Increasing from once to twice (or more) per week?

Does anyone else have experience with going from weekly therapy to twice-weekly or more? If so, what was that like for you? Was it a good experience, and how did it change things?

The backstory is that I've been seeing my current therapist for about a year, weekly except for a couple of crisis situations and scheduling blips where I went twice in one week (and of course some weeks off here and there with vacations and illness and stuff). Things are generally going well and feeling productive, and my therapist recently suggesting bumping things up to two or three times a week so that we can cover more ground and go into more depth. I'm game to give twice-weekly a try and see how it goes, but also a bit hesitant about the possibility of it being too intense or feeling repetitive or otherwise changing things in a way that makes them worse! I'm definitely going to talk to my therapist about those concerns, but also wanted to see if anyone else has made this decision before

I went to therapy twice (and eventually increased to three times) per week for about a year. It definitely increased the intensity of the therapy quite a bit. It didn’t work out well for me, as I developed a severe attachment/had transference issues with that therapist because of it. I started to feel like I needed her all of the time to even function and it was unbearable the days I didn’t have therapy. I ended up in the hospital for the first time due to our therapy going south and then was in and out of the hospital for months.

I really don’t want to scare you though...that’s just my personal experience with it, yours could be different. My therapist was also very unskilled and unable to deal with the transference and countertransfefence that was occurring. If your therapist is more skilled and can actually use more frequent therapy as a tool to better help you, I still say it’s worth a shot to see. If you start feeling too dependent on therapy or like things are too intense, you could always dial it back down.

Definitely a good idea to talk with him about it though! Good luck! 😊

I went to twice a week after about two three months by my choosing because I didn't want to be in therapy forever. I was trying to get over a car accident at the time and I have multiple complex traumas from childhood through early adulthood to get through. I've been going twice a week for almost a year now and the progress is so slow even with that. It also doesn't help that I have DID from dissociate constantly. Twice-weekly I think helps me make maximum progress I don't think I would like to go 3 times a week I think that would be too stressful and I would feel like I was always in therapy. Luckily I do not have any inclination to become dependent on him or any kind of attachment to him if you do have those tendencies it might be an issue.

I have also started a DBT class about 2 months ago so I guess in a way I am in therapy 3 times a week just not with the same therapist. I only joined the class though because my therapist kept pushing me to do it because I have no emotion regulation.

If you have a lot to work through I might be helpful to go twice a week if you start getting too attached or dependent you can always push it back. I know if I only went once a week I would probably be in therapy 10 years or more and there's no way I'm going to let that happen.

I went from 50min once a week to two sessions a week that can last up to 1 1/2 hours each
And it still feels like its never enough. Thats what happens when it gets intense and you have severe issues

I saw my T weekly for about a year before starting to see him twice weekly (about a year ago too). It has helped me tremendously. I used to "obsess" about therapy all the time, having imaginary conversations with my T in my head, feeling left alone etc.

Since I 've seen him twice weekly, it's gotten much better. My SH urges have gotten less too. I feel like I trust T more. If something comes up during the week, I feel less overwhelmed because I know that I'll be able to talk with him soon (and don't have to wait for up to 6 days and 23h...)

I'm at 2x a week now, plus is I'm less depressed between sessions, minus is I'm far more attached

After the 1st yr when the Stabilising work was done and I was ready to get into the unconscious stuff. 2x began. That was 13yrs ago. Still go 2xwkly now. In the beginning. It was beneficial because it caught me as I begun to fall between sessions. It helped with the internalisation, and the object relations.
Of course. It all depends on what one goes to therapy for, and what one wants or needs from it.

I found twice weekly appointments useful for going more in-depth. I would say I'm making more than twice the amount of progress by going twice as often as I was before. I feel much more comfortable with my therapist this way (even though we already had a good relationship to begin with) and find it easier to open up to her. I am less likely to be struggling with daily life things at any given session, which means I generally feel stable enough to go into things from the past or things happening inside of me. Plus I don't have the stress of having to wait a whole week if something specific is bothering me.

It is definitely more intense, but I think that's a necessary part of going deeper however you manage to do it. I do feel more attached to my T, but neither she nor I think that's a bad thing in and of itself. She is of a school of thought that it's okay for me to lean on her a bit until I grow to where I won't need her anymore. Lately I tend to agree that that's likely to happen because I can tell that I'm getting stronger and healthier.

I think this is a really individual choice. Going twice a week can be really helpful. I went 2-3/week with my longtime T for a while, and it helped me stay out of the hospital. I do think it can increase dependence, if you're worried about that. However, that doesn't always end badly. With longtime T, I was actually the one who initiated less frequent meetings (from once/week to every other week, don't remember how I decreased from multiple times per week, it was like a decade ago). So it's possible to become dependent and then move towards independence again without the pain that so many people experience. I wouldn't advise 3x/week unless you are DID - that's the only condition I can think of where someone might need that frequency and who wouldn't be better served by a higher level of care. Unless you're seeing a psychoanalyst, I guess, since my understanding is that they usually see clients at a high frequency.

I would consider several things before making a decision. First, what are your expectations in terms of how much faster you will get through therapy if you increase the frequency? What is your financial/insurance situation.?If you have a set number of visits, you need to make sure that they are distributed in such a way as to allow you weekly and biweekly visits as you approach the end of therapy. Going from 2x/week to nothing or 2x/week to a short period of weekly or biweekly before termination is not advisable. I would also want to know more about what your T's reasons are for increasing frequency, and what specifically she's trying to address by proposing this. It sounds like you feel things are going well, so I would want to understand what my T is trying to remedy by upping visits. My own reasons for seeing a T more than weekly have been related to my own instability or severity of symptoms, not to increase productivity, so I don't know how well that works. I have heard it said that you can't hurry therapy along because true and lasting change takes time. Just something to consider.

Just wondering how people afford going multiple times/week. Is it covered by insurance?

I've been seeing my T 2x a week for a while. It has contributed to some attachment issues that I question but she seems cool with. On the flip side, it has given me the support I need to get through so really difficult things and helped me build trust in her. I think, for me anyway, 2x a week has been a good thing.

Once I went from once a week (with fairly regular extra sessions) to twice a week, I felt more able to keep a connected feeling with him. I need that feeling of connection in order to talk about hard stuff, but I'm sure other people feel differently about that. We were also able to get more done than just relating the facts of the week (I was in an abusive relationship, so a lot of time was just telling what happened that week). I started going 3x/week about 4 months ago after a traumatic event. I don't have much of a support system at this point and I need his support right now to keep myself alive. At some point I will go back to 2x/week, but not right now.

My insurance pays, but it really depends. I think they'll usually pay, but if they have a max number of sessions they're authorizing, you might run out of sessions this way. In my situation (in the US with private insurance), it seems like my T just has to justify based on medical necessity. When I worked for an agency serving Medicaid clients, it was similar.

I got insurance to pay for 3x/week for a few months but then they said that I need a higher level of care if I'm going that often. Now they will only pay for once a week. Any additional sessions are at the full negotiated insurance coverage rate. My T's out-of-pocket rate is $120, which is what I paid before I started using my insurance. I'm paying $92.50 now for sessions above the one a week allowed.

I suppose I'm technically seeing a T twice a week--once for my regular T and once my marriage counselor. The marriage counseling is under my H's name, and he bills it as "family therapy," which is covered by insurance, while "marriage counseling" is not. We get 60% back, since both are out of network (as are most therapists in my area). And I've seen current T twice a week on occasion for an emergency session, but have been reimbursed OK so far. (I think...there's maybe a month lag in the reimbursements, so we'll see...) We don't have an annual limit on therapy though, thankfully. Helps that H works for a health insurance company, but our insurance is still quite pricey--we picked the highest tier for the most benefits. It's still a significant portion of our budget, which is something I feel guilty about at times...especially because we're largely continuing to see MC because of my attachment issues with him, but a recent rupture may have knocked those out, not sure...

Hi friend,

I have had many many Ts over the years and the first time I had to start twice a week, I remember feeling like a failure. But oh my goodness, it was so helpful and we were able to cover so much ground because he was an excellent T.
The next time was with a T who was kind of slower in her therapy style, and it just always took a long time to get to what we were going to talk about. Eventually I saw her three times a week (because I wasn't doing well at all), and that made me feel like a failure as well, but helped me realize that it's ok to accept where you're at, and sometimes you just need a little extra support.
The next T I saw twice a week was a T who would just sit and listen to me talk and not give me a lot of feedback. Because of her therapy style, our sessions became rather repetitive, and not all that helpful. I should have done once a week with her, but I didn't see her all that long.
The T I see now is better than any T I've ever had at giving me feedback and challenging me. I see her twice a week currently, and I wish I could afford to see her more because we are making so much progress and she is really helping me a lot.

I hope that all helps with a bit of perspective, and I hope your T was able to answer your questions.
Seeing your T more than once a week does not mean you are failing at therapy or life, and there's nothing wrong with getting a little extra support.

Good luck!

I saw two different therapists for an appointment each week for a few years. Just seeing the one was a disaster for me - so I started seeing the other. I paid out of pocket. I don't have children or a lot of expenses and I don't like to travel very much - so therapy was sort of a hobby for me.

Wow, what a great range of helpful responses so far! You're all giving me lots to think about for sure.

I'm definitely concerned about the dependence aspect, but that's something I could really stand to work on and look at regardless, so it goes in the plus column (while also being terrifying, of course). The payment question is significant--I'm hoping insurance won't balk too hard at 2x per week, since while I can afford to double my monthly copays and I don't have any annual visit limit to worry about, I strongly suspect my therapist's cash pay rates are out of my price range.

I'm hoping more frequent sessions help with covering more ground more deeply, since as things stand it seems like the only way for us to really delve deeply into one topic is to focus on it nearly exclusively for weeks on end. Which is sort of the approach we've been taking lately, and is helpful but feels very non-ideal. I'm not really thinking that going more often will mean I'm done with things sooner, since I see therapy as a long-haul project that I expect will be ongoing for years, but I am hoping that increasing frequency/intensity brings more of my "major issue" stuff to the forefront sooner.

I suppose it shouldn't be a huge shock that my therapist suggested this, since he's a psychoanalyst, and it makes sense that someone who sees his own therapist 4x per week would see value in having patients come in more than weekly! I'm still definitely having a lot of feelings around the possibility/risk of dependency, which I'm going to try to bring up in my session today.

Because my therapy was always going to be for the long haul. T took that in to consideration and also offers a sliding scale dependent on how many full paying clients she has.
I've paid £20 x2 for all this time. The full rate is £75 per session.

Never did it long in a row, but I had a month here and there when I had two sessions per week. For me, I found that it mostly just fueled my obsessive thinking about therapy (why I wanted to go more often also) rather than helped. I never became dependent on the T per se, but got hooked on the mental stimulation of figuring things out and experimenting aspect pretty massively, and then used it as a distraction rather that constructive resource.

The cost was also deterrent for me relative to what therapy could provide (I live in a very expensive area) and I just didn't feel comfortable spending that amount of money on scheduled talking. I made better use of regular weekly (or even irregular, as needed) sessions plus unstructured emails (that were free and largely one-sided) between sessions.

I would say try for a bit if interested and see. It sounds like people's experiences vary quite a lot.

I have been seeing my T (T1) for three and a half years. There was a time I actually had THREE T's at once...all for different purposes, and my insurance covers it. Basically, I could have a different T for every day of the week, and insurance would pay...which is really nice to not have to worry about that. I ended up quitting T2, and T3 (whom I loved dearly) abruptly terminated recently, without even a final termination session.

Anyway, to get back to the topic, when I started seeing T1 three and a half years ago, we started at once a week. After two months of that, we increased it to twice a week, and I have been seeing her every Monday and Thursday since then. It works for me, although I am considering going down to one session per week now. I have not talked to her about that yet.

I have been seeing my current T for a little over 2 years. We started out with 1 session a week, then quickly to 2 and then just recently we have gone to 3. Luckily my insurance covers multiple sessions a week.

We have been able to go through a lot more stuff quicker. I have lessened my obsessional thoughts. And I have gotten much support. For me it has been a good thing, as I have become more stable, even though I still have lots of 'moments'.

I started off with two sessions a week a year ago. At the moment we've done one session a week because of my school schedule and I really felt the difference. I've had 3 sessions a week when I've needed it- I felt he kept me in check.

I'm seeing a psychoanalyst 4 times a week and I pay fully out of pocket - in my country we have public health care and it doesn't cover long term therapy unless you have a severe and acute condition.

Most therapists are in private practice and because there is no insurance they cannot set their fees arbitrarily based on what an insurance company would pay but they rather have to set their fees based on what people realistically can pay.

I pay roughly 1/3rd of my monthly income to my analyst though but I feel it's worth it and I can afford it.

Yeah, I think once you hit 3x/week, they start thinking a higher level of care might be necessary if you continue to need that frequency. The period when I saw my T that often coincided with placement in a therapeutic group home and several hospitalizations - which are extremely expensive. I actually got approved for Medicaid in addition to my BCBS because of my treatment needs. Their goal is to find the most cost-effective treatment. Sorry you're having to pay so much... My T charged $120 for the intake and $60 after that until I hit my deductible. Have you considered whatever the higher level of care is that they're recommending?