How Often Do I Need to Go To My Psychologist?
It's one of the first questions people ask, and it's a fair one. Before you commit to therapy, you want to understand what you're signing up for. How much of your time, your money, your emotional energy? Weekly? Fortnightly? Does it actually matter?
The honest answer is: yes, frequency matters, probably more than most people realise. But it's also more nuanced than a simple prescription. Let me walk you through what the research actually says, and what I've found to be true in practice.
What the Research Tells Us
Over the past decade, a growing body of peer-reviewed research has examined the relationship between how often people attend therapy and how well they do. The findings are reasonably consistent.
More frequent sessions, particularly in the early phase of treatment, are associated with faster recovery. A large naturalistic study by Erekson and colleagues (2015), which followed over 21,000 clients across 17 years, found that people attending weekly sessions recovered significantly faster than those attending fortnightly. A more recent randomised controlled trial by Bruijniks and colleagues (2020), published in the British Journal of Psychiatry, found that twice-weekly sessions of CBT and interpersonal therapy for depression produced better outcomes and lower dropout rates than once-weekly sessions. A meta-regression by Cuijpers and colleagues (2013), one of the most cited researchers in psychotherapy outcomes, found that increasing from one to two sessions per week was associated with a meaningful increase in treatment effect size (g = 0.45) for depression.
What's particularly interesting is that the research distinguishes between the speed of recovery and the total amount of recovery. Fortnightly therapy can produce equivalent outcomes to weekly therapy, but it takes longer to get there, and can require more sessions overall.
For more complex presentations, including PTSD, borderline personality disorder, and significant depression, the evidence leans more clearly toward weekly or more frequent sessions, particularly at the outset. But…
What This Looks Like in Practice
Based on both the research and clinical experience, here's how I generally think about session frequency:
The initial phase (roughly the first six to eight weeks) is where frequency matters most. This is when the therapeutic relationship is being established, when we're building a shared understanding of what's happening for you, and when your nervous system most needs the consistency of regular contact. Weekly sessions during this period tend to produce better outcomes across most presentations. For more acute or complex difficulties, weekly is really helpful here.
The middle phase often settles into fortnightly sessions, as the work deepens. This is where most of the substantive therapeutic work happens, and fortnightly contact maintains the momentum necessary for that work to compound.
The later phase is where frequency can often reduce. Once progress is established, insight is consolidating, and you're applying what you've learnt more independently, fortnightly or even monthly sessions can work well as a maintenance or tapering approach. Many people find this transition a natural and useful part of ending therapy, rather than stopping abruptly.
The Most Common Presenting Concerns and What They Tend to Require
The most frequent reasons people come to therapy in private practice are anxiety disorders, depression, stress and adjustment difficulties, relationship concerns, and work-related issues including trauma, burnout, and career stress. Across all of these, the research supports weekly sessions as the standard for the active treatment phase, with more frequent sessions considered for more severe or complex presentations.
Monthly sessions from the outset are not well-supported by the evidence for most acute presentations. They can be appropriate for maintenance once significant progress has been made, but starting treatment monthly is unlikely to produce meaningful change in a reasonable timeframe, and may actually extend suffering by slowing the rate of recovery.
The Practical Reality
I want to be honest about something the research also acknowledges: weekly or even fortnightly therapy isn't always financially or logistically accessible for everyone. Cost, work schedules, family commitments, and geography all create real constraints. These are legitimate barriers and they're worth discussing openly.
Where practical constraints exist, the evidence suggests it's worth prioritising frequency in the early weeks if at all possible, even if that means spacing out later. A concentrated start tends to produce better returns than a diffuse one.
It's also worth noting that research published in 2024 by Keane and Smout in an Australian context found that most psychologists were aware that more frequent sessions produce better outcomes, but that a significant proportion scheduled at lower frequencies due to systemic and practical barriers rather than clinical reasoning (I would gladly admit to being in this cohort of psychologists). In other words, the gap between what the evidence recommends and what actually happens in practice is real, and often driven by factors outside the client's or clinician's control.
What I'd Say to Someone Trying to Decide
If you're in a position to attend weekly, particularly at the start, the evidence supports doing so. It will likely mean less time in therapy overall, faster relief from what you're experiencing, and a stronger foundation for the work.
If weekly isn't possible right now, fortnightly is still worth doing. Progress will be slower, and you may need more sessions to reach the same point, but meaningful change is still possible.
What I'd encourage you to move away from is the idea that monthly sessions from the start are equivalent to weekly ones. For most presentations, in most people, they're not. That's not a judgment; it's just what the research shows.
If you're unsure what frequency makes sense for your particular situation, that's worth discussing in an initial consultation. The right answer depends on what you're bringing, where you're at, and what's realistically workable for you. There isn't a single prescription that fits everyone, but there is evidence to inform the decision, and you deserve to have access to that.
If you're unsure what frequency makes sense for your particular situation, that's worth discussing in an initial consultation. The right answer depends on what you're bringing, where you're at, and what's realistically workable for you. There isn't a single prescription that fits everyone, but there is evidence to inform the decision, and you deserve to have access to that.
A Note on the Research
The studies referenced here draw predominantly from research on depression and anxiety, which represent the most extensively studied presentations in the psychotherapy literature. The evidence base for session frequency is less developed for some other presentations, and recommendations may vary depending on the complexity and nature of what you're experiencing. Clinical judgment, your individual circumstances, and an ongoing dialogue between you and your therapist will always be part of the picture. The research informs good practice; it doesn't replace the human conversation at the centre of it.
Ready to Talk?
If you're considering therapy and want to understand what might work best for your situation, an initial consultation can discuss this: what you're dealing with, what the process might look like, and what frequency of sessions makes sense given your circumstances and goals.
You don't need to have it all figured out before you reach out. That's what the first conversation is for.