Culturally, we are doing a really good job of normalizing the use of therapy and medication, but I wonder sometimes if we underemphasize the fact that therapy takes time and effort to truly work. Because of the cultural normalization of being in therapy versus the lack of discussion regarding the true reality of the therapeutic process, it is not unusual for people entering therapy for the first time to expect rapid results or that they can use therapy to recover with minimal participation in the process.
While there are treatments for various symptoms designed to bring relief quickly (usually a combination of medication and therapy), and that there are therapies that can help individuals who are not completely bought into the idea of psychotherapy, those are the exceptions rather than the norm.
Quick-fix breakthroughs get glamorized in pop culture’s version of therapy and shape our expectations of how therapy will work for us, but in real life, change comes slowly.
How Long DOES it Take for Therapy to Work?
A huge study (source below) was conducted in 2001 of 10,000 people. It showed that about 20 sessions (which is the equivalent to about six months of weekly sessions) were needed for 50% of people to experience notable symptom improvement. With a full year of treatment, that number jumped to 75%.
These numbers change depending on how researchers measure “improvement,” and there are many studies that can be used to argue different timelines, but this massive study is the reference point I use in my work.
For many, noticeable relief in symptom intensity can some sooner – sometimes in the first few sessions – but when therapy does not help as quickly as we would like, it is important to set our sights on long term outcomes. Therapy is all about the long game: improvements in the short term are possible and reasonable to hope for, but a good attitude to bring to therapy is to focus on the long term goal.
There may be a few significant “lightbulb moments,” along the way, but more often – therapy looks like lots of little “oh’s” of small realizations. These little “oh’s” are each markers of tiny shifts in thinking that add up to bigger shifts time over months and years. Think of these little realizations and shifts as a compass: they change your trajectory by just a degree or two and, over time and distance, take you to a completely different destination. But remember: this takes time.
Whether you are just starting therapy or if you are months into the process, you can read more about the therapeutic process in my Therapy: Expectations vs. Reality article, and find more information about navigating therapy on my About Therapy page.
Therapy Takes Time: Purchase PDF printable download:
The research study that inspired this art can be found on PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11393594 if you don’t have academic access to that resource, it can be downloaded directly via this link. The language is academic and technical, so for a layperson outline and explanation of some of the issues with research that tests the “effectiveness” of various therapies for mental illness, see Jonathan Shedler’s article in Psychology Today.