5 Reasons Why I Recommend Weekly Therapy
I’d like to start off with three important notes. Firstly, I acknowledge that the ability to attend therapy, however often, is inaccessible for many people, particularly at the moment in the UK. This is a reflection of current governmental policies and priorities, which impact both public provision, as well as the economy at large, greatly reducing disposable income for everyone. It’s clear that we need both a more compassionate government (yep, I said that) as well as some real experimentation to learn what works and doesn’t in terms of low-cost therapy provision. Secondly, every therapist is trained in a primary modality (and many have secondary/tertiary modalities too!) that informs how we work and what we believe is most effective. I’ll be addressing the modality question in a future article, but for now, it’s sufficient to say that different modalities can have very different approaches and therefore different ideals when it comes to how they work. Thirdly, I’m primarily speaking about those starting out therapy in this article. By starting out, I mean within the first ~6 months. Every client is different and sometimes it makes perfect sense to reduce frequency to bi-weekly or even monthly if we’re nearing an obvious end. Equally, in situations of crisis or deep work, sometimes meeting more than weekly is effective.
With that out of the way, let me outline my 5 reasons why I really believe weekly therapy is best:
Building and Maintaining a Relationship
The truth about therapy (excluding, to a degree, interventional methods such as CBT which are frequently quite short-term and focus on exercises and standardised interventions) is that much, if not most, of the benefit of it comes from the relationship between the therapist and client.
For many people, for any number of reasons, therapy can be the first place they experience a safe, non-judgemental relationship. Parents didn’t always provide that, and lovers and friends hold a different place in our psyches. This kind of relationship takes time to develop, and initially can feel threatening or scary because it’s unfamiliar. The weekly container creates a consistent holding environment in which the therapeutic relationship can take root and grow. This sense of secure attachment with your therapist, and the trust and rapport that is created helps to rewire your nervous system, creating a sense of emotional safety, which enables growth and healing to really accelerate and the changes that happen to be deep and lasting.
Momentum
Most people come to therapy for a reason – often it’s depression, anxiety, transitions from one phase of life to another, or relationships. (I’ll also say– you don’t need a reason, either. Sometimes you just know that speaking with someone on a regular basis feels nurturing or helpful).
These reasons are things the client wants to understand better and/or change – definitively. And while it’s difficult to predict how long a given issue will take to shift (often because one thing uncovers another), it is reasonable to expect to see change over time. Weekly therapy ensures that the wheels continue to roll consistently, making maintaining momentum considerably easier. What we tend to see with wider gaps between sessions is two things – 1) clients are less likely to complete assignments and 2) there is often more “catching up on what happened” (which is really about rebuilding comfort and feeling safe enough to be vulnerable again) vs therapeutic work taking place, thereby slowing growth, or making change a very stop-start experience.
Consistency
We’ve come to understand that consistency is key when it comes to trying to increase muscle or improve cardio fitness – neither are things you can do once every two weeks and expect to see much benefit. We’re behind, though, when it comes to how we think about improving our mental health. But there are real similarities – therapy can feel like a mind stretch, an emotional workout, a relational obstacle course, a soul challenge. Consistency is key for us to get better at the basic skills and then to enable us to go deeper, and also to avoid backsliding into old patterns and habits. Particularly at the beginning of therapy, the whole experience is new - it’s a skill to learn, and as with any skills, repeated practice (in this case, having consistent sessions) leads to improvements in how we’re able to express ourselves, how we’re able to tune into what’s going on internally, and what’s really important for us. Consistency also means recency, which means we are much less likely to forget important insights and threads of work.
Deep Self Care
Putting aside all the negative connotations the phrase “Self Care” is weighed down with currently (thanks Goop & lightweight Insta influencers), coming to therapy is one of the strongest steps we can make to prioritise our healing and growth. And I want to ask - how much is that worth to you? How much are you willing to invest on yourself?
If you come to therapy once a month, that’s 50 minutes of therapy against 730 hours of life. There’s no way to process that + all the history you bring with you and come out with change.
Giving yourself a place to land every week is worth the investment. Between sessions, you will continue to process and unpack what we’ve worked on. Our psyches really seek safety, and knowing that there is a consistent place to come to work with your emotions allows you to manage much more easily during the week - there’s less chance of overwhelm or numbing.
Deep self care starts by believing that our feelings and spirit deserve regular attention, and going on prioritise the actions (like going to therapy) that make that belief tangible. This is self-love in action.
“Emotional Math” for your Therapist
Yes, there is math in this for your therapist, but it’s not simply financial math. The majority of us are in this line of work to help clients, and we don’t enjoy extending therapy beyond the point where it’s helpful. But what does really come into our calculations is what I call “Emotional Math”.
The average case load for a private practice therapists in my circle is around 15-20 client sessions a week. I suspect that sounds blissful to many of you - I know it did to me when I worked full time (and more) in startups. It’s a subject of rueful reflection amongst therapists too - we often comment on how strange it feels to be exhausted at the end of a day of sessions, when from the outside it looks as though we are sitting in our chairs listening most of the time. The reality is, though, we hold our clients both in session and outside - and that means the details, the history of our work, what’s most current, their inner worlds, their struggles, and their joys. Our job is to hold all of this with presence, curiosity, consistency and care, and a rough shape of where we’re going, and typically we enjoy this. But there does seem to be an upper limit for many of us, and that’s where Emotional Math comes in. Can I hold 15-20 people? Definitely. If everyone is bi-weekly, can I hold 30-40 people? Possibly, but I know I start to feel crowded internally - there’s a lot of content to hold and I can more easily lose the thread of our work. If it were 60-80 (ie everyone monthly) - not possible for me, that’s for certain. My style of therapy works at depth and that’s not possible with so many people. When it comes down to it, my preference is to work with fewer people, where I know we can work deeply and meaningfully, vs more in a sporadic way. It’s best for me, and I truly believe, best for my clients.
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I hope that was helpful bringing some light to a topic that sometimes feels controversial in the therapy space. I’m curious - what do you think about this? What has your experience been with weekly/biweekly/monthly therapy?
