How Long Will Treatment Take?


Many patients ask me how long they should expect their treatment to take. This is a common question and a conundrum in psychiatry. Not surprisingly, the answer is: "it depends." Namely, it depends on the nature of the patient's problems and goals. Some people have illnesses that are chronic, enduring and life-long, like diabetes. As with a doctor who treats diabetes, such patients can stay in treatment with me throughout my career. Sometimes we will meet more frequently, sometimes less, as their symptoms and stability require. The LEAST frequently I am comfortable meeting with stable patients, however, is once every three months (every change in season). This is a format I use for patients who need to stay on medications indefinitely, and are no longer needing talk therapy with me on a regular basis. Other patients come to do a focused piece of work that may take regular visits for a few months. When we have finished considering that problem, we may chose to progress on to other issues that may have arisen in the course of our work, or not. Still others go in and out of treatment with me as their life progresses.

Like a family physician who is called upon only when there are health problems, many people call upon me only when going through emotional turmoil, or at a time when a major life decision, event, or crossroad (e.g. a death, a marriage) comes up. Such patients may go years between each series of visits with me.

The breadth of goals for your treatment is largely up to you. Are you interested in just addressing a specific set of symptoms (e.g. anxiety, phobia about crossing bridges, depression), or do you have broader goals (e.g. tolerating stress better, finding more meaning and satisfaction in life, developing more capacity for intimate relationships)? Sometimes patients are unsure of their goals at the beginning of treatment, and I try to help them clarify those goals. Sometimes goals change in their breadth over the course of treatment and are modified.

Finally, when is it time to stop treatment? I have found over the years that the best approach is to allow a patient in treatment to bring up the issue of ending the treatment on his or her own. Just like it is important for patients to take the responsibility for starting treatment, unless they are very impaired, its also important for them to take responsibility for introducing the idea of ending the treatment when they feel ready. Then, it becomes, like all things in psychiatric treatment, a topic for discussion, examination, and conclusion.