How To Know: Once Per Week or Twice?

Hi, What is your experience of seeing your therapist one time each week versus twice each week? How did you decide, did your therapist decide, or did you decide together, and why?

When I begun therapy with my current T, 17yrs ago. She mentioned after initial assement, that we will start at one a week for a while then go up to 2 x a week.
She asked was I willing to commit to that?

I did one a week for a year. Thst was to contain me. Get me stable. Then the twice a week begun.
Twice a week for my history, my damage, the type of therapy I was undertaking was right.
To knee that whrn you leave session after dealing with difficult stuff. The wait before being back in that safe space was bearable. The difficult stuff was still conscious because of the small gap between sessions.

Yes it's a commitment. Yes it's at times exhausting.

But anything worth doing is worth doing seriously.

He suggested to go twice a week and made it clear that it was not necessary for me to go twice a week but it would move things along faster with EMDR. It sure moved things along faster with my ATTACHMENT to him.

Now he is trying to get me to once a week by reducing sessions gradually. one week once a week the next week twice and week back to once a week until I feel I can reduce them further.

Thank you both; your replies are helpful.

I've been seeing my therapist this month (and in August) 2x/week. I'm fine with it; I believe it has more impact. Oddly, my transference with her seemed stronger when I was seeing her only once per week (for five months). Now she feels more like a "human friend" to me. Go figure...the mind is so confusing (at least, mine is).

Moxie Doxie, it sounds like your attachment is not necessarily a good thing?

Oh I thought it was a good think so I could trust him and tell him things and open up and do the work but now it has become the most painful thing I feel I need therapy just to deal with that.

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Originally Posted by MoxieDoxie Oh I thought it was a good think so I could trust him and tell him things and open up and do the work but now it has become the most painful thing I feel I need therapy just to deal with that.

Oh, wow. I was in that situation with my therapist from years ago. It was frankly awful. I lived for sessions with him. The worst part of it was that I never communicated how I felt to him. Spent 6 years like that, spinning circles.

After seeing my current therapist once a week for about a year, I increased to twice a week. It was his suggestion, but the actual decision was completely up to me. I found it immensely helpful to go more often... It became much more possible to talk about things in more depth, and to feel supported enough to talk about more difficult topics. At once a week therapy felt a little like treading water (or in worse moments, like bailing out a leaky boat). At twice a week it started to feel like we were actually making progress.

I did twice a week for a year and a half, before increasing to three times a week recently. My opinion is that three times a week is great for me and what I need and want from therapy, but wouldn't be ideal for some. But I think twice a week would be a beneficial option for many, many people, and to be honest I think a lot of people would be better off if twice weekly were more of the "default" frequency, instead of once weekly.

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Originally Posted by starfishing After seeing my current therapist once a week for about a year, I increased to twice a week. It was his suggestion, but the actual decision was completely up to me. I found it immensely helpful to go more often... It became much more possible to talk about things in more depth, and to feel supported enough to talk about more difficult topics. At once a week therapy felt a little like treading water (or in worse moments, like bailing out a leaky boat). At twice a week it started to feel like we were actually making progress. I did twice a week for a year and a half, before increasing to three times a week recently. My opinion is that three times a week is great for me and what I need and want from therapy, but wouldn't be ideal for some. But I think twice a week would be a beneficial option for many, many people, and to be honest I think a lot of people would be better off if twice weekly were more of the "default" frequency, instead of once weekly.

It sounds like you have a terrific set-up with your therapy. I agree that the once per week is superficial. All it is, is playing catch-up.


I'm currently seeing my T 2 x per week, but I don't know if that will go past September. I hope it does, but I also won't be surprised if she goes back to once/week. There seems to be that immense "thing" about getting too attached...I really don't understand it. I mean, either a person is in therapy and all that comes with it, or forget it.

Yes, I'm really very lucky that things have worked out this way with my current therapy. I don't think once a week is always superficial, and I think a lot of people do well and do useful work in therapy with once per week, but I agree with you that for me once a week felt like constant catch-up. Not so much in the sense of being caught up on everyday goings on; at once per week my therapist often had no idea about many basic things I had going on, because the only way to go into any depth with trickier material was to ignore a lot of day to day things. But definitely in the sense that just getting to the point of being ready to talk about certain things would take up almost all of the time, and it often felt like starting over again every week.

I'm curious why it sounds like you don't think the decision about staying at twice per week is up to you, or is at least primarily your therapist's decision rather than yours?

Twice a week seems rather excessive to me. In fact, as someone who only sees her own therapist once monthly, this is mind boggling to me. My appointments are made by her office. They are not my choice.

I saw 2 therapists -each once a week. I would never let a therapist tell me what I could or could not do. The therapist can decline to work more than one appointment, but there are multiple ways to skin a cat. They were each partially retired and only worked as therapists a couple of days a week. I was on a quest to figure out how therapy was supposed to help and gathering information from more than one of them was useful in some ways.

More than once a week would have seemed too much for me. I wanted and needed the space. In fact, I really liked my sessions spaced more like 10 days apart. For me, more than once a week would have been too much time allotted to navel gazing. LOL! It was important to have as much regularity in my life as possible; therapy never felt "regular" and I preferred it that way; I wanted therapy to be something I could finally be done with and move on, but going more than once a week would have put too much focus on therapy to the negligence of my real life -- family, kids, work, other interests. The only times I went in more than once a week was when I was in a serious crisis, and that may have happened a just two or three weeks a year.

Strange to call it "excessive." Twice or more a week is very helpful for a lot of people. Different things work for different people's therapy--if it works for you then that's great, but once a month would be worse than useless for me.

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Originally Posted by starfishing Yes, I'm really very lucky that things have worked out this way with my current therapy. I don't think once a week is always superficial, and I think a lot of people do well and do useful work in therapy with once per week, but I agree with you that for me once a week felt like constant catch-up. Not so much in the sense of being caught up on everyday goings on; at once per week my therapist often had no idea about many basic things I had going on, because the only way to go into any depth with trickier material was to ignore a lot of day to day things. But definitely in the sense that just getting to the point of being ready to talk about certain things would take up almost all of the time, and it often felt like starting over again every week. I'm curious why it sounds like you don't think the decision about staying at twice per week is up to you, or is at least primarily your therapist's decision rather than yours?

I agree that for many people (maybe most) once/week is just fine. I should have pointed out that it feels superficial to me...I can't really get deeply into issues.

I have the feeling that my T will be the one to decide how frequently I come in because after I asked if I could see her twice/week she seemed a bit taken aback, just for a moment. Then she mentioned hoping the clinic schedule would allow - quickly followed it up with, "But don't worry, we'll find a slot for you" and said something about assessing me at the end of September.

I went into a tailspin after that and was a complete mess. I was horribly embarrassed about having asked for more sessions (they're free for me). T assured me that there was no problem at all, she'd just have to work with the schedule. She said she hadn't realized how upsetting the whole thing was to me. I believe tht to her, it is a mtter of juggling the busy clinic schedule, whereas for me, it about how I feel. So I am very anxious about what will happen at the end of this month.

I saw former T weekly. I would have loved to see her twice a week but as I was paying cash I couldn't have afforded it even on a sliding scale. Current T I see every two to three weeks. It's not my choice, it's the way the scheduling works at her place of business. It's not even her choice, I don't think. I would be okay with every week, but it just doesn't work out that way with Current T. I do have some time in September and October where I see her three weeks in a row because the office made a scheduling error and I didn't correct it. I am intrigued to know if that would help me feel more stable going every week.

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Originally Posted by ArtleyWilkins More than once a week would have seemed too much for me. I wanted and needed the space. In fact, I really liked my sessions spaced more like 10 days apart. For me, more than once a week would have been too much time allotted to navel gazing. LOL! It was important to have as much regularity in my life as possible; therapy never felt "regular" and I preferred it that way; I wanted therapy to be something I could finally be done with and move on, but going more than once a week would have put too much focus on therapy to the negligence of my real life -- family, kids, work, other interests. The only times I went in more than once a week was when I was in a serious crisis, and that may have happened a just two or three weeks a year.

I can understand that. Definitely. I do find myself structuring my entire week round those two therapy sessions. But then, I live alone nd my kids are grown. So my schedule is flexible. I do worry about either becoming too attached or too detached, though. I drive myself crazy, I swear it.

Ive never seen a therapist twice per week. Sometimes when Im really struggling I think twice would be good but it has never happened.

I would not see a therapist who insisted on making this decision for me.

I was going twice a week and it was like okay what can we talk about today we didnt 3 days ago. Sometimes I'm like I need to get this out of my head and spoken to someone. Just depends.

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Originally Posted by susannahsays I would not see a therapist who insisted on making this decision for me.

Well, there are a few considerations. First of all, I trust her. Second, I do not pay to see her and she works in a clinic that is overflowing with patients. I have absolutely no money for a therapist and my town is small. I feel incredibly lucky to be able to see her even once per week - but twice is excellent.

Then, too, I'm not at all sure she'd be making the decision. I believe she alluded to us assessing at the end of this month.

i had started going twice a week about four months into therapy with my ex-T because when there was too much time between sessions and it was too easy for me to disconnect, push away and switch off from the work we had been focusing on and each week it felt like starting over again. this was especially true when trying to build trust with my T or even a workable connection to him because my object permanence was severely lacking. it mainly was my idea to go twice a week and T was happy to give it a try and see how it went and it definilty made a big difference in my progress. i continued with twice a week for 4.5 years. eventually, he was willing to extend one of my sessions to 90 mins, and again, that made a big difference because it allowed more time for me to warm up and to go deeper with out feeling rushed or pushed out the door too soon. in my last year of therapy with him, i was ready to cut back down to once a week, which i kept the 90 min session and continued to make a lot of progress during that final year until the day i was ready to officially end.

I'm lucky enough to have the flexibility to see my therapist three times a week. We did once a week for a while, but I found it difficult to maintain the connection at that level. He suggested twice a week, but I didn't take him up on it at first. Maybe a month later I asked if we could change to twice a week, so we did. Then I had a traumatic event happen and we upped it to three times a week and have stuck with that for some time now. I really appreciate the continuity this provides and also I feel that the relationship has deepened immensely, and I think he likely feels that as well. I know this isn't for everyone and I'm sure some here are judging this, but it works for me.

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

T doesn't believe in more than one session a week unless it's an emergency. She believes it promotes dependency and if you need that much, you need a higher level of care. L, on the other hand, believes in twice a week to get more work done and support. I'm in the middle. I see both sides. I think with L I would want to go more often because we have a lot to work on. With T, we were running out of things to talk about. Sadly, we can really only afford one session a week. But I do see how more can be helpful.

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.