How Often Should You Go to Therapy?

How Often Should You Go to Therapy?
This is one of the first questions people ask, and it's a reasonable one. Therapy costs money and time, and most of us have limited quantities of both. So: how often should you go?

The honest answer is that it depends — but not in the vague, unhelpful way that phrase usually gets used. It depends on what you're trying to do. If you're coming to therapy to manage a specific problem — a rough patch at work, a decision you can't make, a relationship that's driving you crazy — once a week may be plenty. You come in, we think together, you leave with something useful. That's real and it matters.

But some people discover, after a while, that the most interesting things happen not in any single session but in the space between them. You start noticing things during the week — a reaction that surprised you, a dream that stuck around, a moment where your body did something your mind hadn't caught up to yet. You bring it in. We look at it together. And over time, a kind of continuity builds. The work starts to have its own momentum.

That's when coming more often can matter. Not because there's a rule about it, but because the thread holds better when you pick it up more frequently. It's like any practice — music, exercise, writing. Once a week keeps you in the game. Twice or three times a week and something shifts. You're not starting over each time. You're deepening.

I bring this up not to sell anyone on more sessions, but because the question of frequency is really a question about what therapy can be. And most people don't know the full range of what's available to them.

Here's what I mean. In a single session, we can do good work with what you bring in verbally — the thing that's been on your mind, the story you need to tell, the problem you want to think through. But therapy has more channels than conversation. There's what your body is doing while you talk — the tension in your shoulders, the way your breathing changes when certain topics come up, the restlessness or the stillness. There's what happens in silence, which is its own kind of communication and often a more honest one than speech. There's what shows up in dreams, which most people dismiss but which often carry exactly the thing that waking life is trying not to look at.

None of these require special effort. They're already happening. The question is whether there's enough room and enough continuity for them to become part of the work.

A client might mention, offhandedly, a dream about a locked room. We might sit with that for a minute. It might not mean anything yet. But the next session, they're talking about their mother, and something clicks — not because I drew a line between the two, but because they felt it. The dream was already knowing something. It just needed a little time and a little quiet to land.

Or someone is telling me about an argument with their partner, and mid-sentence they stop. Something shifted in their chest. They don't know what it is. In a faster-paced therapy, that moment might get talked over — filed away, moved past in favor of the next thought. In the kind of work I do, that's often where the session actually begins.

These are the moments where contact happens — not the polite, social kind, but the real thing. Contact with yourself, with what you're actually feeling rather than what you think you should be feeling. Contact with me, in the sense that something true passes between us and we both know it. That kind of contact is what makes therapy work. Everything else is just talking.

So when someone asks me how often they should come, what I'm really hearing is: how much room do you want to make for this? There's no wrong answer. Some people come once a week for years and the work is rich and real. Some people come more often for a stretch and then settle into a rhythm. Some start slow and increase when they're ready.

The only thing I'd say is: don't let logistics be the only thing that decides. Think about what you want from this. Think about what it might be like to have a place where you don't have to rush — where the quiet parts count as much as the talking, where a dream is worth mentioning, where your body gets a vote. That's what's on offer. How often you come is just a question of how much of it you want.

​About the Author: Andrew Bertell is a licensed clinical social worker with over 15 years of experience in psychoanalytic psychotherapy. He practices in Ashland, Oregon and works with adults and young adults via telehealth throughout Oregon, Maryland, New York, and Idaho.