How often should you go to therapy and how long does it usually take?

These are practical questions with empirical answers — and the research is more decisive than most people expect. Frequency and duration are not arbitrary; they track the nature of what is being treated and the depth of change being sought.

Frequency. The overwhelming majority of outpatient therapy occurs once weekly, and this is the baseline from which everything else departs. Yalom (2008) notes that while most group therapists have never led a group meeting more than once a week, twice-weekly contact produces meaningfully greater intensity — members continue working through material between sessions, and the process takes on the character of a continuous conversation rather than a series of discrete appointments. For individual psychodynamic work, the same logic applies: psychoanalysis proper involves at least three sessions per week, while psychotherapy typically runs once or twice weekly. The difference is not merely logistical; frequency shapes the depth of the transference relationship and the pace at which unconscious material becomes available.

Duration. Here the research speaks with unusual clarity. Shedler (2010) synthesizes the outcome literature and finds that effect sizes for psychodynamic therapy are as large as those reported for any other modality — and, crucially, that patients appear to continue improving after treatment ends, a finding that distinguishes depth-oriented work from symptom-focused approaches. This "sleeper effect" — gains that consolidate and grow in the months and years following termination — is one of the most consistent findings in the long-term psychotherapy literature.

The dose-effect research Yalom (2008) summarizes offers a useful rough map: clients with acute, circumscribed difficulties may remoralize in eight sessions or fewer. Those with more chronic difficulties typically require fifty to sixty sessions to show meaningful improvement. Significant personality disturbance — the kind that has organized itself across decades — requires considerably more. Leichsenring and Rabung (2008), in their meta-analysis of long-term psychodynamic psychotherapy, found large and increasing effect sizes for patients with personality disorders, chronic mental disorders, and multiple comorbidities, with pre-to-post effect sizes ranging from 0.78 to 1.98. Notably, the number of sessions correlated significantly with improvement in target problems and general psychiatric symptoms — more sessions, better outcomes, up to the thresholds studied.

The Berlin Jungian study, reviewed by Roesler (2013), followed patients treated with an average of 162 sessions over one to two years per week. At six-year follow-up:

Of 60.4% of patients reporting their well-being as very poor prior to therapy, 86.6% rated their global well-being at follow-up as very good, good or moderate — well-adjusted close to normal reference group on all scales of psychopathology.

Hospitalization days, sick days, psychotropic drug use, and visits to primary care physicians all dropped — below the average for the general German population. The effects were not merely symptomatic; they touched every domain of life.

De Maat and colleagues (2009) draw a distinction worth holding: symptom reduction comes faster than personality change. Perry and colleagues estimated that 50% of patients with personality disorders would no longer meet diagnostic criteria after roughly 92 sessions (about 1.3 years), and 75% after 216 sessions (about 2.2 years). Personality change — the kind that alters how a person meets the problems of living — takes longer than symptom relief, and its effects are more durable.

For short-term work, Abbass (2014) reviews over 100 trials of short-term psychodynamic psychotherapy averaging 12 to 24 sessions, finding large effects for depression, anxiety, and somatic disorders that are sustained and sometimes increase at follow-up. Short-term work is not a lesser version of long-term work; it is a different instrument, suited to focused problems rather than characterological depth.

The practical answer, then: once weekly is the standard; twice weekly deepens the work considerably. For circumscribed difficulties, 12 to 24 sessions may be sufficient. For chronic conditions or meaningful personality change, a year or more — often considerably more — is the realistic frame. The research does not support the idea that therapy should be as brief as possible; it supports matching duration to the depth of what is being addressed.

Sources Cited

  • Roesler, Christian, 2013, Evidence for the Effectiveness of Jungian Psychotherapy: A Review of Empirical Studies
  • Shedler, Jonathan, 2010, The Efficacy of Psychodynamic Psychotherapy
  • Leichsenring, Falk, 2008, Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis
  • de Maat, Saskia, 2009, The Effectiveness of Long-Term Psychoanalytic Therapy: A Systematic Review of Empirical Studies
  • Abbass, Allan A., 2014, Short-term psychodynamic psychotherapies for common mental disorders
  • Yalom, Irvin D., 2008, The Theory and Practice of Group Psychotherapy, Fifth Edition