How long are therapy sessions? What to expect for each type of therapy

How Long Are Therapy Sessions on Average?

Therapy sessions typically last 50 to 60 minutes. Keep in mind this number is an average, meaning sessions can be shorter or longer depending on insurance coverage, a therapist’s approach, and your unique needs.

“A therapist should meet you where you’re at,” explains Christopher Pollock, LMFT, a family and marriage therapist in Southern California. “Some clients benefit from 30-minute sessions while others require 90 minutes or more.”

Typical Session Length by Type of Therapy

The type of session also influences the length. Couples, family, and group therapy sessions are often longer since there are more voices to be heard. Medication management sessions, on the other hand, are often the shortest since the purpose is to check if medication is working and adjust the dosage when necessary.

Why Are Therapy Sessions Usually Around an Hour?

A little under an hour is the sweet spot for talk therapy; it provides enough time to explore issues without overwhelm. More practically, this length is also covered by most insurance providers, says Jami Dumler, LCSW, regional clinical director at Thriveworks, who adds that Thriveworks therapists usually stick to 53- to 55-minute sessions.

“By providing a 53- to 55-minute session, we’re able to dive in on treatment goals and make great progress while also allowing therapists to remain on time for their next session and to complete necessary documentation for insurance coverage of the visit,” Dumler explains.

What Does the First Session Look Like?

That first session is often a get-to-know-you (minus the cringy icebreakers) and may run a bit longer—often 60 to 90 minutes. “For your very first therapy session, the provider aims to establish a basic introduction of therapy services, gather critical information to make an informed recommendation, and conceptualize a collaborative, individualized treatment plan to meet your desired goals,” Dumler says.

She adds that first sessions often include a biopsychosocial assessment, a series of questions a therapist asks to establish your strengths, needs, support system, and therapy goals.

Common questions during a biopsychosocial assessment:

• What brings you to therapy right now?
• Have you been in therapy before? If so, what was helpful or unhelpful?
• What are your current symptoms or concerns?
• How are your relationships with family, friends, or partners?
• What does your support system look like?
• Are you currently taking any medications?
• How would you describe your sleep, appetite, and energy levels?
• What are your goals for therapy?
• Have you experienced any significant life events or trauma?
• What coping strategies do you currently use?
• For children or teens: Why do you think your parents wanted you to try therapy?

By the end of that session, you and your therapist should both feel hopeful and confident about your plan moving forward, ideally scheduling another session for one or two weeks out.

Real Examples of How 45 to 60 Minutes Gets Used

In ongoing sessions, the structure typically looks like this:

First 5 to 10 minutes: Checking in about your week, settling into the space, and following up on any homework or previous discussions. Since therapists bill by the hour, those 5- to 10-minute check-ins may feel like “wasted time,” but they’re actually important for both you and your therapist to settle into the session.

“For many clients, especially those with trauma or anxiety, jumping straight into heavy content can feel overwhelming. Those early minutes create a soft landing and signal, ‘You’re safe here,’” says Courtney Shrum, LMHC, a licensed therapist in Washington. “Sometimes what seems like small talk ends up being a breadcrumb that leads us straight to the heart of the work.”

Next 40 to 45 minutes: Once you’ve settled into the space, you and your therapist dive into the core work: exploring what’s on your mind, developing coping strategies, and planning next steps. “Follow-up sessions are often more free-flowing than the intake and would entail jumping into your treatment plan,” Dumler says.

Examples of what specific sessions may cover:

• Learning a new coping skill if suffering from anger management issues
• Releasing a challenging memory from childhood
• Addressing anxiety flare-ups and where they come from
• Having a breakthrough on how your OCD works
• Developing a proactive plan for when a depressive episode hits

There may not be a huge breakthrough or skill learned in every session. “Therapy is not about how many insights you can squeeze into 50 minutes,” Shrum says. “Some sessions are filled with big breakthroughs, others are quiet and steady. Both are valuable.”

No matter where a session leads you, remember that you are an active participant, not a bystander. The stereotypical image of a patient lying on a couch while a therapist writes on a clipboard is more fiction than fact. “We encourage clients to really own their treatment,” Dumler says. “Collaborating with your therapist ensures you’re getting the most out of your visits.”

“Some sessions are filled with big breakthroughs, others are quiet and steady. Both are valuable.”

What If You Need More (or Less) Time?

If you need more time: A therapist may be able to extend a session if needed, especially for trauma work or crisis support. They can also provide activities to complete on your own to continue exploring the issue at hand. But this can only happen if your provider knows you need more time or space to explore a certain topic.

“If someone feels rushed or stretched too thin in their current format, it’s worth bringing that up,” Shrum says.

If sessions feel too long: Communicating this is key so a therapist can adjust the length or frequency to better suit your needs.

Remember: Sessions aren’t a quick fix. It takes time for therapy to work. “Think about any relationship that you’ve ever had in your life. The best and strongest relationships are the ones that grow naturally and with balance and ease,” Pollock says. “When we force the process and don’t allow for the pacing to develop naturally, it interrupts the natural cycle of therapy.”

Can I Contact My Therapist Between Sessions?

Yes, most therapists offer a way for you to reach out between sessions.

Maybe it’s Sunday and you just had a big fight with a family member, but your next session isn’t until Thursday. Or maybe you’re on vacation when a panic attack hits. Stress, anxiety, depression, and other mental health concerns aren’t confined within sessions. They impact us 24/7, and therapists understand that. That’s why most offer communication between sessions, often via a virtual platform, though what this looks like varies by therapist and therapeutic relationship.

“This is unique to each and every therapeutic relationship, therapist and client. There is no hard-and-fast answer,” Pollock says. “The key here is communication of boundaries at the onset of treatment, as well as having a continued dialogue with the client regarding their needs.”

For Shrum, her communication boundaries often look like encouraging clients to share anything urgent or to flag anything to work on in the next session, though she notes therapy isn’t 24/7 crisis support. “I also remind clients that sometimes the most powerful growth happens when they sit with something, journal on it, or notice how they want to respond,” she adds.

The Bottom Line

Therapy sessions typically last 53 to 55 minutes, though they can be longer or shorter depending on the treatment type, your needs, and the therapist’s approach. When it comes to making real progress, however, session length doesn’t matter as much as feeling comfortable with your therapist and the pacing of treatment.

Frequently Asked Questions

What if I’m not “ready” when time’s up?

Voice that concern to your therapist. They can sometimes adjust the session length or provide homework that allows you to work through an end-of-session breakthrough or nagging concern. Keep in mind, however, that extending a session may mean an extra charge, though a therapist will be upfront about the financials.

Do therapists actually watch the clock?

No, therapists are trained to track time without watching the clock or ending sessions abruptly. We’ve all seen in TV or movies when someone is crying in minute 49 of a 50-minute therapy session, only for the therapist to kick them out without remorse. This sort of behavior doesn’t happen in real life. If you are anxious about timing, bring any concerns up with your therapist who can address them and ensure that session pacing suits your individual needs.

What happens if you’re having a crisis—do sessions run over?

Yes, if you’re having a crisis, a session might run over. Many therapists schedule some wiggle room around sessions, in part to make sure they have time to address any crises. Therapists may also provide you with take-home activities to continue the work after leaving their (virtual or physical) office.

Do I have to pay for the full session if I leave early?

Generally, yes. If you leave a therapy session early, you typically have to pay the full cost. To learn if this is the case, check a therapy practice’s cancellation policy. This policy should detail how much notice is required to cancel, what happens if you leave early, and more.