Therapy: Long Or Short?


Therapy: Long Or Short?
A psychotherapist claimed to be able to get to the bottom of many problems in one session. Hmm... does long-term therapy

But major depressive disorder, bipolar disorder, alcoholism, drug addiction, narcissistic personality disorder, borderline personality disorder, anxiety disorder, long-term dissatisfaction in a relationship, or a pattern of unsatisfactory personal or professional relationships? Even the example he uses of a woman who's been unhappy with her boyfriend for the past year is fatally flawed in his formulation of the case. He says that he would ask what could be missing from her relationship and how she could take care of the missing elements or end it. He leaves out a few basic important points: 1) Was she happy before she was in the relationship, i.e., is this a woman who knows how to be happy?; 2) Is she looking for her boyfriend to make her happy and give her happily-ever-after in life, i.e., are her dependency issues getting in the way?; 3) What are her contributions to the lack of satisfaction in the relationship? No one person holds all the good or all the bad in the relationship. It's a dynamic; 4) Did she grow up with a model of parents who enjoyed each other and were satisfied in their relationship, or did she grow up with a parent who was disappointed in his or her partner, who subtly or obviously passed along the idea that men are disappointing? Those questions are just a first pass look at what Alpert has left out in his simplistic, I’ll-just-tell-her-what-to-do approach.

The long and short of it is...

There is effective and ineffective short-term therapy and effective and ineffective long-term therapy. As a therapist in private practice since 1995, I've done lots of short-term and long-term treatment of patients. New patients frequently want me to tell them how long treatment lasts. I make a treatment recommendation about session frequency, based on clinical assessment, but the duration of the treatment is something that evolves, as I learn more about them and their issues, and as they learn more about themselves and their issues. It's not a one-size-fits-all process, despite what Jonathan Alpert says. Bob Newhart's character in the following hilarious sketch beat Alpert's quick-fix record by a mile. He could do it in just two words: "Stop it!!!" If you want change that takes more than two words, read up on the differences between short-term counseling and therapy here


This article was originally published at . Reprinted with permission.
Article contributed by

Diane Spear, LCSW-R


Diane Spear, LCSW-R, is a NYC-based psychotherapist who helps couples and individuals throughout the world find the joy in everyday life! She has been in practice since 1995, working with older adolescents up through older adults. Check out her website at to learn more about her therapy and counseling practice and couples and relationship therapy; and be sure to read her blog.

Connect with Diane through email here, or call 212-353-0296


Location: New York, NY
Credentials: LCSW-R
Specialties: Anxiety Issues, Couples/Marital Issues, Life Transitions
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