By : Dr. Melisa Arias-Valenzuela, C. Psych.

One of the most common questions people ask when starting therapy is: How often should I go to therapy?

For most people, the answer is once a week, at least at the beginning. Weekly therapy provides enough consistency to build momentum, develop a strong therapeutic relationship, practise new skills, and respond to challenges as they arise.

However, there is no schedule that works for everyone. The right frequency depends on your symptoms, goals, treatment approach, financial circumstances, availability, and stage of therapy. Some people benefit from more intensive support, while others may be ready for biweekly or monthly appointments.

What is important is that therapy frequency be based on your clinical needs, not simply on dividing your insurance coverage evenly across the year.

The Short Answer: How Often Should You See a Therapist?

A general framework is:

• Weekly therapy: Often recommended when beginning treatment, experiencing significant distress, or working actively toward specific goals.
• Twice-weekly therapy: Sometimes helpful for more acute symptoms or structured treatments that benefit from greater intensity.
• Biweekly therapy: May be appropriate once progress is established, for lower-intensity concerns, or when finances and scheduling limit weekly attendance.
• Monthly therapy: Usually works best for maintenance, relapse prevention, or occasional check-ins after more active treatment.
• Booster sessions: Can help reinforce gains or address the early return of symptoms after regular therapy has ended.

These are general guidelines rather than firm rules. Your therapist should work with you to develop a schedule that considers both your treatment needs and the realities of your life.

Why Weekly Therapy Is Often Recommended at the Beginning

Therapy is more than having a helpful conversation once in a while. It is a process of identifying patterns, learning new skills, trying different responses, and reviewing what happens between appointments.

When too much time passes between early sessions, you may spend much of each appointment catching your therapist up on what has happened. It can become harder to maintain focus on treatment goals or build on the work from the previous session.

Weekly therapy can help you:

• Develop trust and a strong therapeutic relationship.
• Maintain continuity between sessions.
• Remember and practise new strategies.
• Identify patterns more clearly.
• Address barriers before they derail progress.
• Build momentum while motivation is high.
• Experience meaningful improvement sooner.

This does not mean that everyone needs weekly therapy indefinitely. It means that a more concentrated period of treatment at the beginning may allow you to establish a foundation before gradually reducing the frequency.

What Does the Research Say About Therapy Frequency?

Research increasingly suggests that how closely sessions are scheduled may matter, not only how many sessions someone ultimately receives.

In a naturalistic study of psychotherapy clients, more frequent sessions were associated with faster and greater improvement. The researchers found that clients attending therapy approximately weekly improved more quickly than those attending less often, even when the total number of sessions was considered. (Erekson, Lambert, and Eggett, 2015)

Another large outpatient study involving people receiving treatment for depression, anxiety disorders, and personality disorders found that lower session frequency at the beginning of treatment was associated with poorer outcomes and a greater likelihood of a chronic course. The researchers recommended beginning with at least one session per week during the first three months, while acknowledging that the study was observational and could not establish that frequency alone caused the difference. (Tiemens et al., 2019)

A randomized trial of 200 adults with depression compared once-weekly with twice-weekly cognitive behavioural therapy and interpersonal psychotherapy. After six months, participants assigned to twice-weekly sessions had greater reductions in depressive symptoms, were less likely to drop out, and responded to treatment sooner. Importantly, this finding applies specifically to structured treatments for depression and does not mean everyone needs therapy twice a week. (Bruijniks et al., 2020)

Overall, the evidence suggests that regular, closely spaced sessions can help many clients improve sooner, particularly during active treatment. It does not suggest that weekly therapy is always best or that more therapy automatically produces better results. Progress should be monitored and the treatment plan adjusted accordingly.

A Common Insurance Mistake: Stretching Sessions Across the Entire Year

Therapy can be expensive, and it makes sense to want to use your insurance coverage carefully. A common strategy I’ve observed among clients is to calculate how many sessions a benefits plan covers and distribute those appointments evenly across all 12 months.For example, someone with coverage for approximately 10 sessions might automatically schedule one appointment every five weeks so that the funding lasts until the end of the year.

Although understandable, this may not be the most effective way to use limited coverage, especially when you are beginning therapy with significant symptoms or a clear treatment goal.

You may technically attend therapy throughout the year, but the appointments can be spaced too far apart to create therapeutic momentum. Each session may feel like starting again rather than continuing a focused course of treatment.

In some cases, it may be more beneficial to front-load your available sessions:

• Attend weekly for an initial period.
• Review your progress with your therapist.
• Move to biweekly sessions as you become more stable and independent.
• Transition to monthly or occasional booster sessions when clinically appropriate.

For someone with a limited number of sessions, this could mean using several appointments close together at the beginning rather than spreading all of them evenly across the calendar. The precise schedule should be developed with the therapist.

The goal is not to use your coverage as quickly as possible. It is to use it in a way that gives treatment a reasonable opportunity to work.

What Can You Do?

People sometimes approach therapy as though every appointment must be preserved for a future emergency. But therapy can be more effective when it helps address a problem actively, before that problem becomes more entrenched.

A useful comparison is physiotherapy. If you were recovering from an injury, one appointment every six weeks might provide occasional guidance, but it would be difficult to assess your response, correct exercises, and build progressively from one week to the next. A focused period of regular treatment, followed by increasingly independent practice and occasional follow-ups, often makes more sense.

Psychotherapy can follow a similar rhythm:

Assessment and stabilization → active treatment → consolidation → maintenance

Your needs may change at each stage. Frequency should change with them.

When Might Biweekly Therapy Be Appropriate?

Going to therapy every two weeks may work well when:

• Your symptoms are mild or relatively stable.
• You have already established a relationship with your therapist.
• You are making steady progress and need more time to practise between sessions.
• You have strong supports and effective coping strategies.
• You are transitioning out of weekly treatment.
• Your treatment goals are reflective or developmental rather than urgent.
• Weekly therapy is not financially or practically accessible.

Biweekly therapy can still be valuable. The question is whether it provides enough continuity for your particular needs.

If progress repeatedly stalls, sessions are spent catching up, or you feel destabilized between appointments, it may be worth discussing whether a temporary increase in frequency would help.

Is Monthly Therapy Enough?

Monthly therapy is generally better suited to maintenance or booster care than to the beginning of active treatment.

It may be appropriate when you have already made meaningful progress and want to:

• Reinforce skills.
• Monitor for early signs of relapse.
• Navigate an occasional challenge.
• Maintain accountability.
• Reconnect with therapy during a transition.

Monthly appointments may be less effective when symptoms are severe, risk is elevated, significant behavioural change is needed, or a structured evidence-based treatment is being delivered.

When More Frequent Therapy May Be Needed

Weekly, or occasionally twice-weekly, sessions may be recommended when someone is experiencing:

• Significant depression or anxiety.
• An eating disorder or disordered eating.
• Trauma-related symptoms.
• Major functional impairment.
• A period of crisis or destabilization.
• Rapidly changing symptoms or elevated clinical risk.
• A major life transition requiring additional support.
• A structured treatment protocol that calls for greater frequency.

Some concerns also require a broader treatment team or a higher level of care. More frequent outpatient therapy is not a substitute for emergency services, medical monitoring, intensive outpatient treatment, or hospitalization when those services are needed.

What If I Cannot Afford Weekly Therapy?

Weekly therapy is not accessible to everyone, and financial limitations are real. A sustainable treatment plan is better than one that creates additional financial stress.

If weekly appointments are not feasible, you can ask your therapist about:

• Beginning weekly for a shorter period and then tapering.
• Working with a supervised practicum therapist who has a lower fee.
• Using extended health benefits from more than one plan, when available.
• Combining individual therapy with a therapy group.
• Choosing a structured, goal-focused treatment.
• Using evidence-based workbooks or between-session exercises.
• Planning periodic blocks of treatment rather than very infrequent sessions indefinitely.
• Scheduling booster sessions after completing active treatment.

A good therapist should be willing to discuss cost openly and collaboratively. Financial realities should be incorporated into treatment planning without judgment.

How Will I Know When to Reduce the Frequency?

You and your therapist might consider spacing sessions farther apart when:

• Your symptoms have meaningfully improved.
• You are functioning more consistently in daily life.
• You can use therapeutic skills without frequent prompting.
• You recover more effectively from setbacks.
• Your original goals have been met or substantially addressed.
• You feel ready to test your progress with more time between sessions.
• Standardized measures show sustained improvement.

Reducing frequency does not have to be permanent. You can return to more regular sessions if symptoms increase, circumstances change, or you begin working on a new goal.

So, How Often Should You Go to Therapy?

For many people beginning active psychotherapy, weekly sessions are a strong starting point. They support continuity, momentum, and earlier improvement. As treatment progresses, sessions can often be reduced to biweekly, monthly, or occasional boosters.

The best schedule is not necessarily the one that makes your insurance coverage last the longest. It is the one that provides enough intensity for therapy to be helpful while remaining financially and practically sustainable.

Rather than deciding based only on the calendar, talk with your therapist about:

• The severity and urgency of your concerns.
• The type of therapy being recommended.
• What the research suggests for your presentation.
• Your treatment goals.
• Your available coverage and budget.
• How progress will be measured.
• When frequency will be reviewed and adjusted.

Therapy frequency should be intentional, flexible, and responsive to how you are actually doing.

Looking for Therapy in Ottawa or Online Across Ontario?

At Uprise Psychology & Wellness, we work collaboratively with clients to develop treatment plans that reflect their needs, goals, and circumstances. This includes having transparent conversations about session frequency, insurance coverage, progress, and how to make therapy as focused and useful as possible.

If you are considering therapy, you can contact our team or book a complimentary 15-minute consultation and explore what level of support may be right for you.

This article provides general information and is not a substitute for individualized psychological or medical advice.