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Writer's pictureAdam Lukeman, LCSW

Psychotherapy: Why Once Weekly?

Why does therapy happen once weekly?
Why does therapy happen once weekly?

Weekly psychotherapy sessions are a standard practice, but why? Some evidence suggests that this frequency can be beneficial for many patients. Here are some key points about the benefit of weekly therapy sessions, including summaries of supporting research.


1. Consistency and Routine

Weekly sessions help establish a routine, which can be therapeutic in itself. Regular, consistent therapy helps build a strong therapeutic alliance between the therapist and the patient, which is crucial for effective treatment.


2. Time for Reflection and Integration

Having a week between sessions gives patients time to reflect on what was discussed, apply new insights or coping strategies, and integrate these into their daily lives. This process of reflection and integration is essential for long-term change.


3. Progress Monitoring

Weekly sessions allow therapists to closely monitor a patient's progress and make timely adjustments to the treatment plan. This frequent interaction can help catch any issues or setbacks early, allowing for more effective interventions.


4. Research and Clinical Guidelines

Numerous studies have shown that weekly therapy is effective for a wide range of mental health issues. For instance, cognitive-behavioral therapy (CBT) and psychodynamic therapy, two well-researched modalities, often use a weekly session model. Clinical guidelines and recommendations from professional organizations, such as the American Psychological Association (APA), often support weekly therapy for many conditions.


5. Patient Commitment and Engagement

Weekly sessions can help maintain patient engagement and commitment to the therapeutic process. Less frequent sessions might result in a loss of momentum, whereas more frequent sessions might be overwhelming or impractical for many patients.



6. Practical Considerations

Weekly sessions strike a balance between providing enough support and being manageable for patients in terms of time and cost. This frequency is often more sustainable for both patients and therapists compared to daily sessions, which might be too intense and impractical.

 




 

Supporting Research

 

Hansen, N. B., Lambert, M. J., & Forman, E. M. (2002). The psychotherapy dose-response effect and its implications for treatment delivery services.

Summary: This study examines the dose-response relationship in psychotherapy, finding that significant improvement in clients' conditions typically begins to manifest after a certain number of weekly sessions. This supports the notion that weekly therapy sessions can effectively meet the necessary "dose" for many clients.

Reference: Hansen, N. B., Lambert, M. J., & Forman, E. M. (2002). The psychotherapy dose-response effect and its implications for treatment delivery services. Clinical Psychology: Science and Practice, 9(3), 329-343.

 


 

 

Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose-effect relationship in psychotherapy.

Summary: This seminal paper discusses the dose-effect relationship, showing that a substantial portion of patients begin to experience significant benefits after about eight sessions, which typically corresponds to weekly sessions over two months.

Reference: Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41(2), 159-164.



 

 

 

Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy.

Summary: This meta-analysis highlights the importance of the therapeutic alliance, which is often strengthened through regular weekly sessions. A strong alliance is linked to better treatment outcomes.

Reference: Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9-16.



 

 

Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis.

Summary: This meta-analysis reviewed numerous studies on various forms of psychotherapy for major depression and found that regular, often weekly, sessions were effective in achieving remission, recovery, and improvement in symptoms. The study emphasizes the importance of consistency in therapy sessions.

Reference: Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2014). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. Journal of Affective Disorders, 159, 118-126.

 


 

 

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy.

Summary: Shedler's review highlights the effectiveness of psychodynamic psychotherapy, which typically involves weekly sessions. The paper discusses how the benefits of this therapy continue to grow even after the treatment has ended.

Reference: Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98-109.

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