Long-Term vs. Short-Term Psychotherapy Treatments

These days, psychotherapy treatment options abound, with various forms of therapy offering different advantages and drawbacks. When deciding between short-term vs. long-term types of treatment, there are several key aspects one should consider when deciding on a treatment length, as well as the type of treatment itself.

Psychotherapy: Definition

The American Psychiatry Association (APA) defines psychotherapy as a way to assist individuals contending with various types of mental health difficulties. It is also known as talk therapy. By communicating with one another (mainly through talking, though some forms of therapy also incorporate physical activity), patient and therapist are able to gain a better understanding of the condition afflicting the patient. Over time, the patient is hopefully able to contemplate their own perspectives, defense mechanisms, scenarios, relationships, hopes and fears in their lives, both past and present, and consider how they wish to approach them moving forward. While most forms of therapy include the patient and therapist, others can include the patient and a loved one, group therapy, or animal-assisted therapy, to name a few.

Psychotherapy has been repeatedly proven to offer significant benefits to patients, with roughly 75% reporting an improvement in their well-being following therapy.

The APA goes on to state that psychotherapy can be long or short-term, spanning individual sessions or, in some cases, throughout one’s life. Psychotherapy can be offered as a standalone treatment, or in addition to other forms of treatment, such as medication or medical device treatments. As with other forms of treatment, it is strongly encouraged to consult with a licensed professional when deciding on a therapeutic treatment option.

The APA also stresses the importance of setting: psychotherapy treatments should begin by understanding the patient’s needs from the treatment and why they decided to seek it out. It should also set parameters for the frequency of the treatment’s sessions, its costs, cancellation fees and limits—with the APA particularly underscoring the importance of refraining from intimate contact between patient and therapist.

Long-term Psychotherapy Options

Historically, psychotherapy was offered as a long-term form of mental health support, and an intense one at that, with patients coming in for a session several times a week, for years.

The benefits of long-therapy include allowing the patient and therapist to take their time unpacking troubling, and at times traumatic issues, whose ramifications may have plagued the patient for a great deal of their lives. Though patients often feel an urgency to relieve themselves of adverse symptoms, some can take years to eradicate, just as some patterns of behavior can take years to replace. For these cases, there is long-term therapy.

Long-term psychotherapy options include the following:

• Psychoanalysis. One of the earliest forms of psychotherapy, psychoanalysis was invented by Dr. Sigmund Freud, who sought to uncover the mechanisms behind patients’ seemingly illogical responses. Psychoanalysis is one of the more intense forms of therapy and is typically composed of three-to-five sessions each week. Psychoanalysis can go on for years, or even indefinitely, as it attempts to make sense of the patient’s psyche and adapt their reactions and defense mechanisms to more beneficial ones, allowing them, as Freud put it, to “love and work.” The exhaustive nature of psychoanalysis can be experienced as too adverse for certain patients and may even cause an unraveling effect when they reach a traumatic event in their past. For this reason, patients with active psychosis are usually not referred to psychoanalysis. On the other hand, its in-depth approach has been found to be effective with more expansive mental health disorders, particularly personality disorders. Psychoanalysis can also help in cases of depression or anxiety, when the patient has the time and financial ability to deep-dive into their symptoms, in an effort to gain clarity as to what is causing them.
• Psychodynamics. Less intense than psychoanalysis but still offering long-term support, psychodynamic therapy usually involves weekly or bi-weekly sessions between patient and therapist. It typically goes on for at least a few months, as the therapist and patient learn to build a bond of trust, and an environment conducive to finding out new truths about oneself that have lain hidden and affecting the patient’s life from within. Like psychoanalysis, long-term psychodynamic therapy has been shown to be particularly beneficial with depression and personality disorders.
• Rehabilitative Psychotherapy. Focused not just on the mind, but on the connection between mind and body, rehabilitative psychology offers mental health support to individuals who have experienced a severe disruption to their well-being, and sometimes trauma, due to an accident, injury or illness. It often deals with the ways in which the patient’s ideas of self-worth, role in society, body image and other aspects of their life have changed due to the even or ongoing situation they are facing. Rehabilitative therapy runs the gamut between offering short-term support immediately after an accident, to continuing with the patient throughout their lives, particularly in cases of chronic illness.

Short-Term Psychotherapy Options

Short-term types of treatment are typically more goal-oriented than long-term therapy and tend to focus on specific challenges that are causing patients the greatest amount of adversity at present. One of its main advantages over long-term psychotherapy is that short-term therapy helps the patient face any avoidance tendencies they might have: whereas a long-term setting could allow them to put off dealing with a distressing aspect of their life, the more limited time frame of short-term therapy can push patients toward acknowledging and dealing with their most pressing issues.

Short-term therapy normally lasts up to 10-20 sessions, or three-to-five months. Short-term treatments initially gained recognition in the 1950s, following the rise of behavioral and family therapies, which offered a more direct approach to mental health disorders than psychodynamics. Its popularity grew further during the 1980s, when reports on the benefits of short-term treatments began being published.

Short-term treatment types include the following:

• Cognitive Behavioral Treatment (CBT). Relies on acknowledging distress and gradually exposing the patient to triggering stimuli, in an effort to build up their tolerance to them. CBT has been found to be particularly effective with obsessive-compulsive disorder (OCD).
• Short-Term Psychodynamics. As opposed to classic psychodynamics, which seeks to offer a fuller, contemplative approach to the patient’s life, short-term psychodynamics delves into more specific aspects of their experiences, such as their defense mechanisms and relationships. By turning their attention to certain areas of their life, short-term psychodynamics wishes to help the patient recognize which of their patterns of behavior are no longer adaptive, and where they might benefit from trying out new ways to react to their internal world and external environment. Emotional phobias, where the patient is overwhelmed with anxiety due to a particular emotional context, respond well to short-term psychodynamic.
• Gestalt Therapy. A more humanistic approach, gestalt psychotherapy views each individual’s perspective on their experiences as unique. Gestalt is a very validating form of therapy and aims to create consistency between the patient’s responses and their emotions, so they can feel the different aspects of their lives are integrated with one another. Gestalt has been shown to offer symptom relief in cases of anxiety and relationship-centered difficulties.