How Many Sessions Should Therapy Take? A Case History

Written by NRPC Editorial

May 16, 2024

This blog post has been created with permission of the original client, but details have been changed to protect anonymity.

Abstract. Female senior citizen in her eighties with historical walking and balance issues related to a workplace accident in the 1970s.

In late September of 2022 a client came to see me for a consultation who was very unsteady on her feet and who at that time had very serious balance issues and a severe lack of confidence related to motor skills of walking.
This ladies condition had been getting progressively worse and she had been back and forwards to see her GP to get to the root cause.

After lengthy medical assessments and taking on board her case history, her GP’s diagnosis, based upon the results of medical assessments relating to neurological function, and numerous audiology balance tests drew a conclusion that the condition was most likely to be psychosomatic, related to a severe work place accident in the 1970s that potentially was the original trigger for the loss of confidence with walking and possibly the dizziness.

As we discussed how the therapies I work with might be able to help this lady, I took a full case history and wanted to know in detail, significant milestones of potential trauma of which there were several relating to the original accident and then others where she would collapse for no apparent reason.

Because of this ladies age, and the history of balance issues, and at the time in September 2022, a severe lack of personal confidence in being able to walk without fear of tripping over or suddenly feeling weak in her knees and becoming dizzy and the possibility of passing out, which was a condition in the 1970s which was related to a heart condition which had been remedied at the time, I advised that I would need to write to her GP.

Her condition was at the time keeping her practically housebound and the lady used a stick to get around and would hold onto any nearby solid surface for fear of falling over.

As it happens, her GP had suggested Hypnotherapy which brought her to my Therapy Practise last August.

To begin with, progress was expectedly slow, but step by step through the successive steps of Hypnotherapy, Sanomentology , BWRT, Broadband for the Brain, Magic (Symbio Dynamics T.M) and the You Protocol, steady and consistent progress was made until – very recently, on Wednesday, my client advise me that she was able to walk a return journey of 0.7 miles each way from a local business back to her home locally!
My client did this on two separate occasions which took about thirty minutes each way.

This achievement has given her a real positive boost to her personal confidence on top of the confidence that I have witnessed session by session. My client is a very changed person from the person who came to see me.

As a therapist, there are potentially some lessons here for other therapists which might help. In my time as a therapist I have encountered some professional coaching voices who have openly advocated that clients can be in therapy for too long and that if the therapy has not been successful within six to twelve sessions, then A) its unlikely to be successful and B ) the Therapeutic approach is wrong and the implication is that the therapist is inadequately trained and needs to pay for further training. I disagree with that position for two reasons.

I have in my time since 2011, worked with certain very challenging conditions that were very successful and which were related to physical conditions rooted in a psychosomatic condition. Also I have worked very successfully with a few cases of very deep rooted psychological emotional issues related to self identity and core values. In all of those cases, the number of sessions were in excess of twelve sessions and in some situations 20. Those cases are certainly rare and untypical.

What I learned from those cases was that as long as my client and I could see positive changes, we should keep going. If we hit a brick wall, to try and work through it dismantling the wall bit by bit, as long as the client was happy to continue.

The most valuable lesson I learned long ago, is that no matter what other professionals thought and might openly publicly opinionate upon, take confidence in what you do and learn from your endeavours. Also it is not their business, you most likely have a supervisor, so discuss anything lie this with them in confidence.

Lastly when we understand that clients/patients heal at their own pace, we take personal bias and expectations out of the equation.

I was once told by a trainer, that after six sessions, if the problem wasn’t solved, move them on. Get them out of therapy! But, when we rush client, we are putting limiting barriers in place and you never know that if by taking whatever time it takes to get the result the client wants to achieve, you may just have just helped them changed their life!

Change takes whatever time it takes and just as an athlete or concert pianist does not arrive at the point of excellence without regular practice conditioning and reinforcing neural pathways, so any endeavour to change a pattern of thought and behaviour especially where there are barriers and in some case trauma, It just takes time, belief and engagement.

Whilst most of what we work with as therapists may be resolved in several sessions, there are some cases where patience, commitment, determination and persistence are rewarded. Not for us the therapist, but for our clients which is the whole point! 

Trevor Wales

Published : May 16, 2024