When parents call me for the first time, two practical questions nearly always come up before we hang up. How often will my child need to come? And how long will this take?
They are fair questions. You are fitting therapy around school, work, siblings and budgets, and you want to know what you are signing up for. I can’t give you a fixed number of sessions, because no honest therapist can. But I can explain how frequency usually works, why the early weeks matter so much for children, and how we decide together when to space things out and when to stop.
How often do most children see a therapist?
For most children, therapy starts with one session a week. That matches what you will read from trusted parent resources. Nemours KidsHealth, for example, says that most of the time a therapist will want to meet with a child once a week for a few months. The Association for Play Therapy describes play therapy sessions as usually held weekly.
Weekly is a starting point, not a rule. Some children need a different rhythm, and outpatient therapy can also happen less often, depending on the kind of help and the concern (Hoet, 2024). But in my experience, weekly is where most children begin, and there are good reasons for that.
Why does weekly consistency matter so much for children?
Children don’t think about therapy the way adults do. A seven-year-old won’t arrive with a list of things to discuss from the past month. What helps is a steady, predictable rhythm: the same room, the same person, the same day of the week.
In my playroom, that predictability does a lot of quiet work. A child who is anxious or unsettled learns that this space is safe, that I will be there, and that what they built in the sand tray last week can be picked up again this week. Trust grows through repetition. If sessions are two or three weeks apart, a young child often has to “warm up” all over again, and we lose some of the momentum.
There is some research on frequency, although most of it is with adults, not children. One large study of university counseling clients compared weekly sessions with sessions every two weeks. It found that people seen weekly recovered more quickly, while by the end of therapy the amount of recovery was similar between the two groups; the fortnightly group simply needed more sessions to get there (Erekson, Lambert and Eggett, 2015). I share that carefully, because adults in a university clinic are not the same as a five-year-old in a playroom. Still, it fits what I see: a steady weekly start tends to help things move.
How long does child therapy take?
This is the question I most wish I could answer with a number. The truthful answer is that it depends.
The American Academy of Child and Adolescent Psychiatry puts it simply: the length of psychotherapy depends on the complexity and severity of problems. KidsHealth adds that how long therapy lasts depends on the goals you and your child’s therapist set, and that it takes many visits for a child to learn new skills and keep them up.
You may come across a figure from the Association for Play Therapy, which states that research suggests an average of about 20 play therapy sessions for the typical child referred for treatment. I find that useful as a rough sense of scale, but please read it as an average, not a promise. Some children need fewer sessions. Some need more. A child working through a single worry is in a different place from a child carrying several big changes at once.
Things that often affect the length of therapy include:
- what brought you in, and how long it has been going on
- what else is happening in your child’s life (a move, a new sibling, a separation, a loss)
- how often sessions actually happen, including gaps for illness and holidays
- how involved you are between sessions
How involved will you be, and how is progress reviewed?
Very involved, if I can help it. I start by meeting you on your own before I meet your child, so I can hear your child’s history and your concerns without your child listening in. From there, I keep you informed about the themes I am seeing and how things are going, and I offer ideas you can use at home.
This isn’t just my preference. The Association for Play Therapy notes that positive treatment effects were greatest when a parent was actively involved in the child’s treatment. The CDC also says it is common for therapy with young children to include parents or caregivers directly, and that with older children, parents’ support of the therapy still matters.
Along the way, we check in on progress together. I will ask you what you are noticing at home and at school. Is bedtime calmer? Are the meltdowns shorter? Is your teen talking to you a little more? We look at the goals we set at the start and ask honestly whether they are being met, whether they need to change, and whether the plan still fits.
Good questions to bring to those conversations, many of them suggested by AACAP, include:
- How soon might we expect to see some changes?
- How will I be kept informed about progress?
- What can I do at home to help?
- How will we know when my child is ready to finish?
When do sessions get spaced out?
When things are going well, I often suggest moving from weekly to every other week, and sometimes to monthly check-ins after that. We do this together, and usually once your child has shown some steadier progress for a while, rather than at the first good week.
Spacing out gives your child a chance to practice the skills they have learned in real life, with a safety net still in place. If a hard patch comes along, and it sometimes does, we can move back to weekly for a while. That isn’t a failure. Children’s lives are full of change, and it’s normal for the need for support to rise and fall.
What does ending therapy well look like?
Ending is part of the therapy, especially for children. A child who has built a trusting relationship with me deserves a proper goodbye, not a sudden stop.
When we agree that your child is ready, I like to plan the ending over a few sessions. We talk about it ahead of time so your child knows what’s coming. We look back at what has changed, and I help your child notice what they can now do for themselves. For younger children, that might happen through play; for teens, it’s usually a conversation.
I also let families know that the door stays open. If something new comes up later, a child who has had a good experience of therapy is often more willing to come back.
What about cost and insurance?
Frequency naturally affects cost, and I would rather you ask about it early than worry quietly. I accept the Oregon Health Plan through several CCOs, as well as some private insurance plans. You can find the details on my insurance and fees page, and I’m happy to talk it through with you on the phone.
Talk it through with me
If you are wondering whether your child needs support, and what a realistic rhythm of sessions might look like for your family, I’m glad to talk it through. I work with children and teens in King City, a few minutes from central Tigard. You can read more about my child and teen therapy and how I use play therapy with younger children. For a free phone consultation, call me at 503-495-5072 or send me a message.
Sources
- American Academy of Child and Adolescent Psychiatry. Psychotherapy for Children and Adolescents: Definition. Facts for Families No. 53, updated February 2017. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/What-Is-Psychotherapy-For-Children-And-Adolescents-053.aspx
- Nemours KidsHealth. Taking Your Child to a Therapist (for Parents). Reviewed by Colleen C. Cullinan, PhD, March 2018. https://kidshealth.org/en/parents/finding-therapist.html
- Association for Play Therapy. Play Therapy Makes a Difference. https://www.a4pt.org/page/PTMakesADifference
- Society for the Advancement of Psychotherapy. Session Frequency and Psychotherapy Outcome in a Naturalistic Setting (summary of Erekson, D. M., Lambert, M. J., & Eggett, D. L., 2015, “The relationship between session frequency and psychotherapy outcome in a naturalistic setting,” Journal of Consulting and Clinical Psychology, 83(6), 1097–1107). https://societyforpsychotherapy.org/session-frequency-psychotherapy-outcome-naturalistic-setting/
- Hoet, A. (2024). What to Expect at Mental Health Therapy. The Kids Mental Health Foundation. https://www.kidsmentalhealthfoundation.org/mental-health-resources/finding-help/counseling-expectations
- Centers for Disease Control and Prevention. Treating Children’s Mental Health with Therapy. Updated May 12, 2026. https://www.cdc.gov/children-mental-health/treatment/index.html