How Often Should You Go to Psychotherapy? Finding Your Pace

There’s no exact answer to this question. When Sigmund Freud invented psychoanalysis over a century ago, he saw patients daily — every day except Sunday. In contrast, psychotherapy now mostly occurs once a week. But there’s a lot of variation: some clients go two or three times a week, while others meet with their therapist every other week, or even less.

The best pace for you depends on several factors. We can divide them into practical factors and clinical factors.

Practical Considerations

On the practical side, psychotherapy is an investment of time and money. Some people have more time and money to invest, others have less. Some have work schedules or family obligations that limit how often psychotherapy can occur. Some need to use health insurance that limits session frequency.

Often these practical considerations set an upper limit on the pace of psychotherapy, even if more frequent sessions would offer more benefit. A sensitive therapist works within these practical constraints. After all, an unsustainable meeting frequency that adds to the client’s stress would be counterproductive. On occasion, when the clinical need calls for it, the therapist will refer the client another therapist or therapy clinic better able to work within the client’s practical constraints.

Clinical Considerations

The main issues here are the need for insight and support. For clients who seek to understand themselves better and get to the roots of their problems, meeting more frequently leads to deeper exploration. Psychotherapy takes on a bigger role in the client’s life, brings more feelings into consciousness for exploration and reflection, and generally makes the whole therapy experience more intense and meaningful. In a nutshell, this is why psychoanalysis traditionally occurs several times a week.

Conversely, meeting less often than weekly tends to weaken the “momentum” that carries the process from session to session. Psychotherapy sessions that occur less than weekly are often “catch up” reports of what happened in the client’s life since the two last met. Such sessions can feel disconnected from one another: more a check-in than an ongoing exploration of the client’s emotional life.

The other clinical consideration is whether the client needs the emotional support of the therapist on a frequent basis. This has less to do with exploration and insight, and more to do with the value of the therapy relationship itself. Some clients feel emotionally unstable unless they see their therapist often. Also, therapists may meet with clients more often during a temporary crisis.

The Value of Consistency

One factor that is both practical and clinical is consistency. Meeting at the same day and time every week (or the same two days and times, etc) is easier for both parties to schedule — and to schedule other activities around. Haphazard or ad-hoc scheduling leads to more missed appointments.

Consistency has clinical advantages as well. The regular pace makes psychotherapy a predictable part of the client’s life. Clients anticipate these regularly scheduled sessions, and the regularity itself can be an emotionally stabilizing and comforting factor.

In Summary

The most common pace of psychotherapy is once a week, on the same day and time each week. But aside from ease of scheduling, there’s nothing to recommend it in particular. More frequent sessions offer deeper emotional exploration and more emotional support; less frequent sessions offer less. The best pace for any particular client is a combination of practical considerations, clinical needs, and client preference.

See the other articles on the site for additional information about psychotherapy and to learn how PsiAN works to advance psychotherapy for the next generation.