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 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.

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 forever.  Meeting weekly gives us the chance to reinforce your learning (just like in school) rather than letting hard-won gains slip away because 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, clients typically struggle to maintain that momentum with bimonthly sessions.  As such, we end up spending far too much time reviewing and comparatively little time moving forward.

While it would seem logical to assume that bimonthly clients would progress about half as fast as weekly clients, in my experience clients who attend bimonthly tend to make disproportionately less progress. This reduced momentum can have an especially negative impact on new clients, which is why I strongly encourage weekly sessions for all new clients.

Making a Commitment

Clients who come to therapy seeking sessions once every two weeks (or less often) often feel they are too busy to prioritize weekly 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 temporally), you may want to carefully consider how ready you are to do the difficult work we have ahead.  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 make that commitment, since a focused effort later may be more efficient and effective than a halfway commitment now.

Sticking with it

In my own experience, clients who start bimonthly have been more likely to drop out of therapy prematurely than those who attend weekly.  While I can’t speak with certainty as to the cause of this trend, I imagine it’s much harder to feel committed to something you only do a couple of times a month. It’s hard to form a habit of anything you do so rarely, especially such a challenging task.  Combined with the issues mentioned above, you can see how it might be harder to maintain motivation with less frequent sessions.

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 clients on atypical schedules.  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 bimonthly instead of weekly 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 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. 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 disagrees with me on this matter.

If you’re ready to really commit to therapy but just can’t find time in your schedule for weekly sessions, you might want to consider signing up for text-based support in addition to whatever session frequency we decide on together. 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. You can use this service more when you need it and less when you don’t, but part of the benefit for many clients is simply knowing I’m here when they need me. To learn more about text-based support, click on one of the many hyperlinks.