These days, psychotherapy treatment options abound, with various forms of therapy offering different advantages and drawbacks. When deciding between short-term vs. long-term types of treatment, there are several key aspects one should consider when deciding on a treatment length, as well as the type of treatment itself.
Psychotherapy: Definition
The American Psychiatry Association (APA) defines psychotherapy as a way to assist individuals contending with various types of mental health difficulties. It is also known as talk therapy. By communicating with one another (mainly through talking, though some forms of therapy also incorporate physical activity), patient and therapist are able to gain a better understanding of the condition afflicting the patient. Over time, the patient is hopefully able to contemplate their own perspectives, defense mechanisms, scenarios, relationships, hopes and fears in their lives, both past and present, and consider how they wish to approach them moving forward. While most forms of therapy include the patient and therapist, others can include the patient and a loved one, group therapy, or animal-assisted therapy, to name a few.
Psychotherapy has been repeatedly proven to offer significant benefits to patients, with roughly 75% reporting an improvement in their well-being following therapy.
The APA goes on to state that psychotherapy can be long or short-term, spanning individual sessions or, in some cases, throughout one’s life. Psychotherapy can be offered as a standalone treatment, or in addition to other forms of treatment, such as medication or medical device treatments. As with other forms of treatment, it is strongly encouraged to consult with a licensed professional when deciding on a therapeutic treatment option.
The APA also stresses the importance of setting: psychotherapy treatments should begin by understanding the patient’s needs from the treatment and why they decided to seek it out. It should also set parameters for the frequency of the treatment’s sessions, its costs, cancellation fees and limits—with the APA particularly underscoring the importance of refraining from intimate contact between patient and therapist.
Long-term Psychotherapy Options
Historically, psychotherapy was offered as a long-term form of mental health support, and an intense one at that, with patients coming in for a session several times a week, for years.
The benefits of long-therapy include allowing the patient and therapist to take their time unpacking troubling, and at times traumatic issues, whose ramifications may have plagued the patient for a great deal of their lives. Though patients often feel an urgency to relieve themselves of adverse symptoms, some can take years to eradicate, just as some patterns of behavior can take years to replace. For these cases, there is long-term therapy.
Long-term psychotherapy options include the following:
- Psychoanalysis. One of the earliest forms of psychotherapy, psychoanalysis was invented by Dr. Sigmund Freud, who sought to uncover the mechanisms behind patients’ seemingly illogical responses. Psychoanalysis is one of the more intense forms of therapy and is typically composed of three-to-five sessions each week. Psychoanalysis can go on for years, or even indefinitely, as it attempts to make sense of the patient’s psyche and adapt their reactions and defense mechanisms to more beneficial ones, allowing them, as Freud put it, to “love and work.” The exhaustive nature of psychoanalysis can be experienced as too adverse for certain patients and may even cause an unraveling effect when they reach a traumatic event in their past. For this reason, patients with active psychosis are usually not referred to psychoanalysis. On the other hand, its in-depth approach has been found to be effective with more expansive mental health disorders, particularly personality disorders. Psychoanalysis can also help in cases of depression or anxiety, when the patient has the time and financial ability to deep-dive into their symptoms, in an effort to gain clarity as to what is causing them.
- Psychodynamics. Less intense than psychoanalysis but still offering long-term support, psychodynamic therapy usually involves weekly or bi-weekly sessions between patient and therapist. It typically goes on for at least a few months, as the therapist and patient learn to build a bond of trust, and an environment conducive to finding out new truths about oneself that have lain hidden and affecting the patient’s life from within. Like psychoanalysis, long-term psychodynamic therapy has been shown to be particularly beneficial with depression and personality disorders.
- Rehabilitative Psychotherapy. Focused not just on the mind, but on the connection between mind and body, rehabilitative psychology offers mental health support to individuals who have experienced a severe disruption to their well-being, and sometimes trauma, due to an accident, injury or illness. It often deals with the ways in which the patient’s ideas of self-worth, role in society, body image and other aspects of their life have changed due to the even or ongoing situation they are facing. Rehabilitative therapy runs the gamut between offering short-term support immediately after an accident, to continuing with the patient throughout their lives, particularly in cases of chronic illness.
Short-Term Psychotherapy Options
Short-term types of treatment are typically more goal-oriented than long-term therapy and tend to focus on specific challenges that are causing patients the greatest amount of adversity at present. One of its main advantages over long-term psychotherapy is that short-term therapy helps the patient face any avoidance tendencies they might have: whereas a long-term setting could allow them to put off dealing with a distressing aspect of their life, the more limited time frame of short-term therapy can push patients toward acknowledging and dealing with their most pressing issues.
Short-term therapy normally lasts up to 10-20 sessions, or three-to-five months. Short-term treatments initially gained recognition in the 1950s, following the rise of behavioral and family therapies, which offered a more direct approach to mental health disorders than psychodynamics. Its popularity grew further during the 1980s, when reports on the benefits of short-term treatments began being published.
Short-term treatment types include the following:
- Cognitive Behavioral Treatment (CBT). Relies on acknowledging distress and gradually exposing the patient to triggering stimuli, in an effort to build up their tolerance to them. CBT has been found to be particularly effective with obsessive-compulsive disorder (OCD).
- Short-Term Psychodynamics. As opposed to classic psychodynamics, which seeks to offer a fuller, contemplative approach to the patient’s life, short-term psychodynamics delves into more specific aspects of their experiences, such as their defense mechanisms and relationships. By turning their attention to certain areas of their life, short-term psychodynamics wishes to help the patient recognize which of their patterns of behavior are no longer adaptive, and where they might benefit from trying out new ways to react to their internal world and external environment. Emotional phobias, where the patient is overwhelmed with anxiety due to a particular emotional context, respond well to short-term psychodynamic.
- Gestalt Therapy. A more humanistic approach, gestalt psychotherapy views each individual’s perspective on their experiences as unique. Gestalt is a very validating form of therapy and aims to create consistency between the patient’s responses and their emotions, so they can feel the different aspects of their lives are integrated with one another. Gestalt has been shown to offer symptom relief in cases of anxiety and relationship-centered difficulties.
Different kinds of talking therapies can help all kinds of people through their unique situations. Whether you’re going through a bad time or need help and support with a specific problem or issue, according to the NHS, talking therapies can be just as or more effective than medication .
Speaking with a professional, qualified therapist can in many ways feel easier than talking to loved ones. You may feel you are more able to open out without fear of being judged, to speak freely, as well as to cry, get angry, or look at problems from new angles with the help of a counsellor.
While talking therapies don’t necessarily make a problem or issue go away, they can help you find a way to cope better with your situation or to feel happier. Counselling can help you cope with a wide variety of mental health problems, big life events, and upsetting situations. It can be helpful at any age for children through to elderly people.
What’s the difference between long and short-term counselling?
Other than their length, how do long and short-term therapies differ? Short-term counselling – also known as brief therapy or time-limited therapy – typically refers to solution-based therapy with a distinct goal in mind (for example, looking at patterns of negative thinking). Often having a tighter focus than long-term therapy, short-term sessions typically span six to twelve sessions.
Short-term sessions may involve tasks or assignments you need to complete each week outside of your sessions, while long-term therapy usually doesn’t. Time-limited therapy may have a more structured approach (both within the sessions themselves and overall), whereas long-term sessions can be more led by where you decide to take each session, exploring your past, thoughts, memories or experiences.
Where short-term therapies often focus on how you can improve your life now, focusing on issues you are experiencing in your day-to-day life, long-term therapies tend to look more at the past, helping you understand both yourself and how your past may affect things you do today.
What different types of therapy are available, and what can they help with?
Different types of short and long-term therapies can be effective for different issues. Some of the types offered can include:
Cognitive behavioural therapy (CBT) – a popular short-term therapy, CBT can help you recognise how your thoughts can affect your feelings and behaviour. Examining your thoughts and behaviours, CBT tries to break overwhelming problems down into smaller, more manageable parts that you can work towards changing in the present.
Dynamic interpersonal therapy (DIT) – a short-term therapy that looks at the way you relate to others, and how this affects the way you see yourself. Helping you to create new ways to relate with others and new patterns that can lead to seeing yourself in a more positive light, DIT offers the space to talk openly about what is affecting you now whilst uncovering past hurts that may also be affecting you.
Cognitive analytic therapy (CAT) – looking at past events and experiences and how they are affecting your present, CAT aims to help you understand why you feel, think and behave how you do. A type of short-term therapy, it also helps you to problem solve and develop new ways of coping, as well as helping you recognise how the way you’re behaving with and around others can affect your life as a whole.
Solution-focused therapy – also known as solution-focused brief therapy or just brief therapy, is based around solution-building rather than problem-solving. Looking at your future hopes and current resources, it helps you to use your own strengths, look forward, and achieve your goals.
Psychodynamic therapy – a form of long-term therapy, psychodynamic therapy also known as psychodynamic counselling aims to bring the unconscious mind to the surface. Helping you to understand your deep-rooted feelings in order to resolve them, it looks to uncover painful feelings or memories. Generally thought to be more effective treating specific issues such as depression, anxiety or addiction, it can be particularly beneficial if you feel like your life may have lost meaning, or you have trouble maintaining or forming personal relationships.
Psychoanalytic therapy – typically looking at your early childhood experiences to see if they have had a particular impact on your life or current worries, long-term psychoanalytic therapy can last from months to years. Aiming to help you start changing through the understanding of your past and how early life events may be affecting you, sessions vary depending on why you are seeking therapy, but often involve time you can speak freely with your therapist in a non-judgemental, safe space.
While short-term therapies often tend to be solution-focused, some people feel they often do not look at the underlying reasons why you may be experiencing emotional difficulties or issues. If you are looking for more of a quick solution for a specific problem, short-term therapies can be beneficial, whereas if you would rather have space and time to explore multiple problems or an issue and its potential roots in-depth, long-term therapy may be the right choice for you.
What type of therapy is right for me?
It’s hard to know what type of therapy will work best for you; it can really vary between individuals – there’s no single ‘best’ type of counselling for a specific issue of life event. Just because a type of therapy may be popular or have worked for someone else you know, doesn’t mean it will have the same benefits for you. Exploring your reasons for talking to someone, reading more about the different types of therapy on offer, and trying sessions with different therapists until you find someone you click with can all help you to find what works for you.
Some counsellors may offer alternative kinds of sessions from traditional face-to-face counselling, including online counselling. These can range from video or phone calls, to emails or instant messaging. Whatever your unique needs are, qualified, professional therapists can offer help and support to suit you.
If you’re finding it difficult to find a method or therapist you connect with, try to remember: therapy is an ongoing process that requires commitment and being present. It can take more than one session before you start feeling or seeing the benefit.
No matter which kind of therapy you decide to try, recognising you may need help and support is the first step towards making positive changes.
