How Often Should Clients Attend Counseling?

This is a question that clients and counselors both struggle with: How much treatment is appropriate for me? The answer to this question depends on the person and what they're struggling with at that time.

Waybridge Counseling, the practice where I work, is considered a "step-down" practice. That means that we are a "step down" from higher levels of care, such as inpatient treatment, partial hospitalization, intensive outpatient, and community mental health agencies. Generally, I see my clients for one fifty minute session per week. If a client is struggling with more severe mental health issues (such as persistent suicidal thought, persistent disordered eating that has lead them to be medically unstable, or experiencing hallucinations or delusions), then a higher level of care is more appropriate for them than a step-down practice.

I usually recommend that clients begin treatment with me coming once weekly. Coming to treatment each week reinforces the skills and techniques used in each session. However, sometimes coming weekly isn't feasible. One pertinent factor is money. Therapy can be expensive, and some folks have financial barriers to attending weekly treatment. Other times, a person may have schedule conflicts that stop them from coming weekly. In these instances, I'm flexible and work with the client on their schedule.

If a client is experiencing persistent disordered eating patterns, losing weight, and reports an inability to reduce the frequency of their behaviors, I'm less flexible with bi-monthly appointments. In order for me to provide competent care, I need to make sure that my clients are receiving an adequate amount of treatment. 

Ideally, a client will begin treatment weekly, and then will begin to meet their goals and see a reduction in their symptoms. At this point, I may suggest that we switch from weekly appointments to bi-monthly appointments (or meeting every other week). Sometimes, clients make significant progress on their treatment goals, but want to meet once monthly for maintenance and check-ins. 

I always consult with the client and get their feedback about the amount of treatment that they believe is appropriate for them. I view the client/counselor relationship as a team and it's important to take into account the client's wants and needs while still ensuring that they are receiving adequate care.

Emily Teegarden