Does therapy (or counselling) really have to happen weekly? Wouldn’t less frequent sessions be just as good?
One of the problems with going to therapy is that (in many cases) it’s a regular weekly commitment. Which can be a pain! A hassle. An inconvenience. A chunk of time out of your busy schedule. Not to mention a considerable expense.
Yet it appears that a majority of counsellors and psychotherapists recommend weekly sessions, as opposed to less often.
Why do so many therapists want their clients to attend regularly once a week? Why not once every two weeks, or even once a month?
This question was recently asked by my colleague Jodie Gale, a psychotherapist in Sydney, Australia.
Therapists from around the world (including myself) chipped in with their views, which Jodie collected together and published as a blog post.
Holding, Containment and Attachment Deepen the Work
For me (and many other depth-oriented therapists) the main benefit of regular, scheduled weekly therapy sessions is to do with trust, ‘holding’, and building a secure attachment.
The frequency and reliability of week-in, week-out therapy sessions over a period of time, contributes to a feeling of safety and trust that allows client and therapist to work on a deeper, more effective level. This is often the level at which we need to work in order to allow healing, growth and restoration to happen.
Here’s what I wrote for Jodie’s article:
One reason why attending therapy weekly, as opposed to less often, is beneficial is because it helps make the work more ‘holding’. If you don’t feel ‘held’ in therapy you aren’t going to be able to build the kind of trusting and healing relationship which helps rewire your nervous system.
Therapeutic holding isn’t about touch or physical holding – instead, it’s about emotional safety. Emotional safety comes from many aspects of therapy, but having a regular, reliable session that you go to every week is one of the basics. Going less frequently can really interfere with developing emotional safety.
When you, the client, feel held and emotionally safe enough to connect to your inner self, in the context of your relationship with your therapist, then change, growth and healing can really start to happen.
Attachment in Therapy: Good or Bad?
Does it mean, though, that once you’re attached to your therapist, it’ll be harder to eventually let go and live an emotionally independent life?
No. The aim of attachment-based psychotherapy is in fact to deepen and strengthen your emotional resilience. To help you become more able to form more satisfying and healthy relationships and patterns of living in your daily life, sustainable long after your therapy has ended.
And here are some other important reasons given by counsellors and psychotherapists* in favour of weekly therapy:
Keeps Things Moving
Weekly therapy sessions can keep things fresh and moving along at a good pace.
Good for Homework
A week is just enough time to try out a homework assignment a few times, and report back [many therapists don’t give homework, but some do].
‘Use it or lose it’ – longer gaps can mean forgetting important themes and insights.
You’re Honouring Your Growth Process
Making and keeping a weekly commitment allows you to show yourself that you are prioritising your healing and growth.
Keep Open, Not Shut
It takes a lot to open up and get vulnerable; longer gaps between sessions mean you have more time to close up and harden inside, making your inner self less accessible for change and connection.
A strong therapy relationship is crucial for effective therapy, and this alliance is strengthened and deepened with a regular, predictable, frequent-enough connection.
Less Catch-Up, More Deep-Dive
A longer gap between sessions means there’s more time for stuff to happen in your daily life, making therapy sessions more about catching up with recent events rather than focusing in depth on working on a particular issue.
Keeping A LifeBelt Handy
Knowing that before too long you’ll have a session in which you can offload and discuss things, can help you manage your feelings better in day-to-day life.
Mind the Gaps
Fortnightly (two-week) sessions can easily stretch to monthly if you or your therapist have to miss a session because of being sick or away.
A Place to Land
Clients process feelings and insights after and between sessions, not just during the set therapy hour, and this can feel overwhelming if there isn’t the weekly session in which to ‘land’, unpack and express things.
Longer gaps between sessions make it easier to fall back into familiar unwanted habits of thinking, feeling and behaviour.
Practice and Repeat
Making changes involves repetition and practice, and weekly check-ins can support this.
Holding in Mind
Weekly sessions can help the therapist and client to feel connected and to exist more clearly in one another’s mind.
Building More Efficient Connection
A one-foot-in, one-foot-out pattern in therapy is more common with less frequent sessions; the consistency and commitment of weekly therapy builds connection and hastens healing and growth.
Weekly Sessions Mean Your Therapist is Supported to Help You Better
One last important point: Weekly therapy fits the financial model that many therapists rely upon.
The average therapist has perhaps fifteen** client ‘slots’ per week. That’s how we earn our living and support ourselves and our family. That’s fifteen people’s inner worlds to hold with thoughtfulness, care, presence and emotional connection. But if each client only comes every two weeks, or every month, then that’s going to have to be 30 or 60 people’s inner worlds to attend to, to remember, and to deeply consider between sessions. (Because yes, we therapists do spend quite a lot of time between sessions considering you and your needs). Personally, I couldn’t do that and still be the kind of attentive, effective, emotionally-attuned therapist my clients deserve to have.
If I want to pay my bills, and look after my family and myself, and strive to be an excellent therapist for every single one of my clients, I need to see each client regularly once a week for however long we decide to work together. (This is not to tie anyone into therapy for longer than necessary; it doesn’t matter whether their therapy lasts for a few weeks, a few months, or even a few years).
What are your thoughts?
Whether you’re a client or a therapist, what’s your experience and your view on the value of weekly therapy? Let us know in the comments below. And don’t forget to head over to Jodie’s blog post ‘Why Counsellors and Psychotherapists Recommend Weekly Therapy’ to read about the value of weekly therapy sessions in more detail.
**Many therapists and counsellors see more than fifteen clients weekly, whilst many other therapists see fewer; I’m just offering what seems to be an average, based on therapists I know.
*Thanks to my colleagues Jennifer Brady LPC, Kameela Osman MSW RSW, Alicia Hite MS. LMFT, Cindy Blank-Edelman LMHC, Rebecca Newkirk LCSW, Renee Outland OTD OTR/L, Toni Jackson, Sheryl Woodhouse LMFT, and Jodie Gale.