How long should therapy be? 

Treatment length depends on what you want to get out of therapy. Typically, short-term therapy is for symptom relief and often involves meeting specific concrete goals. You might seek therapy for several months in order to resolve a crisis or to adjust to a new role or phase of life. Conversely, long-term therapy is for achieving enduring personality change. People who seek long-term therapy may be looking more generally to learn more about themselves. You might go to therapy for several years to gain an understanding of how you've been affected by childhood trauma. For some, therapy takes place over the course of the lifespan. You can go to therapy for months or years at a time and take breaks in between, returning because something happens that shakes you, or simply when you feel inspired to do more work. 

How do I know when therapy is over?

Sometimes it can be hard to tell the difference between reaching an endpoint versus resistance to change. Sometimes you reach an endpoint in therapy because you've achieved your goals. Other times you reach an endpoint when you've done all you can do with a specific therapist. Perhaps you've only worked with male therapists, and although you've made significant changes, you realize that in order to best address conflicts related to your relationships with women, it may be time to see a female therapist. Perhaps you've seen a cognitive behavioral therapist and you've learned some coping skills for reframing destructive thoughts, but you want to go deeper. Strict cognitive behavioral therapy is a present-oriented treatment and there is typically very little if any discussion of the past. You would be better served by seeing a therapist who offers insight-oriented treatment if you want to work through conflicts stemming from early childhood. Resistance is not necessarily a sign that therapy should end. Sometimes working through resistance is part of the therapy. Maybe you've always stopped going to therapy because it's "not working quickly enough" and you realize that this a larger pattern that exists across various domains in your life. If you learn to work through this issue in real time in therapy, you can translate what you learned to these other domains. 

Some people identify so much with their struggles that change feels more threatening than staying in a familiar misery. It's not unusual to fear losing an important part of yourself when you make changes, but this does not have to be the case. You may think "my depression makes me funny--being depressed helped me to develop a sense of humor." Your sense of humor might change when you feel less depressed, but you may also find that you're more creative and less inhibited. You might also experience resistance due to a general fear of the uncertainty associated with change. You may wonder, if I'm no longer as anxious, what will I think about and who will I be? You may even fear that you'll be lonely without the same, familiar anxiety because it's been a sort of companion. However, there are times where it's appropriate to take a break from therapy. You may find that you lack enthusiasm for therapy. You notice that you're prioritizing other things over therapy. You feel like you're getting serious diminishing returns from therapy. Whatever the reason, I recommend coming in for at least one final session to discuss why you've determined that termination makes sense and to review the therapy journey together, as this final step helps to consolidate treatment gains. I always welcome former patients to come back when they have something new to explore, but also understand that it can be beneficial to try different therapists in order to get other perspectives. 

How frequent should appointments be? 

I recommend weekly sessions. Meeting weekly can feel overwhelming for some clients, but I advise working through this discomfort and I will help you do it. There may be some weeks where it's difficult to wait for therapy because you have something pressing to discuss. There may be other weeks where you dread therapy and you don't want to come in. As I stated above, it is perhaps even more important to come in on these weeks where you are the most resistant because they provide a prime opportunity to learn in real time how to respond differently to your feelings and to stop allowing your mood to dictate your actions. It's okay to come in and say you don't want to be here. We can work together to better understand the resistance you feel. It's okay if there are topics you don't want to broach. Every therapy session doesn't have to be a heavy session. It's okay if you don't know what to talk about. As long as you are willing to work with me, I'll help you figure out how to make good use of the time. 

Can I come bi-weekly?

Bi-weekly sessions are often more inefficient than weekly sessions. For many clients, so much happens in two weeks that it can be hard to focus deeply on any one topic. Therefore, the work done in one bi-weekly session is not equivalent to the work done in two weekly sessions. Let's say it will take 26 sessions to accomplish your treatment goals. That's six months of weekly sessions or one year of bi-weekly sessions. Other issues are more likely to arise in bi-weekly therapy i.e. client disengagement and premature termination due to lack of continuity between sessions. I make rare exceptions and typically only for established clients with compelling reasons for switching to bi-weekly.