Assessment, brief therapy, planned short-term therapy, and long-term therapy

Brief therapy can be anything between one and twelve sessions. Planned short-term therapy is usually a maximum of twelve sessions. Long-term or open-ended therapy generally involves weekly or twice-weekly sessions for a minimum of a year. Long-term therapies are generally seen as a minimum of about 50 sessions and on average are about 75 sessions.

In many ways the question of brief, short-term or long-term therapy is determined by resources available: these resources include financial resources, availability of time for sessions, and inner resources. Decision making in this regard is never simple and as a client you are active in having a say. This may be simply by not coming back for further sessions – though in the interests of getting the most from the resources you have already used it makes sense to talk to the therapist about your intentions and reasons for them.

I prefer to start the therapy process by contracting for four sessions. During this time we work together to clarify what you hope to get from the therapy, to identify the problems you are dealing with, and to consider options for how you might manage your situation most effectively.

Brief and short-term therapy is often best when’s its a first therapy experience and is most likely to have a satisfactory outcome if you have modest goals. It is most useful when your life problem can be clearly defined and offers a clear cut theme or focus for therapy. It can be helpful for dealing with loss and mourning or a life stage crisis rather than ongoing struggles and emotional problems.

Long-term therapy is often useful when we are struggling to establish and maintain long-term intimate relationships. It is also helpful for more complex mental health issues. It can be effective for personality disorders and difficult-to-treat anxiety and mood disorders. This approach often involves uncovering and learning to deal more effectively with unconscious conflicts. It may also involve building an understanding of how certain types of adverse childhood experiences have left you feeling incomplete, anxious, or plagued with low self-esteem that interferes with your functioning.

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