Why Weekly?
When you consider all the factors, you start to see why so many therapists encourage weekly sessions…
A rationale for weekly sessions…
“See you next week!” I say to my clients before signing off. It’s almost automatic at this point, since the vast majority of my clients I see once a week. Everyone knows that traditional therapy happens weekly, but does anyone know why?
It wasn’t always the standard. Back in the day, psychoanalysts like Freud would often see clients 5 days a week! And of course most therapists have at least a few established long-term clients who no longer feel the need for weekly therapy and only come in every 2-4 weeks, as well as the occasional client with more intensive needs who they might see twice a week or more during particularly difficult times. But overall, most therapists still encourage most clients to commit to regular weekly therapy, at least to start. Why is this?
Practice and Feedback
For one thing, a week is a nice chunk of time in which to practice new skills you’ve learned in therapy, or to try out new relationship boundaries and report on your results. However, it’s not too long. If you run into trouble implementing what you went over last week, your next session is just a few days away! This can make it much easier for clients to get practice and to receive feedback quickly so they can refine their skills as they go rather than getting frustrated or discouraged if a new approach doesn’t work right away.
A Closer Relationship
Seeing someone weekly also enables you to maintain a close bond with your therapist. This may sound weird, but therapy is pretty weird if you think about it. You’re meeting a complete stranger and then are expected to (relatively quickly) trust them with your deepest darkest thoughts! Building that relationship takes commitment on both ends, and waiting two weeks or more between sessions can make it difficult to sustain that level of connection. This may leave clients less open and comfortable overall with their therapist, and less likely to make significant progress. On the other hand: some clients may need more time to learn to trust their therapists, and may want less frequent sessions right at the start!
Better Learning
If you’re like most of my clients, you have a lot on your mind. As much as you may try to remain focused during our session, I realize that human memory is imperfect, and I don’t expect you to remember every single thing we discussed in session. Meeting weekly gives us the chance to reinforce your learning (just like in school) rather than letting hard-won gains slip away (e.g. if you’ve forgotten most of what we talked about by our next meeting.)
Most clients can remember enough from one week to the next to make consistent progress without having to do much review of previous session content. This consistency creates momentum that helps clients stay motivated and engaged in therapy, which leads to even more progress. However, some clients struggle to maintain that momentum with bimonthly sessions. As such, we end up spending more time reviewing and less time making progress.
While it would seem logical to assume that bimonthly clients would progress roughly half as fast as weekly clients, that isn’t always the case. In my experience, weekly clients tend to make much quicker progress, especially in the earliest stages of therapy. I’m not sure why this is, but my guess is that it’s because these clients are taking full advantage of the therapy “honeymoon” period (a time of especially high excitement, commitment, and optimism on both sides of a newly-formed therapeutic relationship). For whatever reason, weekly clients tend to progress much faster, which is why I encourage all new clients to consider weekly sessions if affordable.
Making a Commitment
Clients who wish to start with sessions every 3 weeks or less may do so because they feel they are too busy to prioritize regular therapy. While it’s good to know your priorities, a wise man once said “Never half-ass two things; whole-ass one thing” (Ron Swanson, Parks and Recreation). I tend to agree. If you don’t feel ready to prioritize therapy right now (either financially or schedule-wise) at least once a fortnight, you may want to consider how ready you are to do the difficult work we have ahead, including therapy homework! For clients in this situation whose need for therapy isn’t urgent, I may encourage them to consider waiting to start therapy until they’re ready to commit to more frequent sessions, since a focused effort later may be more efficient and effective than a halfway commitment now. That said, clients are welcome to start with biweekly sessions if they wish, and can move to monthly sessions once they’ve made significant progress, or when they’re getting ready to transition out of care.
Feeling Safe
One of the most valuable benefits of weekly therapy is knowing you have a time every week reserved just for you, where someone who cares will be listening and truly focusing on you and your needs above all else. This feeling can be empowering on its own, and helps many clients feel safe taking risks, trying new things, and learning new ways of interacting with the world. This feeling of safety supports more rapid therapeutic progress, whereas less frequent sessions can leave new clients feeling lost and alone when things in their lives suddenly go sideways.
Personally, I believe clients benefit from even more frequent access to their therapist, which is why I offer text-based support in addition to weekly therapy for those who want a little more support. I want my clients to be able to reach out when they need me, not just when their therapy schedule dictates. While I won’t push anyone to use text-based support if they don’t wish to, I do feel it’s important to reserve a time each and every week for you, whether you end up needing it or not.
Caseload Considerations
To end on a practical note, I’ll bring it back to numbers. If a therapist sees all their clients weekly, they’re able to help quite a few clients benefit efficiently from their services. If the same therapist saw clients bimonthly, they would need to take on double the caseload to keep their practice running. This would mean keeping the dreams, hopes, fears, concerns, and personalities of twice as many clients in their head at one time, all the time. It would effectively double that therapist’s mental and emotional workload, leaving them with half as much mental and emotional energy to devote to each client’s care. If you think about the extreme impact this could have on quality of care, you may understand why most therapists do their best to stick to the traditional weekly schedule rather than filling their caseloads with monthly clients. It’s simply more sustainable for everyone involved in the long run.
Conclusions
So, if you came here looking for an answer to the titular question, you’re probably wondering: will I see you monthly despite these concerns? I can’t answer that in a blog post, sorry. If, after reading all of the considerations above, you still don’t want to commit to weekly or biweekly sessions, please reach out and explain your situation. While I don’t generally accept new clients on a protracted schedule like this, I’ve made exceptions in the past and will listen carefully to your reasoning before making a decision. I have never yet accepted a new client on a less-than-monthly basis.
If I decide I can’t take you on with the schedule you desire, I will do my best to find you a therapist who can!
P.S.:
If you’re ready to really commit to therapy but just can’t find time in your schedule for weekly or biweekly sessions, you may also want to consider signing up for text-based support in addition to regular sessions. With text-based support, you can message me anytime; after a difficult meeting at work, an argument with your significant other(s), or a hard day, and I typically respond to messages 1-2 times daily. You can use this add-on service more when you need it and less when you don’t, and you can start or stop it at any time. To learn more about text-based support, click on one of the many hyperlinks.