What is the Right Dose of Therapy?
Adele O’Hare
Understanding Therapy Duration and Outcomes: What to Expect
Psychotherapy is a process of growth and change that varies for each person. The number and frequency of sessions that you need will depend on multiple factors, including the depth and complexity of your concerns, and your therapy goals. Below is a general guide to help calibrate your expectations about what different doses of therapy can achieve. It is based on insights from intensive short-term dynamic psychotherapy, emotion focused therapy, research on earned security and attachment theory, the writings of psychodynamic psychotherapists Nancy McWilliams and Jonathan Shedler, and my own clinical experience.
Short-Term Therapy (6–10 Sessions, Weekly or Fortnightly)
Potential Outcomes:
Symptom relief (e.g., reduced anxiety, depression, or distress)
Increased emotional awareness and insight
Practical coping strategies and improved self-regulation
Identification of core relational patterns
Enhanced motivation for deeper change (if needed)
Best Fit For:
People who have a well-integrated sense of self and good functioning but are experiencing acute stress or situational difficulties
Those seeking a focused intervention for a specific issue
Individuals unable to commit to long-term therapy but wanting to gain insight and tools
Limitations:
Deep characterological change is unlikely in this timeframe
Root causes of difficulties may only be identified, not fully processed
Gains may be temporary without further work
Medium-Term Therapy (11–20 Sessions, Weekly or Fortnightly)
Potential Outcomes:
More stable symptom relief and improved resilience
Greater capacity for emotional regulation and distress tolerance
Beginning shifts in entrenched relational and self-defeating patterns
Strengthened reflective function (ability to think about thoughts and feelings with greater clarity)
A stronger sense of self-agency and confidence in navigating relationships
Best Fit For:
Individuals with moderate personality integration who struggle with recurring emotional or relational patterns
Those wanting more than symptom relief but unable to commit long-term
People with early relational wounds seeking some reparative experiences in therapy
Limitations:
Deeper shifts in core self-concept and relational templates require ongoing reinforcement
Patterns may resurface under stress if deeper work is left unfinished
Longer-Term Therapy (1 Year or More, Weekly Sessions or More Frequent)
Potential Outcomes:
Profound and lasting changes in personality structure and self-concept
Increased earned security in attachment (greater capacity for stable, fulfilling relationships)
Transformation of deep-seated relational patterns and defences
Greater emotional depth, authenticity, and integration of past wounds
Strengthened reflective function and increased psychological flexibility
Best Fit For:
Individuals with complex trauma, early attachment disruptions, or personality-based struggles
Those seeking deep personal transformation and relational healing
People dedicated to long-term growth and wanting to develop a stronger, more resilient sense of self
Commitment & Considerations:
Change is gradual and requires sustained engagement
Moments of resistance or discomfort are part of the process
The deeper the change, the more lasting the impact
What’s the right fit for you?
Your therapy journey depends on your goals, resources, and readiness for change. Even brief therapy can be meaningful, while longer-term work fosters deeper transformation. If you’re unsure, we can discuss a realistic therapy plan that aligns with your needs.
The most important factor? Your active engagement in the process. Therapy works best when approached with openness, curiosity, and commitment.
Let’s explore what’s possible together!
