When people are considering psychotherapy/counseling, they usually ask me “How long do you think it will take?” People who have a very specific problem – e.g., “I just got laid off my job” or “My partner just got a cancer diagnosis” – may get the tools they need to tackle their problem in only a session or two. I’ve had clients who got what they wanted/needed from one session with me.
Short-term therapy is usually considered to be 3 to 5 sessions. For many people I see, this is enough. They present their problem, I help them “deconstruct” it, we look at the emotional environment they’re operating in, and – together – come up with a strategy/plan. This usually works best when there is not a long history of problems in this area. “I have been depressed ever since I was a teenager” or “I’ve never been really fulfilled in any of my relationships” are probably not going to be quick fixes.
Work situations are another problem that often respond well to a few sessions. If you have a rotten boss or got a bad job review or have a colleague who’s sabotaging you, I can often help you address this and come up with a strategy in a few meetings. This is closer to what some people call “personal coaching”, where the goals are very concrete and often an action plan is the key to success.
Sometimes short-term therapy deserves a follow-up session later on to see (1) what worked, (2) what didn’t work so well, and (3) what needs to be adjusted in our original strategy.
Some people come to me wondering if their reaction to a situation is “normal”. This is often quickly addressed: the person’s reaction is totally “normal” and they want a professional – like me – for reassurance. I’ve had queer men tell me that they feel shame and embarrassment because they don’t like anal sex. One guy even said, “How can I really be gay if I don’t like anal sex?” I think he’d been watching too much porn. Recently, a new client told me, “Is it normal to be jealous of my husband when he webcams with someone hot? Even though we have an open marriage, I find myself jealous of his webcamming. What’s wrong with me?”
Probably nothing. You’re probably normal.
Different people have their own unique reactions to situations, but “normal” is a pretty big box. When I was a new therapist, I used to (half-jokingly) tell a lot of my clients, “I’m sorry to tell you, but (pause here) you’re normal”. So many people thought their reactions extreme or atypical, or thought of themselves as so screwed up that they couldn’t possibly be “normal”. It was a shock for many people to hear my validation.
Now, let’s look at situations that usually need more than a few sessions. Therapists are not magicians. We don’t want to merely focus on symptoms, we want to get in there and clean out the (mental) wound, not just put on a new band-aid. Without doing so, the “wound” is likely to get infected again and your problem will inevitably return.
It takes time to clean out the wound, especially if it’s something that’s been bothering you for a long time. Here are some situations that usually require longer-term therapy:
- You have a history of panic attacks and/or chronic anxiety
- You suffer from suicidal ideation or have a long history of depression
- You want to understand your long-term patterns of dysfunction and how to change them
- You’d like to be more successful, but have a history of self-sabotage
- You’re had repeated difficulties with your family and/or romantic relationships
Because the roots of most problems are personal and complex, it’s hard to “speed up” someone’s ability to work through major conflicts. Nonetheless, some situations can be addressed by empowering clients to generate a few simple solutions.
If you want to tackle some mental health issues in your life, talk to a professional and see what they advise. And be willing to be surprised: it could be a quick fix!