Couples Therapy:How Many Sessions Will it Take?

When deciding to start therapy, two frequent questions couples ask are "how long will couples therapy last?" and "how often will we meet?"  There are two ways to answer these questions. The first is based on clinical research and the second is based on personal experience.  Both approaches provide largely similar answers. 

What the research says:

Couples therapy researchers are often working under a time limit due to funding or other reasons.  The typical study evaluates couples at the start of therapy, at one or more points during the therapy process, at the end of treatment, and sometimes one last evaluation is done six months after therapy is completed.  The research seems to largely concur with actual experience, with a couple of important differences.  

Depending on the type of therapy, couples typically attend between 10 - 14 sessions.  

  • Solution focused therapies, where the couple agrees on one and only one specific issue are the shortest, with a typical duration of 6-8 sessions.  These couples are most likely to return to therapy at some point over the next year. 
  • Emotionally Focused Therapy and some  behaviorally based treatments average 10-14 sessions.
  • Even couples with complex cases who were offered up to 26 free meetings rarely attended more than 22 sessions before considering therapy resolved. 
  • Couples report noticing benefits to their relationship and improvement in communications within the first 4-5 sessions.  For the next several weeks there is a bit of a plateau until a second round of deeper and more meaningful change often occurs at 10-16 weeks.
  • Couples reported the greatest improvements in functioning and longer lasting benefits of counseling with weekly sessions initially and gradual tapering  over the final 3-4 sessions (i.e. once every 2 weeks, then a 1 month follow up.)

What I notice in practice: 

This is the unscientific part and is based on the couples who visit my office.  I agree with the 10-14 week average.  

  • Couples who wait longer to start therapy may need more sessions to overcome negative impressions of their partner and often have more wounds to work through.  
  • It is important that couples figure out a time they can meet regularly with the therapist. Couples who attend weekly make the best progress.  Those who attend every other week or even less regularly tend to stagnate early in the process and take longer before seeing improvements. 
  • Co-occurring conditions like anxiety, depression, past traumas, or other concerns can also mean more visits.

  • Tapering at the end of therapy is very beneficial to helping improvements last.  The couple will learn new skills and ways of sharing during therapy, but road bumps occur while putting new habits into practice.  Closing therapy with less frequent follow up sessions can help with those tough moments. 

Every individual and every couple are different, and that makes couples therapy a bit more complicated than individual therapy, but there also seems to be a real benefit to the relationship when people learn they can work through their issues together.