How Many Counseling Sessions Are Needed?
I hear this question asked in a variety of ways: how many sessions do I need to come, how many counseling sessions are needed, when will counseling be over. It would be a much easier question to answer if I had a cookie-cutter, one-size-fits-all approach to therapy. I don’t. I tailor an action plan for each client focusing on what they need.
Counseling as a Multi-Stage Process
I think of counseling as a multi-stage process. Not everybody moves through the same process at the same rate. Not everyone needs to spend time in each stage. Some people will cycle back through a couple of stages over and over. There is no definitive answer to “how many counseling sessions are needed”. I can give you averages, but the statistics don’t mean much. Give me a group of a hundred people who are in therapy and based on current research I can give you an average; point to any one person (or couple or family) and no one has any idea if they will be the stereotypical average or one of the outliers.
Crisis Management. Some people contact me as soon as a crisis occurs. A suicide attempt. The disclosure of an affair. A child or teen expelled from school or in legal trouble. For many people, the first step is getting through the shock of the crisis. It is hard to pin down the number of sessions for a person or couple to work through the shock because we all have different levels of resilience. There might be 0 sessions of crisis management if you wait to contact me until after the shock has worn off. Or, you might come in every day – or every other day – to help navigate the crisis. (Typical number of sessions = 0 to 5)
Assessment. The first counseling session is a get-to-know-you time. It is a chance for us to get to know one another. You are trying to decide if I am a good “fit” for counseling. I am trying to decide the same plus I need to know: am I the best therapist to help you. Assessment isn’t necessarily psychological testing, it may simply be my listening for key pieces of information as you tell your story. I generally do a lot of listening in the first session. I will ask questions if I need to fill in some blanks and I’m not shy about asking for formal testing/assessment if I believe it is needed. (Typical number of sessions = 2 to 4)
Setting Goals. Counseling is most effective if everyone in the room is working toward the same goals. I won’t tell you what your goals should be. Counseling is collaborative, that is, we decide together what direction counseling should take. This is pretty easy if one adult is my client. Marriage therapy and family therapy may take a little longer since we are negotiating a set of goals that everyone wants to work on. (Typical number of sessions = 1 to 3)
Skill Building. Sometimes all people really need is information and education. Anger management, communication, conflict resolution, assertiveness training, and relaxation skills are some of the types of skill training and education I provide. (Typical number of sessions = 1 to 6)
Understanding the Problem(s). Far too many people waste time and money trying to fix the wrong thing. Your boss may be a jerk but we can’t fix that. We can help you react differently to your jerk of a boss. Or , help you explore other jobs or career fields. Many people come to marriage counseling wanting me to fix their spouse (“I’m okay and you’re not”) instead of changing the underlying dynamic in the relationship. Understanding the problem involves understanding the underlying dynamics. changing what you can, and accepting those things that are beyond your control. (Typical number of sessions = 1 to 5)
Resolving the Problem(s). Problem resolution is why people come to therapy. Many therapists start here with their clients. Many clients want to start here. But, I have found that if we skip over the first few stages and go directly to problem resolution my clients get frustrated. Couples end up having the same arguments with the same outcomes as they did before counseling. Individuals end up either blaming others (taking no responsibility for their well being) or adopting a martyr mentality (taking responsibility for everything and everyone). Neither stance is helpful. Laying the proper groundwork first may feel slow in the beginning but will actually save us time in therapy and make counseling more effective. (Typical number of sessions = 6 to 12)
Maintenance/Follow-up. Once we both/all believe the goals for counseling have been met and the problems have been resolved, then the last stage of counseling is follow-up or maintenance. I want to make sure that whatever work you have done becomes your new normal. Rather than shake your hand and wish you well, I will ask you to come back in a month to check in. If all is still good, then I’ll ask you to come back in two or three months for another check up. (Typical number of sessions 1-5)
So… How Many Counseling Sessions Are Needed? To paraphrase one of my professors in seminary (when asked how many pages a paper should be) “…as long as it needs to be.” There is no one, right answer for everyone. But, to work all the way through the whole process without taking any shortcuts most of my clients are looking at 12 to 40 counseling sessions. Twelve (12) sessions doesn’t necessarily mean once per week for three months. Once we begin seeing improvement we may cut back to one session every two weeks.
How to Contact Us:
You may contact Bowden McElroy and Associates by telephone or e-mail. Our office hours are from 9:00 a.m. to 5:00 p.m. Monday through Friday. Additionally, a limited number of evening counseling appointments are available by request. You can call or email to make an appointment or you may schedule an appointment on line.
Executive Tower I (71st and Yale)
7136 S. Yale, Suite 300 Tulsa,Oklahoma 74136
E-mail: Bowden McElroy