frequency of counselling sessions?

[shrinknightmare]

Was wondering about frequency of counselling sessions.

How do they decide how often you go? Do they have a scale or something?

What does it mean if you are seeing them once a week? Does this mean they are keeping an eye out on you?

My shrink said she would start spacing them out when I first saw her, I did a couple of fortnightly ones, then went downhill a bit and now they are back to weekly again. Has been that way for months.

The shrink even had me see someone else from the same office for a 2nd opinion and she still saw me in that same week.

[Daisychain]

I usually see my therapist once a week, sometimes she books me in for two sessions weekly which happens maybe once every 3 weeks. She does this when I am feeling low and depressed. Yea I agree with you, once a fortnight is isn't enough, especially when you are relying on your therapist to get you through the week.

[shrinknightmare]

I get upset because I am in a support group for parents who have lost a child to suicide and they are not seeing their counsellors/shrinks as often as me??? I wonder why I am more needy then them? I know I have other issues as well such as workplace bullying and I was hassled by the media over it.

[Jenny]

I used to go to counselling once a week, it was very boundaried so only one weekly session was offered. I've heard of other therapies that offer twice weekly, or even 3, 4 or 5 times a week therapy sessions. I think it depends largely on the counsellor's therapeutic approach, for example a psychodynamic counsellor may work on sessions 3, 4 or 5 times a week whereas a CBT counsellor may offer one a week or one a fortnight.

I hear your fear of being needy and treated differently because of this, but i don't think it's possible to compare with other people.. if you feel going once a week helps then stick with it.. it doesn't matter how often others go. It doesn't make you needy in my view.

:arms:

[Fluffy Flowers]

To be honest, I think the frequency you see your therapist is down mainly to how they work, more than anything else, and the type of therapy used.

I agree with Jenny about comparing yourself. When you compare yourself you will often end up feeling something detrimental because often the comparisons are very unfair and inaccurate. The best thing you can do is to focus on what you have and what works for you. If what you are having works for you, then that's great, go with that.

I personally see my therapist once a week for individual therapy, and also I see her in group therapy once a week too. When the group finishes, I will probably carry on seeing her once a week. In previous therapies I have seen them once a week with the exception of one therapist who I saw twice a week.

[TDM]

A few years ago I'd see her once a week, but I was forced into it. Now, it's whenever I want to make an appointment, which, I should say, is not very often. I probably should make a greater effort though, because I kind of need it.

TDM

[IndieSoul]

When I saw a counselor a couple years ago, I saw her once a month.

With my new counselor, she said that it's once a week at the beginning, then after a while it would go to once every two weeks.

[Old Wolf]

I think the biggest factor in how frequent appointments are lies with the type of therapy and therapist. Psychoanalysts and psychotherapists are more likely to offer the more intense therapy focus that can include several appointments each and every week while counsellors are more likely to stick to one session a week. I, personally, think that frequency and timing (i.e. same time and same day each week) are just one of the boundaries that I strive to maintain for my clients – “same time, same day” has a sort of solidity, a sense of being dependable which, like a good parent, encourages a sense of security within the individual. So, perhaps what is important is not the frequency so much as the dependability of the appointments.
One thing I would add here is that the therapeutic “journey” is an ongoing process i.e. it is a process that continues for the client in between the sessions – in fact some would say that some of the most important work takes place within this “space” – that the session may be where the work is instigated but the client continues to process that and “make it their own” in the periods between sessions!
There are two other important factors that run alongside and can often become intertwined with frequency and these are support and dependency. These are themselves two sides of the same coin. It is not unusual for the client to look to their sessions for support at the start of therapy – to become dependent on the session and on the therapist. Like the child, having this dependable space in which to grow is a necessary precursor for some clients before rejoining life’s journey as a strong, secure and independent individual which is, of course, the ultimate aim of any good therapy. However, if this dependency continues for too long it can indicate an underlying problem/issue that will need to be explored in its own right – a secure and mature adult will normally be seeking independence or, with a partner, interdependence (the position where you, as an independent person, know that there is another person, your partner, that you can depend on when YOU NEED THEM i.e. not a continuous state of dependency.).
I digress – as always, this is only one view of the matter i.e. mine!
BW
Old Wolf

[andyhp]

The 'theme' that seems to come from most of the answers to the original questions holds true most of the time. It is very much dependent on the approach of your therapist e.g. see a psychoanalytic therapist and it may be 3/4/5 times a week for however many years, see a counsellor and it's likely to be once a week or fortnightly.

There are other 'factors' which can influence frequency though.

Many organisations will only allow once a week contact at most; this would include the NHS (under 'normal' circumstances') and most other free or contribution based providers of counselling. So, if you see your therapist/counsellor in one of these settings then whether you, or you and your therapist/counsellor want to meet more it probably isn't going to happen. In reality it's highly unlikely, although not impossible, that you would actually be seeing a psychoanalytic therapist in one of these settings as this intensive therapy normally exists only in the private arena nowadays.

Of course free/contribution or private can be a major factor for frequency with any approach. In theory you could, if your therapist/counsellor agrees, see your private one as many times as you agree providing you can afford it and cost can be a major issue. See our hypothetical pschoanalytic therapist 3 times a week and it could cost you £300 a week!

Even in the private sector, and sometimes in the public, 'what' the issue is could be important. Work with severe phobias, OCD's or PTSD for example will often need more than one meeting a week particularly at the start of therapy. Again if it's private this is going to hurt financially and this kind of time intensive work is difficult to access on the NHS and as I've implied non-existent in many settings. To refer to one of the original questions, in some instances there is often a kind of 'scale' and many psychotherapists will use questionaires and assessment to decide on frequency for 'extreme' cases (sorry if words like 'extreme' or 'cases' may offend but that's the reality)

The 'status' of your 'helper' can come into play as well. The kind of intensive work described will 'usually' be done by psychotherapists (and would certainly be done by them in the NHS) and not counsellors (The 'difference' is addressed in another thread).

'Normal' then would be once a week in the public/voluntary sector. However many you agree on and can afford in the private sector possibly depending on the therapist's approach and more frequent in some cases in the public/private sector.

I would hope that if your therapist suggests a change in frequency they explain why and as for 'looking out for you' I would hope they are all doing that no matter how often you meet!

Of course as well as frequency there's the 'issue' of session length...why 50 minutes/1hour...who decided that time and why!?

[shrinknightmare]

I also suppose it depends on your Country. We don't have NHS hear. She did try to change it to fortnightly, but then I took a nose dive and she changed it back to weekly. I don't pay as work pays.

When I was first saw a counsellor at work it was emergency as usually it is a 5 week waiting list and I only had to wait a day!!!!!!!!

My case involved my daughter committing suicide, it was in all the papers, the radio, magazines etc. The media were at her funeral and they were also sitting of my house. I didn't get to tell anyone my daughter had died because they already knew, they saw it on TV.

[shrinknightmare]

ok she asked me last time how often I wanted to see her, I told her that I was being guided by her, and again she mentioned that if work cut the funding she would be happy to bulk bill (means medicare covers and I don't pay).

So now have to make a decision how often to see her, I don';t really know. I know that there has to come a time where I stand on my own 2 feet and sort out my own problems. I mean even when I have had leave from work I get (11 weeks per year), she has asked that I come and see her.

[IndieSoul]

My first three sessions were weekly, but now for whatever reason, she moved them to every other week. My parents said that it's fine because now I can go on pay week. But I'm kind of upset about it. It's nice to have an hour a week to talk to someone uninterrupted.

[Ms. Creepshow]

I was in grouptherapy 4 days a week for a year from June 2007 - June 2008, and had individual sessions besides that. It would depend on how I was doing. When I wasn't doing well, it'd be once a week, otherwise once every two weeks.
When I left the grouptherapy at first I kept going to individual sessions weekly (Psychomotor therapy) and once every two weeks (regular therapy session), then I stopped PMT, and kept going to my regular therapist about once every 3 weeks or once every month.

Until yesterday I didn't have any sessions for over 5 months (!), and in two weeks I'll have my last session :)

[ell]

Every week. I'd like it to be more often though, like twice a week.

[shrinknightmare]

My boss at work keeps saying about me going every week, so I am changing it to fortnightly. I even rang today and cancelled a couple of appointments. I mean there has to come a time when I have to say no more. It is going to be hard at first but then I will just have to get used to it.