Actually this is a question very few of my clients ask. They come with problems and concerns and want to have help for as long it takes for them to achieve the benefits they are seeking. This might be a few weeks, a few months or even a few years, depending on the nature of what they are facing.
But sometimes spouses, parents and friends have definite opinions about how quickly clients need to “get over” whatever has brought t
hem to counseling. One parent, for example, was upset their child’s serious behavioral problems were not resolved after only three 40-minute counseling sessions. The friends of another client said her counselor must not be any good if after three months of help she still needed counseling for a life-long depression.
Sadly such expectations are not realistic. While sometimes the length of treatment is affected by limits placed by one’s the insurance company, the ability to pay or research protocols, such limitations should not be the determiner of how long a person needs counseling.
One study by Dr. Martin Seligman for Consumer Reports indicated that long-term therapy of over two years resulted in the greatest reports of psychological improvement. But in reality many people benefit from short-term therapy of only a few weeks or months, while others may need three or more years.
The length of time someone needs counseling is best determined by the client and the therapist together based on when the improvement is sufficient that the client feels ready to be on their own again. How long this might take depends on many different factors such as:
The nature and severity of the problem. A client may be suffering from a serious underlying mental illness that is part of their inherited biological nature and is compounded by difficult circumstances in their life history. It may take far longer to address such issues than it does someone who has always been emotionally and psychologically healthy but suddenly must adjust to a difficult and painful life decision, change or trauma that throws them temporarily for a loop.
- How long the problem has existed. Some people come to counseling to address chronic lifelong problems they have may have previously denied, discounted, tried unsuccessfully to handle on their own, or never found the proper professional help with. Life-long, deeply buried, or highly painful psychological wounds will usually take longer to address. For example, some people who suffer from the effects of child abuse or post-traumatic stress may require extended treatment.
- The ability of a client to make needed changes and resolve their problems or learn to manage their symptoms. Some people are ready and willing to make changes but circumstances in their lives make actually learning to master and implement such changes a slow process. They may have many problems past and present to deal with. There may be serious financial issues, family discord, or physical illnesses that drains their time and energy. Crises on a job or at home or the needs and demands of others may prevent them from devoting as much time and energy would they’d like to their own psychological issues. They may not have a sufficient supportive system in place to charge ahead through their healing process, leaving them to handle their progress alone. They may even encounter opposition from others to make the changes they need to make.
- How open and honest a person can be with the counselor. It is not easy for everyone to trust a counselor. It can take time to get to know one’s counselor well enough to feel safe sharing the worst aspects of one’s problems. Sometimes it’s difficult to even admit to the true nature of one’s the problems to one’s self. But as trust grows, it becomes easier to acknowledge and address real issues that were too painful or embarrassing to face previously. Also, how readily someone can face and deal with psychological matters can seriously hindered by the stigma that persists toward mental illness and asking for help from a professional. Sadly such negative judgments still linger in our culture and among some families and friends.In other words, we can think of counseling as a process that starts wherever one is now and unfolds along a path with no predictable time frame but with an open-ended opportunity, be it long or short in duration, to learn, grow and develop through understanding ourselves and mastering the psychological tools that enable us to become the full human beings we know we’re meant to be.
- The counseling methods used. There are many approaches to counseling and many types of counseling and the time they require varies. Some for example are supportive, skill-based or problem-solving in nature. Some help establish new brain patterns that with practice over time can replace undesired thoughts, feelings and behavior. Newer approaches can actually erase or delete undesired memories, thoughts, feelings and behavior. These newer approaches to less time and result in far fewer relapses for certain kinds of needs. Working together the therapist and the client will collaborate to find the methods best that will work best in their situation and how long it many expect to take.
In other words, we can think of counseling as a process that starts wherever one is now and unfolds along a path with no particular set time frame but with an open-ended opportunity, be it long or short in duration, to learn, grow and develop through understanding ourselves and mastering psychological tools and undertaking personal transformations to become the full human beings we know we’re meant to be.
When that time comes, both I and my clients recognize it and know it’s time to go.
If your loved one is disappointed with your progress, please invite them to read this blog and if you or they have questions about the length of treatment you might need, please contact me. I will be glad to answer your questions and discuss your concerns.
If you would like more information or assistance in dealing with bipolar, please contact me.