Is Long-Term Therapy for Me?
A Preston Therapist’s Reflections
If you’re considering counselling, you may be wondering whether you are wanting short-term or longer-term therapy? This is a common and very understandable question. Here at my therapy practice in Preston, I work with clients who are seeking longer-term therapy as well as clients accessing short-term counselling. If you’re considering whether long-term therapy is right for you, my hope is that this blog will help you to become clearer on your own thoughts and feelings in response to this question.
In this article, I’ll explain what long-term therapy in Preston involves, who longer-term work can help, and how to know whether longer term therapy is a good fit for you.
Considering long-term therapy
Knowing the what, why, who and how of longer-term therapy may help you to assess whether long-term therapy is a good fit for you.
Noticing what emerges as you consider if long-term therapy is right for you?
If you are considering longer-term therapy, a place to start can be to check in with yourself about any thoughts, feelings and sensations that emerge for you around the idea of long-term therapy. There can be a range of emotions, thoughts and questions that lie behind this query. For example:
If I’m thinking about long-term therapy, does that mean I’m broken?
Am I weak if I am giving longer-term therapy a go?
I feel shame that I want something other than 6 sessions of counselling
I feel conlicted! I don’t like to have needs, and yet I feel a need to talk with someone about what’s happened to me.
Why does it take me so long to open up and trust a therapist?
As you read through this article, tuning into how you feel about the idea of long-term therapy could help you to become clearer on whether you feel longer-term therapy is right for you.
What is long-term therapy?
Long-term therapy usually refers to open-ended counselling or psychotherapy, rather than a fixed, time-limited number of sessions. Instead of working towards a specific short-term goal with a solution focus, in longer-term therapy, there is scope to:
Understand emotional patterns
Explore past experiences and how they shape the present
Develop self-awareness and emotional resilience
Create lasting internal change rather than symptom management.
Long-term therapy isn’t about “fixing” you, it’s about creating a consistent, safe relationship where deeper patterns, emotional wounds, and long-standing difficulties can be explored at a pace that feels manageable. For many people, it becomes a powerful space for sustainable change rather than temporary relief. Longer-term work allows for exploration at depth, and at a pace that is tailored to you and your process.
For many people, long-term therapy offers the depth and continuity needed to work with issues that didn’t begin overnight — such as trauma, relationship patterns, identity struggles, or long-standing anxiety, grief work or low self-esteem.
Like the proverbial iceburg, long-term therapy can help you to explore deeper themes “under the surface” of the presenting issues you face.
If you’re looking for long-term therapy in Preston, this approach may feel especially appealing if you’ve tried short-term support before and felt there was more underneath to explore.
How is long-term therapy different from short-term counselling?
Short-term counselling often focuses on a specific issue, such as a recent life event, work stress, or a relationship difficulty. It can be extremely helpful when the concern is contained and time limited. Short term-time limited counselling typically involves a set number of sessions, often around 6, where the client and counsellor work on here-and-now concerns.
Long-term therapy, however, allows space for:
Emotional patterns that repeat across relationships
Childhood or developmental experiences
Trauma that affects trust, safety, or self-worth
A deeper understanding of how you relate to yourself and others
Space to explore
In longer-term therapy, there is space for the work to unfold organically, guided by what feels most alive or important for you at any given time.
Signs long-term therapy might be for you
You might benefit from long-term psychotherapy if:
You’ve been struggling with anxiety, low mood, or emotional overwhelm for a long time
You notice the same patterns repeating in relationships or work
You feel disconnected from yourself, unsure of who you are, or stuck
You’ve experienced trauma or neglect that still affects you today
You want deeper understanding rather than quick strategies
You’ve tried therapy before but felt it ended too soon
Many people seek long-term therapy not because something is “wrong,” but because something doesn’t feel settled — and they want a space to explore that safely and within a therapeutic relationship that feels “holding” as they explore places of pain.
What actually happens in long-term therapy?
Sessions usually take place weekly or fortnightly and follow a consistent structure, creating safety and continuity. Over time, the therapy aims to become a relationship where you can:
Speak freely without needing to filter or perform
Explore emotions that may feel confusing, uncomfortable, or difficult to name
Understand how past experiences influence present reactions
Develop greater compassion, clarity, and emotional resilience
There’s no pressure to arrive with something specific to talk about. Often, the most meaningful work emerges naturally from what you’re noticing in your life, or in yourself — or even in the therapy relationship itself. I am open to what emerges between myself and a client in the here-and-now as we work together. In the face of not knowing what it is that might emerge between us, I trust my own sense of stability and creatively to hold and respond to my client.
How long does long-term therapy last?
There’s no one answer to how long is long-term therapy.
Some people stay for several months, others for a year or longer.
There’s no fixed timeline for long-term therapy. Some people stay for several months, others for a year or longer. Therapy continues for as long as it feels useful and supportive to you and the therapist is comfortable the work remains ethical and therapeutic. In any form of counselling or psychotherapy, it is vital the client has autonomy and the right to end therapy at any point. Long-term therapy does not need to last beyond how long you want the therapy to last.
Endings are a part of long-term therapy
That said, in longer-term therapy, it is important that the therapy comes to a close at some point. From the outset of the work with my clients seeking long-term therapy in Preston, I am clear that it is helpful to talk about our therapy ending at some point. It is a rewarding aspect of my work to say goodbye to clients I have worked with, with the knowledge of how they have grown and developed through our work together. There comes a time when the therapy is concluded. However, rather than that be imposed on us from the outset, with longer-term therapy, we work together on this process of when it feels right and therapeutic to bring the therapy to an end. This way of working calls for responsibility and open communication about the therapeutic process. Communication and working collaboratively and mutually are key to how I approach endings in therapy with all my clients, including my longer-term therapy clients.
Reviewing the Long-Term Therapy
In my work with clients, regularly reviewing how we’re working, and what a client is getting from the work is an important aspect of working collaboratively. I regularly review and check in with how therapy feels for you, whether you’re getting what you need, and how we can work together towards this.
Is long-term therapy evidence-based?
Asking if long-term therapy is effective is an important question.
Evidence shows some people respond well to short-term therapy, whilst for other people, longer-term therapy produces greater overall benefits
Yes. Research has shown longer-term psychotherapy is more effective than shorter term psychotherapy (Howard, Kopta, Krause, & Orlinsky, 1986). This research has been refined since, with a recognition that some people respond well to short-term therapy, whilst for other people, longer-term therapy produces greater overall benefits (Nordmo et al, 2021). A systemic review (Robinson et al., 2020) concluded that the optimal dose of “how many therapy sessions” ranged between 4 and 54 sessions. There’s a huge variation there, suggesting that for many people it is optimal to engage in longer-term therapy beyond 6 sessions.
What if I’m not sure yet?
Not sure if long-term therapy is for you?
That’s okay - you can take your time. In therapy, your autonomy is important.
Uncertainty is completely normal. Many people come to therapy unsure whether long-term work is what they want — and discover clarity through the experience itself. A first therapy session need not become long-term therapy – if you don’t feel comfortable or feel the therapist is not the person for you, then you will be free to autonomously decide you don’t want to take the therapy any further.
A good therapist will not push you into commitment but will offer space to explore what feels right for you. You don’t need to decide everything in advance.
Choosing a therapist for long-term work
If you’re seeking long-term psychotherapy, it’s important to find someone who:
Has experience working long-term with adults.
Is qualified and experienced at working at depth. One way to establish this is to look for a BACP Senior Accredited therapist aligned with column C of Scoped. This means the therapist has been assessed as meeting the standard of an experienced, highly competent, and accomplished practitioner, demonstrating advanced skills, extensive training, deep ethical practice, and reflective ability.
Offers consistency and emotional safety.
Feels like someone you could build trust with over time.
The relationship itself is one of the most important factors in therapy’s effectiveness (Johns et al., 2018; Orlinsky et al, 2004), so attending to whether you feel rapport and sense of safety and trust with a therapist you are considering working with longer-term is important.
The relationship itself is one of the most important factors in therapy’s effectiveness
Feeling that there is rapport between yourself and the therapist can be a way to establish if you feel okay to continue with the therapy.
Thinking about long-term therapy in Preston?
If you’re considering long-term therapy in Preston, or online, and would like a supportive space to explore whether this approach is right for you, you’re very welcome to get in touch.
I offer confidential, professional psychotherapy for adults, both face-to-face in Preston and online across the UK. There’s no obligation — just an opportunity to ask questions and see whether working together feels right.
👉 You can contact me here to enquire about availability or arrange an initial conversation.
References:
Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose–effect relationship in psychotherapy. American Psychologist, 41(2), 159–164. https://doi.org/10.1037/0003-066X.41.2.159
Johns, R.G., Barkham, M., Kellett, S., Saxon, D.. A systematic review of therapist effects: A critical narrative update and refinement to review. Clin Psychol Rev. 2019 Feb;67:78-93. doi: 10.1016/j.cpr.2018.08.004. Epub 2018 Aug 25. PMID: 30442478
Nordmo, M., Monsen, J. T., Høglend, P. A., & Solbakken, O. A. (2021). Investigating the dose–response effect in open-ended psychotherapy. Psychotherapy Research, 31(7), 859–869. https://doi.org/10.1080/10503307.2020.1861359
Orlinsky, David & Rønnestad, Michael Helge & Willutzki, Ulrike. (2004). Fifty years of psychotherapy process-outcome research: Continuity and change.
Robinson, L., Delgadillo, J., & Kellett, S. (2020). The dose-response effect in routinely delivered psychological therapies: A systematic review. Psychotherapy Research, 30(1), 79–96. https://doi.org/10.1080/10503307.2019.1566676