New clients in therapy often ask me, “How long will this take? When will I feel better?” The short answer is “it depends – on your treatment goals, on your level of engagement with therapy.” Particularly in the beginning of therapy, I emphasize that it’s very important to attend sessions consistently, usually on a weekly basis, and to actively participate in the between-session activities that we discuss in our sessions. I make this recommendation based on findings from research performed across more than 10,000 therapy cases, which find that “it takes more than 20 sessions, or about six months of weekly therapy, before 50 percent of patients show clinically meaningful improvement.”
Here’s a quick exercise you can do right now while reading – whatever you do, do NOT think about a green polka dotted elephant. DON’T. DO. IT. See what happened? This is why you can’t tell someone to not be anxious or not be depressed. It just doesn’t work and sometimes, it can make it worse. The more you try to NOT think about the green polka dotted elephant, the image almost gets more vivid. Similarly, the more we try to suppress our anxiety, depression, or any uncomfortable emotions, the more likely these internal experiences will become magnified. This is why I approach therapy using a cognitive behavioral therapy (CBT) framework. CBT does not teach you how to get rid of negative thoughts. CBT teaches you how to address these negative thoughts head-on.
Clinicians, like myself, who practice CBT, emphasize that thoughts have the power to guide our feelings and behaviors, sometimes outside of our awareness. Individuals with anxiety or mood disorders tend to have thoughts that are global, negative, and recurring. Global, meaning these thoughts/beliefs are broad generalizations about the individual, those around them, and their future. Negative, meaning these ideas are not optimistic or positive. Recurring, meaning these beliefs often come up time and time again, across various situations and life phases. Most importantly, these thoughts are inaccurate and unhelpful, meaning they are not supported by facts and can drastically worsen a person’s quality of life.
Together, we will explore the anxious, depressed, and/or negative thoughts that have been swirling around in your mind, challenge them, and REPLACE them with accurate and helpful thoughts. For example, instead of thinking about a green polka dotted elephant, think of a purple giraffe. For many clients, negative thoughts have become the soundtrack in their lives, constantly playing on repeat, quietly when stress levels are low, yet deafeningly loud when stressors emerge, blocking out supportive and helpful messages. Together, we will find a new soundtrack, new melodies that sing about your resilience, strength, and courage.
- Lambert, M.J., Hansen, N.B., Finch, A.E. (2001). Patient-Focused Research: Using Patient Outcome Data to Enhance Treatment Effects. Journal of Consulting and Clinical Psychology, 69, 1590-172.
- Morrison, K.H., Bradley, R., Westen, D. (2003). The external validity of controlled clinical trials of psychotherapy for depression and anxiety: A naturalistic study. Psychology and Psychotherapy: Theory, Research and Practice, 76, 109-132.
- Mental Health: Does Therapy Help (1995, November). Consumer Reports, 734-739.
- Seligman, M.E.P. (1995). The Effectiveness of Psychotherapy: The Consumer Reports Study. American Psychologist, 50, 12, 965–974.