How Long is Too Long?
When Therapy is No Longer Effective
As positive and rewarding as therapy can be, like all methods of medical treatment, it should be monitored for efficacy, necessity, and the presence of unwanted “side-effects”. If therapy is allowed to go on too long, in some cases it may form a crutch which actually enables a person's illness (as they must stay “sick” to create a need for therapy) and supplants the supportive relationships the patient ought to be forming outside of a therapeutic setting. The existence of this cycle is likely why some people can stay in therapy for many years without appearing to benefit from it in a truly meaningful, lasting way.
Not only is this unproductive, it can be excessively costly, which may in turn create more stress for the patient. It is therefore essential that patients occasionally take an honest and objective look at what they are getting out of therapy in order to perform a personal cost-benefit analysis.
The first thing to assess is the nature of the problem that caused you to seek therapy in the first place; were you going through a period of atypical stress, one which changed your (previously functional) behaviour patterns and/or led to a negatively altered mood? (Note that therapy even for such “temporary” issues may sometimes require medication, and the need for medication should not be taken as indicative of a chronic condition in and of itself.)
If you answered “yes” to the above, your therapy likely ought not to evolve into a decade-long need; in such situations, therapy should instead be goal-oriented, with the goal being getting the patient back on track. This is usually accomplished through bolstering his or her existing resources and developing whatever additional skills he or she needs to face and surmount life's challenges.
If, on the other hand, you have a chronic condition which you have struggled with for many years regardless of external circumstances (these usually arise due to biochemical abnormalities), it's possible that you legitimately have an enduring need for supportive therapy in addition to medication. Therapy, in such cases, offers patients a viable way to understand and better regulate the various emotions, thinking patterns, and behaviours that often accompany their conditions, enabling them to lead the fullest and most functional lives possible. However, while therapy for such conditions may be more long-term in nature, it should be approached with the goal of getting the patient to a place where he or she does not need frequent, regular sessions—allowing him or her more time to focus on leading a “normal” life.
In between these two extremes lies the treatment course for so-called “personality disorders” (when a person has learned maladaptive coping strategies due to both their innate tendencies and environmental factors); while therapy for these is goal-oriented, as a “cure” is often possible, these learned behaviours are often so deeply ingrained that they take years to change.
How to Determine Whether You've Been in Therapy too Long
While it should, technically, be the therapist's job to recognize when a patient's need for therapy has concluded, or when dependence is in fact holding him or her back, often those therapists which find themselves “enabling” patients are, unfortunately, equally unaware of the situation or the harm it is causing. As such, this task all too frequently falls to the patient.
Clinical psychologist Dr. David Metzner suggests that if you have begun to suspect that your therapy has gone on for too long, or you wish to avoid being in therapy for any longer than you must be, ask yourself the questions outlined below; they will help you to ensure that your therapy does not drag on needlessly, and that it is serving a productive purpose:
1. Do I have a diagnosis? Do I fully understand what it means?
In order to fairly asses your treatment plan, you need to understand your diagnosis; this is, of course, not always a simple endeavour—some people have more than one diagnosis, and the conditions may interact in nuanced and unpredictable ways. That being said, you should feel as though you are (at the very least) slowly coming to understand what your diagnosis means, how it affects you, and why your therapist has selected the treatments he or she has.
2. Do I understand and agree with my treatment plan?
Ideally, you should have access to a plan set forth by your therapist which includes a formal assessment of your strengths and needs along with both short- and long-term goals for your health, and these goals should all be specific and measurable so that progress may be actively monitored. Often such a plan is required by insurers, but if it is not in your case, don't feel hesitant to ask for something similar and to freely voice any questions or concerns you might have about said plan.
3. Do I agree with my therapist that these sessions are generating real, lasting results?
Always keep in mind that therapy is not there to provide the sort of temporary relief you could get through venting to a friend; it exists to help you change dysfunctional mental, emotional, and behavioural patterns in a long-term way. You should notice, over the course of a reasonable number of sessions, that you feel more balanced, empowered, and in control. If you don't feel this way, your therapist should listen to your concerns and be fully on board to change the tactics and strategies that are being employed, re-evaluate the diagnosis, or do anything else that is necessary to ensure results are attained.
If your therapist is not providing you with the sort of clarity, results, and support illustrated above, it may be time to seek out a new therapist—one who understands your needs and how to effectively work with them.