How long does therapy take?

If you’re about to start therapy, or you’re already going, you probably want to know how many sessions you’ll need and what you’re committing to in time and money. There’s no single answer. It depends on what you’re bringing, the Approach (modality) The kind of therapy someone uses, such as CBT or psychodynamic therapy. You'll also see it called a modality. More in the jargon decoder , and how often you go, and how long you stay is also up to you. Here is what the research shows, what shapes the timeline, and how to plan for the cost.

What the research shows

A review of 26 studies of therapy in everyday practice, rather than in trials, looked at how much therapy people needed (Robinson and colleagues, 2020). Improvement tended to come faster in the earlier sessions and slow down later on. The amount that worked best ranged from about 4 to 26 sessions, depending on where people were seen, what they came with, and how improvement was measured. For guided self-help programs, where you mostly work through material yourself with some support, the amount that worked best was lower, about 4 to 6 sessions.

Most of the studies were in university counselling services and outpatient clinics, with people seeking help for common problems such as anxiety and low mood. There was very little evidence about people with long-term or more severe difficulties.

In Australia, people using a Mental Health Treatment Plan A document your GP writes with you. It makes you eligible for a Medicare rebate on up to ten individual sessions a calendar year: six, then a review with your GP, then the remaining four. The plan itself isn't therapy. More in the jargon decoder had about five sessions on average, fewer than the ten a plan allows each year (Department of Health, 2022). That average includes people who stopped for all sorts of reasons, so it isn’t a guide to how many you’ll need.

What changes how long it takes

How long it’s been going on. How long something has been going on changes the pace of the work more than whether it can be helped. Recent problems often shift quickly. Long-standing ones usually take longer, and they respond to different approaches.
What you want from therapy. Getting through one specific thing and dealing with something you’ve carried for twenty years are different projects.
The approach. Some approaches are deliberately brief and built around a set number of sessions. Others run open-ended for a year or more. Schema therapy typically runs one to two years. A full program of dialectical behaviour therapy usually runs six to twelve months, often longer. Psychodynamic therapy A therapy that looks at the parts of your life you can't quite see from the inside. Its core idea is that a lot of what shapes how you feel and act sits outside your awareness, and was laid down early. More in the jargon decoder is usually weekly and open-ended, and often runs for a year or more.
How often you go. Weekly sessions seemed to bring improvement faster than less frequent ones (Robinson and colleagues, 2020).

It’s your decision

How long you stay in therapy is up to you. You can stop after one session, or partway through. It’s still a commitment worth taking seriously, and how you stop matters. In one set of interviews, people who had talked their ending through with their therapist in advance mostly found it a good experience. People whose therapy ended suddenly mostly didn’t. If you’re thinking about stopping, raising it with your therapist means you can plan the ending together. If wanting to stop has come with a feeling that nothing is going to help, tell your therapist or your GP (general practitioner) For most people, where getting help starts. A GP can write a Mental Health Treatment Plan, prescribe medication and refer you on, and some are trained to deliver a small number of structured therapy sessions themselves. More in the jargon decoder about that feeling too. When is therapy finished? covers what a planned ending usually involves.

Medicare’s ten sessions

A Mental Health Treatment Plan gives you a Medicare Australia's public health insurance scheme. For mental health, it gives rebates on sessions with psychologists and some other professionals, usually through a Mental Health Treatment Plan. More in the jargon decoder Rebate The amount Medicare pays back towards a session. It comes back to you after you've paid, so what you pay yourself is the fee minus the rebate. More in the jargon decoder on up to ten individual sessions a calendar year. They’re arranged as six, then a review with the GP, then the remaining four. Group sessions are a separate ten a year, on top of the individual ten. Ten sessions is the number most people have in mind because it’s what Medicare rebates, but that’s a funding limit, not a judgement about how much therapy anyone needs.

If ten rebated sessions aren’t enough, there are several ways to manage the cost:

Fortnightly instead of weekly sessions. Spreading sessions out spreads the cost.
A practice with sliding-scale fees. Some practices charge less if you can’t afford the full fee.
A group program. Groups usually cost less per session.
Blocks of sessions with breaks in between. A few sessions, a break, then a few more.

Planning for the cost early can help you avoid having to stop before you’re ready.

There are several ways to pay for therapy:

Full fee. Seeing a private Psychologist Someone trained to assess mental health problems and treat them with therapy. It takes at least six years of study and supervised practice, and they're registered with Ahpra, the national regulator. Psychologists can't prescribe medication. More in the jargon decoder , Counsellor Someone trained to help people talk through and work on difficulties. The title isn't protected in Australia, so it's worth checking a counsellor's training and registration. Medicare doesn't give a rebate for counsellors. More in the jargon decoder or Psychotherapist Someone trained in therapy, often for longer-standing patterns. Like counsellor, the title isn't protected in Australia, and Medicare doesn't give a rebate for psychotherapists. More in the jargon decoder directly. Medicare doesn’t cover counsellors or psychotherapists.
Workplace programs. Many employers pay for a few sessions for their staff.
Community services. Non-profit organisations and local community health centres provide low-cost care.
headspace A national youth mental health service for anyone aged 12 to 25, with centres around Australia and support online and by phone. It's free or close to it, you don't need a referral or a parent, and you can book it yourself. More in the jargon decoder . headspace offers free or low-cost support for people aged 12 to 25.
Groups. Group therapy A trained professional, sometimes two, working with several people at once. It's a way of running therapy, and many approaches work in groups. More in the jargon decoder programs, which usually cost less per session.
A Mental Health Treatment Plan. Your GP assesses whether a plan suits you. A plan gives you a Medicare rebate on up to ten sessions a calendar year.

Free and low-cost options has more on each of these. If you’re partway through a plan and aren’t sure what happens next, ask your GP or the practice.

Asking about it

Both cost and expected length are reasonable things to ask about in the first conversation, and you should get a straight answer. You could ask your therapist:

“How long do you think this might take?”
“How will we know when we’re done?”

Once you’ve started, is my therapy working? covers how to keep track of whether therapy is helping.

Where next

However long it takes, how well you and your therapist work together matters a great deal. Why who you see matters more than what they do explains why.