As a therapist in private practice, I'm asked regularly how long therapy is going to take, and how often a client will have to come to sessions. People still see a trope about therapy on tv showing stereotypical psychoanalysis where people are expected to come several times a week and see the same analyst for years at a time. I read an essay recently written by a real psychoanalytic psychiatrist about refusing to take on new clients if they already have a psychiatrist- the argument being that since it is such an in-demand specialty, that patients should just work out their issues with their current shrink and be happy they are getting care at all. This essay also reinforces the idea that therapy means working for years and years with the same therapist.
But the field of mental health has come a long way since Freud, and psychoanalytic psychiatrists are not the only clinicians out there. In many states, other behavioral health clinicians, including mental health counselors (LMHC's) and marriage and family therapists (LMFT's). These master-level clinicians are able to treat clients, submit to insurance, and in the case of cognitive behavioral therapists, are providing a mental health treatment style that is as effective as medication for treating anxiety, depression, ADD / ADHD, sexual dysfunctions and more. And here's a little known secret- insurance panels do not cover years pf psychoanalysis because cognitive behavioral therapy (also known as CBT) is effective in a relatively short amount of time.
Not making progress with your therapist? Change and insight probably are not going to happen over night, but if your therapist is not able to show the progress you've made, or set some tangible goals to reach, it might be time to start looking for someone new. Feedback Informed Treatment is one tool that counselors are using to measure the work you're doing in your psychotherapy sessions. When you get to guide the session by measuring how things are going in your life, and how things are going in the session, then talking to a therapist becomes actual therapy and not just that stream of consciousness from days of psychoanalytic yore.
I liken therapy to learning a language. If you're learning a new language, you can not expect to be fluent overnight. By learning the basics in therapy, and practicing at home, then really using the language in your day to day life, you'll be on your way to fluency. But even when you're fluent in a new language, that does not mean there is not more to learn. How does that translate to therapy? You may start with one therapist and learn some things – but by all means – continue with another therapist when you need some booster sessions and build on that! Therapy can be evidence-based but still is not so simple as – you have this diagnosis, and now you're cured. But the benefits of therapy do not have to take years on the couch to achieve!