How To Know: Once Per Week or Twice?

I went 2x a week for almost 7 years

I'm at 1x a week now since late 2016.

I've noticed a lot less time spent thinking abt therapy and my therapist. More independent now and not so dependent on him

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Originally Posted by just2b Was 2 times a week for past 5 years. Now down to 1 time a week. Insurance requirements, not her or my decision. I am struggling to adjust. Just started 1 time a week last week. Trying not to show my attachment issues, yet having difficulty in writing to her via email or text. She will not respond back either.

I'm so sorry. The lack of humane health care rears its ugly head far too often.

I don’t have a set schedule with my T so like this week I saw her on Wednesday and then I’m seeing her again on Monday. It’s still technically once a week though according to insurance. She makes the appointments not me since she gets booked pretty quickly and with my work schedule scheduling can sometimes be tough. I’m trying to get several decent size issues under control with her help though. So these sessions are kinda crucial.

I've been seeing my T for, I think, about 4 years. Up until July of this year, it was on a weekly basis. Then we bumped it up to twice a week and I now have 2 standing appointments a week.

Twice a week appointments help me to get beyond the discussions of what happened in life since last I saw her. I process things really slowly, and seeing her twice a week means that I have time to process the session and figure out my thoughts/feelings about it, but not so much time that I talk myself out of sharing such things.

I've wanted to go to twice a week for quite a while, but didn't really have the courage to bring it up and ask for it. She made the suggestion after some in-depth conversations about my thought processes, and I really like it.

Hey @susannahsays

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Originally Posted by susannahsays You sound a tad jealous. That would be understandable, since you are apparently victim to the whims of your therapist and her office.

I may have missed context here...did wishful share information that explained she/he was forced to go to therapy once a month against her wishes? Or is it that you know she wishes to go more than once a month but is not allowed? I am just trying to understand why you are saying she is a victim and jealous.

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But that doesn't mean people afforded more appointments than you have an excessive number. And surely, it would all be relative to why the person was seeking therapy anyway.

agreed.

I really do think it depends on circumstances and treatment goals. And I do not mean to offend anyone, these are just my opinions.
I think in times of crisis (suicidal ideation, recent trauma or traumatic events) twice a week may be necessarily in order to promote stabilization and a safety plan.
But in a general sense with a long term treatment plan over time and with a set pace I do not see how twice a week would ultimately make a difference. Lets say you are methodically dealing with past abuse. And that you and your therapist have a long term plan. On a Monday you start to deal with XYZ event. You are able to tolerate the session without being triggered. Seeing the therapist on thursday might mean you havent had time to ponder and think about monday's session long enough to explore what you can discuss about this event the following week. And some people can be overloaded discussing trauma so close together. But like I said its up to the person.
I also fear that a therapist insisting or recommending twice a week could have a monetary conflict of interest. A vunerable client might not see an unethical therapist recommending twice a week as a financial tactic.

I doubt my T made much money out of me. She only charges me £20 a session. And has never raised that in 17yrs

My therapy is free, which relieves me of a lot of concerns.

Amusingly, this topic came up in my (third) therapy session this week. We were discussing my feelings about having increased from 2x to 3x weekly, and ended up talking a bit about the insurance industry pressures and other forces that have made more than once weekly therapy less common and less accessible, and the ways 2+ sessions a week is unfairly stigmatized.

I think going twice a week could be helpful for a lot of people, and should be much more available. When something is important and useful to me, why wouldn't I prioritize it by spending more time on it? It's what I do in other areas of my life, why wouldn't I make the same choice here to put more time into therapy? From my perspective that's all that 3x a week is for me: an investment of time and energy in something important. I'm not in a crisis, I'm just looking to get a lot done in therapy and explore what needs to be explored.

My therapist also has zero financial motive to work at a higher session frequency. His practice is full, and each time we've added a session there's been a delay in needing to wait for a timeslot to open up. He's a psychiatrist, and if money were the goal he'd be taking on medication-only visits, not adding hours of therapy.

She said "My appointments are made by her office. They are not my choice." I also know that 99% of the time, she thinks providers know best and on the occasions I recall when she has been wronged, she has wound up being an apologist. As for knowing how many times she wants to go, of course I don't know that. But I do think it's a reasonable assumption that she would like to have the option to see a provider more often if she wished. People don't tend to describe situations as them not having a choice when their feelings are positive or neutral about that fact.

And I do think people in Canada, where she is, are frequently victimized by the difficulty in obtaining mental health services there. When they are provided, the person has no autonomy or choice on the types of services available to them.

I don't think it's unreasonable to be jealous in such a situation. I have noticed that some people who are denied things they want or need deal with it by identifying with the system or person (such as a therapist) who is responsible for denying them. This allows them to feel less like a victim of their circumstances and moves judgement from the system or person denying them to other systems, people, or people receiving what the person herself desires. That is what I personally think is happening in this case, based on what she said and also on other things she has said in the past.

I wish i could go twice a week, i did ten years ago when i was seeing a eating disorder pdoc. Now i can see my t only every three weeks, or two weeks because she needs to keep spots open and her case load does not allow it to. I know that if im in a rough spot i can phone her and she will try to get me in. Im very lucky to go long term no end in sight, it's open ended as long as im making progress. They are now starting to force short term counseling and groups here in my province. I do not like the big change. Allot of people including therapist, pdoc, ect are fighting to keep mental health from being cut. im very grateful to go to my session every 3 weeks and day program.

I saw T mainly twice a week since we first started. (almost 2.8 years now) We did three once when I really needed it and once a week due to my school schedule getting in the way. I liked twice a week as I felt more supported and a week felt too long.

Because I was so dependent on him it allowed me to be a bit more independent now.

My experience has been that 2 and 3x a week sessions have been very helpful in a very different way from what you're describing. More like, on Monday I talk about XYZ event. Which also reminds me of ABC issue, and also brings up some confusing feelings that I can't quite place but that remind my therapist of DEF issue I spoke about a few months ago. Then on Tuesday I come back, and it's easier to talk more freely about XYZ than it was Monday, and I also have some new ideas about the connection to DEF that we explore in more depth. Then Friday I focus on ABC but also come up with some new insight into XYZ. And then Monday again and it all continues, adding new strands and picking back up on ongoing ones.

For me, going more often makes the whole enterprise of therapy feel much more like a continuous conversation, where I can focus on more issues in much more depth and in a much more comprehensive way.

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Originally Posted by starfishing My experience has been that 2 and 3x a week sessions have been very helpful in a very different way from what you're describing. More like, on Monday I talk about XYZ event. Which also reminds me of ABC issue, and also brings up some confusing feelings that I can't quite place but that remind my therapist of DEF issue I spoke about a few months ago. Then on Tuesday I come back, and it's easier to talk more freely about XYZ than it was Monday, and I also have some new ideas about the connection to DEF that we explore in more depth. Then Friday I focus on ABC but also come up with some new insight into XYZ. And then Monday again and it all continues, adding new strands and picking back up on ongoing ones. For me, going more often makes the whole enterprise of therapy feel much more like a continuous conversation, where I can focus on more issues in much more depth and in a much more comprehensive way.

I entirely agree.