The Question Everyone Asks (and Few Can Answer Definitively)

"How long will I need therapy?"

It's one of the first questions people ask, and it's frustratingly difficult to answer with precision. Therapy isn't like antibiotics for a bacterial infection—take this dose for this duration and you're cured.

It's more like physiotherapy after an injury: duration depends on the injury's severity, how long you've had it, your body's healing capacity, how much you practice between sessions, and what "healed" means to you (pain-free? Back to running marathons? Simply functional for daily activities?).

This guide provides honest, evidence-based information about therapy timelines across different conditions, what affects duration, and how to know when you're ready to stop.

The Frustratingly Honest Answer

For many common issues: 6-20 sessions For deeper, complex patterns: 6 months to 3 years For some people: Ongoing, periodic support indefinitely

But this range is huge, so let's get more specific.

What Affects How Long Therapy Takes?

1. What You're Working On

A specific, recent issue (breakup from a 6-month relationship, job loss, exam stress) typically resolves faster than complex, long-standing patterns (chronic depression since childhood, repeated relationship sabotage, trauma).

Single problems (social anxiety) generally need less time than multiple intertwined difficulties (anxiety + depression + relationship problems + substance use).

2. Severity and Duration of the Issue

Someone experiencing their first depressive episode after a bereavement might need 8-12 sessions.

Someone with treatment-resistant depression lasting decades needs longer—possibly years of work addressing underlying factors that brief interventions haven't touched.

The principle: the longer you've had it and the more it affects your functioning, the longer recovery takes.

3. Therapeutic Approach

Different modalities have different expected timescales:

Brief/Time-Limited Approaches:

CBT: Usually 6-20 sessions
Solution-Focused Brief Therapy: 4-12 sessions
Guided self-help: 6-8 sessions

Open-Ended Approaches:

Person-Centred therapy: Varies (6 months to years)
Psychodynamic therapy: Often 1-3+ years
Transactional Analysis: Varies (can be brief or long-term)

The approach you choose partly determines the timeline.

4. Frequency of Sessions

Weekly sessions: Faster progress for most issues Fortnightly: Suitable for less acute issues or maintenance Monthly: Maintenance or long-term support

If you see your therapist weekly for 12 weeks (3 months), you've had 12 sessions. Fortnightly over 3 months is only 6 sessions—half the therapeutic contact.

5. Your Engagement Level

Therapy works faster when you:

Attend consistently (cancellations slow progress)
Are honest in sessions
Reflect between sessions
Try new behaviors
Do homework (if your approach includes it)

Showing up but staying guarded or intellectualizing without feeling? Progress will be slower.

6. Readiness for Change

If you're truly ready and motivated, change happens more quickly.

If part of you is ambivalent—the problem is painful but familiar, change feels terrifying, or there are secondary gains (sympathy, avoiding responsibility)—the work takes longer because you're working against internal resistance.

7. External Support and Stability

Therapy progresses faster when your life is relatively stable:

Safe housing
Financial security (or at least not in crisis)
Supportive relationships (or at least absence of actively harmful ones)

If you're dealing with homelessness, domestic violence, or severe poverty whilst trying to address anxiety, the practical crises will (rightfully) take priority, slowing therapeutic progress.

8. Complexity and Comorbidity

Single issue: Specific phobia Duration: Often 6-12 sessions (especially with exposure-based CBT)

Complex combination: Depression + anxiety + alcohol misuse + relationship problems + unprocessed childhood trauma Duration: Likely 1-2+ years addressing these interconnected issues

9. Therapist Skill and Approach

An experienced, skilled therapist who accurately conceptualises your difficulties and chooses effective interventions will facilitate faster change than someone less experienced or working outside their competence.

This isn't to blame therapists—it's recognising that expertise genuinely matters.

Average Timelines by Issue Type

These are rough guidelines based on research and clinical experience, not guarantees. Individual variation is enormous.

Anxiety Disorders

Specific Phobia (spiders, flying, heights):

Approach: Exposure-based CBT
Sessions: 6-12
Duration: 2-4 months

Social Anxiety:

Approach: CBT or Acceptance and Commitment Therapy (ACT)
Sessions: 12-20
Duration: 3-6 months

Generalised Anxiety Disorder (GAD):

Approach: CBT, Person-Centred, or integrative
Sessions: 12-20+
Duration: 4-8 months

Panic Disorder:

Approach: CBT (particularly effective)
Sessions: 8-16
Duration: 2-5 months

Health Anxiety:

Approach: CBT
Sessions: 12-16
Duration: 3-5 months

Depression

Mild-Moderate Depression (recent onset):

Approach: CBT, Person-Centred, Counselling
Sessions: 8-16
Duration: 2-5 months

Moderate-Severe Depression:

Approach: CBT, psychodynamic, integrative (often combined with medication)
Sessions: 20-40+
Duration: 6 months to 2 years

Chronic/Recurrent Depression:

Approach: Long-term psychodynamic, schema therapy, or integrative
Sessions: 40+
Duration: 1-3+ years

Trauma and PTSD

Single-Incident Trauma (one assault, one accident):

Approach: Trauma-focused CBT or EMDR
Sessions: 8-20
Duration: 2-6 months

Complex PTSD / Developmental Trauma:

Approach: Phase-based trauma therapy (stabilisation, processing, integration)
Sessions: 50+
Duration: 1-4 years

Early, repeated trauma (childhood abuse, neglect) affects fundamental aspects of self and relationships. Healing requires sustained therapeutic relationship and cannot be rushed.

Relationship Difficulties

Recent Relationship Breakup:

Approach: Counselling, Person-Centred
Sessions: 6-12
Duration: 2-4 months

Repeated Relationship Patterns:

Approach: Psychodynamic, TA, schema therapy
Sessions: 30-60+
Duration: 8 months to 2 years

Understanding why you keep choosing unavailable partners or sabotaging intimacy requires exploring deeper patterns, usually rooted in childhood attachment.

Couples Therapy:

Approach: Emotionally Focused Therapy (EFT), Gottman Method, Imago
Sessions: 12-20
Duration: 3-6 months

Some couples continue longer; some separate during therapy (not a failure—sometimes clarity that separation is right is the goal).

Grief and Bereavement

Uncomplicated Grief:

Approach: Supportive counselling
Sessions: 6-12
Duration: 2-4 months

Grief doesn't "end," but therapy helps you process acute pain and adjust to life without the person.

Complicated Grief:

Approach: Specialized grief therapy
Sessions: 12-20+
Duration: 4 months to 1 year+

Complicated grief (prolonged, intense, interfering with functioning) needs more structured intervention.

Self-Esteem and Confidence Issues

Situational (after criticism/failure):

Approach: Counselling, CBT
Sessions: 8-12
Duration: 2-4 months

Chronic Low Self-Esteem:

Approach: Schema therapy, psychodynamic, humanistic
Sessions: 30-50+
Duration: 8 months to 2 years

Deep-rooted self-worth issues, often from childhood messages, require sustained work to internalize a different self-concept.

Addiction and Substance Misuse

Therapy alone (without additional supports like AA, rehab, medical management):

Sessions: 20-40+
Duration: 6 months to 2 years

Most addiction treatment combines therapy with other interventions. Therapy addresses underlying issues (trauma, self-medication for mental health) but isn't usually sole treatment.

Eating Disorders

Mild-Moderate Eating Disorder:

Approach: CBT-E (Enhanced CBT for eating disorders)
Sessions: 20-40
Duration: 5-12 months

Severe/Long-Standing Eating Disorder:

Approach: Multi-modal (therapy + nutritional support + medical monitoring)
Sessions: 40+
Duration: 1-3+ years

Eating disorders are notoriously difficult to treat and often require longer-term work.

Life Transitions and Adjustment

Career change, relocation, becoming a parent:

Approach: Supportive counselling, existential therapy
Sessions: 6-12
Duration: 2-4 months

Transitions aren't pathology—therapy provides space to process change and find your footing.

Personal Growth (No Specific "Problem")

Duration: Entirely individual

Some people see a therapist for 8 sessions and gain what they need. Others engage in years-long exploratory work, uncovering layers of self-understanding.

Different Phases of Therapy

Understanding therapy's natural phases helps set realistic expectations:

Phase 1: Assessment and Alliance Building (Sessions 1-4)

You and your therapist are:

Getting to know each other
Building trust
Identifying goals
Formulating a shared understanding of the issues

Progress feels exciting—finally someone understands! Insights arrive quickly.

Phase 2: Active Work (Sessions 5-20+)

The real therapeutic work:

Addressing core issues
Processing difficult emotions
Challenging patterns
Trying new behaviors

This phase can feel harder—progress slows, you hit resistance, sessions are emotionally demanding.

Phase 3: Consolidation and Maintenance (Variable)

You're:

Integrating changes into daily life
Dealing with setbacks (they happen)
Deepening understanding
Preparing for ending

Change is less dramatic but more stable.

Phase 4: Ending

Planned endings involve:

Processing the loss of the therapeutic relationship
Celebrating growth
Identifying what to do if difficulties resurface
Sometimes a few "booster" sessions months later

NHS vs Private: How Timelines Differ

NHS Therapy

Typical offering: 6-12 sessions of CBT or counselling

Why so brief?

Limited resources and high demand
Evidence that many people improve significantly in 6-12 sessions
Focus on symptom reduction rather than deep exploration

Limitations:

Not enough for complex cases
Time pressure can feel rushed
May not address underlying patterns

Option: Complete NHS therapy, then continue privately if you want deeper work.

Private Therapy

No imposed time limits: You and your therapist decide together

Advantage: Flexibility to do brief or long-term work as needed

Disadvantage: Costs accumulate (though you control frequency and can pause/restart)

How to Know You're Done

Therapy doesn't have to continue until you're "perfect" or never struggle. Consider ending when:

You've met your goals: The issues that brought you have improved significantly

You're handling life differently: Your coping mechanisms, relationships, or emotional regulation have changed

You feel equipped: You've internalized skills and insights; you can be your own therapist for routine difficulties

Diminishing returns: Sessions feel less productive; you're attending out of habit

Life circumstances change: Financial strain, relocation, time constraints mean continuing isn't feasible

You're ready to test independence: You want to see how you manage without therapeutic support

Good Endings vs Premature Endings

Good ending: Planned, discussed over several sessions, chance to process the loss, clear sense of what you've gained

Premature ending: Leaving in frustration, avoidance (it's getting too hard), or without processing the work

If you're considering ending but feel ambivalent, discuss this in session. Sometimes the desire to leave is avoidance of difficult material; other times it's genuine readiness. Your therapist can help distinguish.

Can You Go Back?

Absolutely. Many people do therapy in "seasons":

Year 1: Intensive work on depression
Years 2-4: Living independently
Year 5: Return for 10 sessions around relationship breakup
Years 6-10: No therapy
Year 11: Return for support during career crisis

This isn't failure—it's wise use of resources when you need them.

Some people maintain very low-frequency ongoing contact (monthly or quarterly) indefinitely. This can be valuable for chronic conditions or simply helpful ongoing support.

When Therapy Takes "Too Long"

If you've been in therapy for years and aren't seeing meaningful change, ask:

Is the approach right? Maybe CBT isn't working; try psychodynamic. Or vice versa.

Is this the right therapist? Competence and fit matter enormously.

Am I genuinely engaging? Or attending but resisting the work?

Are external factors blocking progress? (Abusive relationship, addiction, unaddressed medical issues)

Have I actually changed but not noticed? Sometimes we don't give ourselves credit for growth.

Is therapy the right tool for this problem? Some issues need practical support (housing, legal help, medical treatment) more than therapy.

Years of therapy with no change isn't virtuous perseverance—it's a signal something needs to shift.

Quick Reference: Realistic Expectations

After 4-6 sessions: You should feel heard, have some clarity on patterns, notice small shifts

After 10-12 sessions: Moderate improvement in symptoms for many conditions; clearer understanding of issues

After 20 sessions: Significant change for straightforward issues; good progress on complex issues

After 40+ sessions: Deeper personality-level changes consolidating

No universal timeline: Individual variation is huge; these are rough averages

Final Thoughts

"How long does therapy take?" depends on what you're healing, how you heal, who's helping, and what "healed" means to you.

Brief therapy (6-12 sessions) works beautifully for many issues and many people. Extended therapy (1-3+ years) is right for others. Neither is superior—they serve different purposes.

The real question isn't "How long will this take?" but rather "Am I making progress toward what matters to me?"

If yes, continue. If no, reassess (talk to your therapist, try something different, take a break).

Therapy is a tool, not a lifestyle. Use it as long as it serves you, then live your life.

About the Author: The Kicks Therapy content team provides realistic, evidence-based information about therapy. Our practice offers both brief focused work and longer-term integrative therapy depending on your needs.

Ready to start therapy but wondering about the commitment? Book a consultation to discuss your specific situation and get an honest assessment of likely duration. We can work briefly or long-term, adjusting as we go. £80 per session in Fulham or online.

How Long Does Therapy Take? Realistic Timelines for Different Issues