How Long Does Therapy for Relationship Patterns Take?

It is a fair question, especially when you pay per session and the pattern you want to change has been around for years.

The honest answer has two parts. There is research on how long therapy takes in general, and it gives real numbers. None of it was measured in people seeking help for relationship patterns as such. This article gives the numbers, says where they come from, and marks where the evidence stops. None of them is a promise.

Why is there no standard length?

Because the answer depends on the person. The American Psychological Association says: "How long psychotherapy takes depends on several factors: the type of problem or disorder, the patient's characteristics and history, the patient's goals, what's going on in the patient's life outside psychotherapy, and how fast the patient is able to make progress."

A page from the APA's Society of Clinical Psychology adds that "Acute difficulties usually require fewer treatment sessions than do chronic conditions," and that "Treatment length is often tentative and revisited throughout the course of treatment." A relationship pattern may be something a person has lived with for a long time, which is worth keeping in mind when you read the averages below.

What does research on therapy length show?

Researchers call this the dose-response question: how much therapy, for how much change. The main findings come from people in therapy for a range of problems, mostly depression and anxiety, and "improved" means a change on a questionnaire or rating scale. It does not mean the problem is gone.

• A 1986 analysis pooled data on more than 2,400 patients over 30 years of research. By 8 sessions approximately 50% were measurably improved, and approximately 75% were improved by 26 sessions. Results differed by diagnostic group and by outcome measure.
• A 2002 review noted that few studies have been published on the question, and reported "general consensus that between 13 and 18 sessions of therapy are required for 50% of patients to improve." In a national database of over 6,000 patients in routine care, the average number of sessions was under 5, and only about 20% improved.
• The APA's Society of Clinical Psychology says that, according to recent research, on average 15 to 20 sessions are required for 50 percent of patients to recover as measured by self-reported symptoms.
• A 2006 study of 1,868 clients in routine primary care found that the share achieving reliable and clinically significant improvement did not rise with the number of sessions. The authors suggest people tend to stop once they have improved enough for them.

Put together: in pooled data, the share of people who improve rises as sessions add up, but in routine care people often stop when they feel improved enough, and the right length differs from one person to the next.

When might therapy take longer?

The American Psychological Association says some people take longer, perhaps a year or two, to benefit. "They may have experienced serious traumas, have multiple problems, or just be unclear about what's making them unhappy." The Society of Clinical Psychology page says people with co-occurring conditions or certain personality difficulties "may require longer treatment (e.g., 12-18 months)."

The same APA page says "Most people find some benefit after a few sessions, especially if they're working on a single, well-defined problem and didn't wait too long before seeking help." A specific question, such as how to handle one recurring conflict, may be a different task from understanding why closeness has felt unsafe for most of your life.

Is longer therapy better?

The research disagrees, and it is fair to say so. A 2008 meta-analysis reported that long-term psychodynamic therapy, lasting at least a year or 50 sessions, did better than shorter therapy for complex mental disorders. A 2010 re-analysis found "a miscalculation of the effect sizes" and "no evidence to support claims of superiority" of long-term over shorter-term therapy. A 2012 review of randomized trials called the evidence "limited and at best conflicting."

One UK trial of 129 people with long-standing depression that had not responded to at least two treatments added 18 months of long-term psychoanalytic therapy to usual care. Complete remission was infrequent in both groups at the end of treatment, but differences in partial remission emerged during follow-up. The authors wrote that short follow-ups "may miss the emergence of delayed therapeutic benefit."

A fair summary: some people, especially those with long-standing or overlapping difficulties, may need longer therapy, and some benefits may keep growing after therapy ends. But reviews disagree about whether longer therapy does better, and none of these studies measured relationship patterns.

How is progress judged along the way?

By talking about it as you go. The American Psychological Association suggests asking yourself "whether the psychologist seems to understand you, whether the treatment plan makes sense, and whether you feel like you're making progress." The National Institute of Mental Health suggests asking a therapist: "How will progress be assessed? What happens if you (or the therapist) feel you aren't starting to improve?"

What counts as progress is worth defining with your therapist, rather than measuring yourself against an average. 8 signs therapy is working describes some signs to look for.

How long does therapy with Dr. Rabin last?

This guide cannot give a length for her work. Her practice has no fixed timeline. Sessions are usually weekly and last 45 to 50 minutes. As the American Psychological Association puts it, "Psychotherapy isn't a lifetime commitment," and "You and your psychologist will decide together when you are ready to end psychotherapy."

Her individual therapy for relationship patterns is psychodynamic and attachment-based. Because length affects cost, read the fees and insurance page first. Her fee is $375 per session, with a sliding scale on request. You can ask how she thinks about length on a free consultation of about 15 minutes, requested through the contact page.

Keep reading

• What to Expect in Therapy for Relationship Patterns
• How to Choose a Therapist for Relationship Issues
• All relationship guides

Sources

• American Psychological Association, Understanding psychotherapy and how it works (last updated December 12, 2023)
• American Psychological Association (Society of Clinical Psychology, Div. 12), How Long Will It Take for Treatment to Work? (2017)
• Howard et al., The dose-effect relationship in psychotherapy. American Psychologist (1986)
• Hansen et al., The psychotherapy dose-response effect and its implications for treatment delivery services. Clinical Psychology: Science and Practice (2002)
• Barkham et al., Dose-effect relations and responsive regulation of treatment duration: the good enough level. Journal of Consulting and Clinical Psychology (2006)
• Leichsenring and Rabung, Effectiveness of long-term psychodynamic psychotherapy: a meta-analysis. JAMA (2008)
• Bhar et al., Is longer-term psychodynamic psychotherapy more effective than shorter-term therapies? Review and critique of the evidence. Psychotherapy and Psychosomatics (2010)
• Smit et al., The effectiveness of long-term psychoanalytic psychotherapy: a meta-analysis of randomized controlled trials. Clinical Psychology Review (2012)
• Fonagy et al., Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: the Tavistock Adult Depression Study (TADS). World Psychiatry (2015)
• National Institute of Mental Health, Psychotherapies (last reviewed February 2024)
• Mikulincer and Shaver, An attachment perspective on psychopathology. World Psychiatry (2012)
• Levy et al., Adult attachment as a predictor and moderator of psychotherapy outcome: A meta-analysis. Journal of Clinical Psychology (2018)

Last reviewed October 2026. This guide is general information, not medical advice or a diagnosis. If you are in danger, call 911. If you are in crisis or thinking about harming yourself, call or text 988.