks Like

Early Signs Of Therapy Working

• Increased awareness

• Naming feelings

• Noticing patterns

• Feeling worse before you start to feel better (you might feel worse because the veil has been lifted and there is grief in identifying where healing needs to take place because it shows what you might have never received from caregivers)

Middle Phase

• Responding differently to things

• Boundaries are being made

• Emotional range of feeling expands

• Less reactivity, more tolerance to discomfort

Longer-Term Shifts

• Core beliefs shift from negative to empowering (“I’m not enough” to “I’m allowed to exist as I am”)

• Relationships change towards healthier dynamics

• Emotion regulation improves

• How you behave might change from a personality perspective where fight and flight and fear-based behaviors were once dominant to rest and digest, feeling more secure and empowered

How To Tell If Therapy Is Working For You

Ask Yourself These Questions As A Guideline:

• Are you reacting differently to things even just 10% of the time?

• Are you more aware of what’s happening internally to you (emotions, sensations, feelings, the why behind things)?

• Are your relationships feeling better and more aligned with your wants and needs?

• Do you feel more genuine and honest with yourself?

Things To Be Wary Of:

• There’s no sense of direction in therapy although you’ve brought this up to your therapist and there hasn’t been any change

• Feeling consistently misunderstood

• No measurable changes over time in yourself

• Therapist isn’t open to feedback, not collaborative, or open to change

Things You Can Control To Be Most Efficient:

• Being honest and open with your therapist about concerns

• Practicing between sessions and adding supplemental work outside of sessions like podcasts, meditations, self-help books, or workbooks

• Addressing things you don’t like in relationships when they happen

• Staying consistent

Addressing the “It Depends” Answer More Concretely

It’s less about how long it takes and more about what you’re getting out of therapy itself. Plateaus are normal and progress is not linear. You are not “fixing” something, you’re becoming and growing. So yes, “it depends” is the answer to how long therapy will take, but if you’re wondering if therapy is working for you, explore it with your therapist and ask all the questions. 

• Sam Villarreal, MS, LPC, LCDC