Why Weekly Therapy Sessions Lead to Better Results

Choosing How Often to Attend Therapy

When you first start considering therapy, there are many factors to take into consideration. Do you want in-person or online? What model of therapy do you want to engage in? How are you going to fit it into your working and family schedule? It is often a big step to even get to the point of researching possible therapists, let alone reaching out to speak to one. It is no wonder then, that it can feel like huge commitment, both in time and money, and sometimes this can lead to questions around regularity and frequency of sessions. Maybe it feels like spreading out sessions over a longer period feels more manageable, or that flexibility in attendance allows for the other demands in your life to also be fulfilled. There is a huge variation in how therapists offer their sessions to clients; some will be happy to work on an ad-hoc basis, fortnightly or monthly. Our practice, Talking Therapy North, offers weekly therapy sessions and it is a policy that we place a lot of value around. 

Committing to Your Wellbeing Matters

We believe that when a client takes that decision to begin therapy, they are taking a decision to place their own emotional and mental wellbeing as a priority. Reaching out to make that appointment is saying ‘I choose to find support to help me change the way I am feeling because it is not serving me to stay the way I am’. This often takes courage, and sometimes a level of sacrifice of other things that may have to slip down the priority list.

But a client who places importance on their needs, prioritises the time and money for them, and commits to therapy, is far more likely to experience the changes and growth that they seek. They are already stepping into that therapy room with a sense of value around their own needs, and that can make a huge difference to how successful the therapy is. We understand that lives are busy, and there are times when it is simply not possible to make that weekly commitment, and that’s OK. But we believe that a client is better served to wait until they are able or ready to prioritise their needs in this way, rather than stepping into an irregular and infrequent therapy relationship. 

Building Trust Faster With Weekly Sessions

There are several reasons why we adopt this policy; a central one being ‘the relationship’. You build a therapeutic relationship with your therapist, one that takes time to develop. The trust in the therapist’s ability to hold you safely and empathically is essential to creating a space where you can share and explore openly, and like in any relationship, this trust takes time to build. Weekly sessions give the opportunity for that relationship to develop more quickly, so that the client can move more swiftly into the ‘stuck’ or vulnerable areas which are where the change will happen. Meeting weekly with someone is naturally going to enable that relationship to develop faster, leading to a felt sense of safety and trust.  From a more practical standpoint, weekly sessions also aid in the recall of the work done in a previous session, meaning that it can be built on and developed. Two or more weeks is a long time and a lot can happen in a client’s life, and in less frequent therapy sessions there can be tendency to need to ‘catch up’ on what has happened between sessions, rather than keeping a focus and momentum on the areas of growth or development that have been worked on previously. In addition, when sessions are less frequent than weekly, the impact of holidays and other missed appointments becomes much greater; it can result in breaks of a month or more, which makes maintaining momentum much harder. 

What the Research Says About Session Frequency

The research into the impact of the frequency of therapy sessions shows a general trend towards quicker clinical gains when the frequency of sessions is higher. (Erekson, D. M., Lambert, M. J., & Eggett, D. L. 2015) Whilst this initially could be interpreted as ‘getting better faster’, there is another impact that this could have which is more subtle. Many clients come to therapy because they feel stuck; things they have tried before haven’t worked, they don’t know what to do to change or help themselves, or they may feel a  real sense failure.

When therapy sessions are more frequent, and change is seen quicker, this can be a real boost to a client’s self esteem and view of self; there can be sense of achievement, of success, of a belief they can help themselves. The therapeutic alliance is strengthened, motivation to continue is high, and progress continues to grow. Where sessions are irregular or more spaced out, progress is naturally slower, and in some cases can lead to frustration, a feeling of failing and ultimately the belief that therapy ‘doesn’t work’. Once the trust in therapy or the therapist has gone, the motivation to continue also decreases and can lead to ending therapy, without achieving the goals the client set out with. 

Weekly Sessions vs. Spreading Out the Cost

Of course, when you are engaging in private therapy, the financial aspect is an important one to consider. There can be the temptation to spread out the sessions to spread the cost, or to take pauses in months where there are more financial pressures. Private therapy is expensive and it is a huge commitment, we recognise that. However, we believe there can be a false economy in spreading the sessions out, seeing little or  slower progress, and ultimately requiring therapy for longer. Instead, commit to a chunk of weekly sessions- 12 weekly sessions vs 12 fortnightly sessions over 6 months- then take a break, consolidate, reflect, and if necessary, return for additional chunks in the future. The likelihood of seeing change and having a positive experience with therapy is much higher and represents more value for money than spending significant amounts of money on more sporadic sessions where progress is slower. 

When Less Frequent Sessions Make Sense

There are circumstances where less frequent sessions are appropriate; for example, after a significant time in therapy, a client may choose to end their weekly sessions but return for a few monthly sessions to ‘check-in’ and reflect on progress. The nature and purpose of these is very different to initial therapy, however; the client has done the work, they have seen progress and feel like they have the tools to continue to grow on their own, so these sessions are simply to aid the transition between therapy and going it alone. 

There are also many therapists out there who offer more flexibility for their sessions, sometimes because of the models they work in, their own scheduling limitations, or their personal philosophy of therapy. If you don’t want to, or cannot manage weekly sessions, there is support out there that will be accessible to you. It may just be worth considering what this might mean for your therapy journey. 

References

Erekson, D. M., Lambert, M. J., & Eggett, D. L. (2015). The relationship between session frequency and psychotherapy outcome in a naturalistic setting. Journal of Consulting and Clinical Psychology, 83(6), 1097–1107