The Limits of Short-Term Therapy: Why 8 Sessions Often Isn’t Enough

You've probably been there. Six sessions in, just starting to trust your therapist, and they're already talking about "endings" and "consolidating your learning."

The NHS typically offers 6-8 sessions of CBT through Talking Therapies. For some people, for some problems, it helps. If you're dealing with a specific phobia or recent stress, those sessions might be exactly what you need.

But if your struggles go deeper - if they're woven through your earliest relationships, your sense of self, the way you've learned to exist in the world - then eight sessions isn't therapy. It's just the beginning of beginning.

The time problem

Your patterns didn't develop in eight weeks. The anxiety that keeps you scanning for danger, the depression that feels like home, the relationships that keep going wrong in exactly the same way - these took years to build.

The NHS knows this. The therapists delivering CBT know this. But the system is built around throughput, not depth. Around managing waiting lists, not managing complexity.

So you get worksheets about thought patterns when what you need is to understand why those patterns developed. You get breathing exercises when what you need is to understand what you're so afraid of breathing in.

When limits recreate the problem

Here's what's particularly difficult about session limits: they often recreate the exact dynamics that brought you to therapy.

If you struggle with abandonment, being told therapy will end regardless of your progress can feel like another rejection. If trust is hard for you, being processed through a standardised protocol confirms that you're not worth individual attention.

The very structure meant to help ends up reinforcing what hurts.

What actually helps

Real change happens slowly, in relationship. Not through techniques or homework, but through being seen and understood over time. Through having your defences met with curiosity rather than correction.

It happens when someone can hold your contradictions without rushing to resolve them. When you can bring the worst bits and find they don't destroy the connection. When patterns that once kept you safe can finally be understood and, gradually, updated.

This kind of work can't be rushed. Your psyche has its own timeline, and it rarely aligns with service delivery targets.

The evidence problem

The research supporting short-term therapy measures what's easy to measure: symptom scores, attendance rates, discharge statistics. Not whether you understand yourself better. Not whether your relationships have improved. Not whether you feel more authentic.

When the NHS says CBT is "evidence-based," they mean it reduces scores on depression questionnaires. They don't mean it helps you understand why you're depressed in the first place.

Who needs more

Short-term work can help with acute problems, specific fears, or recent life events. But if you're dealing with:

• Patterns that keep repeating despite your best efforts
• Relationships that always seem to go the same way
• A sense that something fundamental feels wrong
• Struggles that started before you had words for them

Then you need time. More time than the system wants to give you.

You need space to explore what's underneath the obvious symptoms. To understand why certain defences developed and what purpose they're still serving. To discover who you are when you're not constantly managing yourself.

What depth work offers

Longer-term therapy - whether psychodynamic, psychoanalytic, or other depth approaches - starts from a different premise. It assumes your symptoms make sense. That your patterns serve a purpose. That understanding matters as much as managing.

It offers consistency over time. The same person, week after week, getting to know the specific texture of your particular mind. Not processing you through a protocol, but responding to who you actually are.

This isn't self-indulgent. It's what complex problems actually require.

If you've tried short-term work

If you've been through NHS therapy and you're still searching, that's not failure. You're not "treatment-resistant" or unable to "engage with the process."

You might just need something the system couldn't offer: time, depth, and someone interested in understanding rather than just reducing symptoms.

The gap between what you needed and what you got isn't your fault.

What's actually possible

Imagine therapy where you're not counting down sessions. Where moving backwards sometimes is seen as information, not failure. Where your contradictions are welcome.

Imagine working with someone more interested in understanding your patterns than eliminating your symptoms. Who sees your struggles as meaningful rather than just problematic.

This exists. Not in eight sessions, but in the longer arc of sustained therapeutic work.

A different frame

You deserve more than learning to cope with patterns you don't understand. You deserve to know why certain things keep happening, why some feelings feel impossible, why you keep finding yourself in the same places despite trying so hard to change.

Eight sessions is what the system can offer. It's not necessarily what you need.

If you're ready for something deeper than symptom management - something that honours your complexity rather than rushing to resolve it - that's worth seeking. Even if you have to pay for it. Even if it takes longer than anyone wants it to.

Your struggles took time to develop. They deserve time to be understood.