Short-Term vs Long-Term Counselling: How to Choose What’s Right for You

Choosing Between Short, Medium, or Long-Term Counselling at Acorn Therapy

At Acorn Therapy, I offer a flexible approach to counselling—providing short-, medium-, and long-term support tailored to your needs. The right duration depends on several personal factors, including the nature, depth, and impact of the issue you’re facing.

What to Consider When Deciding on Counselling Length

Before starting therapy, it’s worth reflecting on the following:

  • How long have you been struggling with this issue?

  • Is it connected to long-standing habits, negative thought patterns, or difficult past experiences?

  • How many areas of your life are affected—such as your work, relationships, or health?

These questions can help determine whether shorter or longer-term counselling might be more beneficial.

When is Short-Term Counselling Appropriate?

Short-term counselling (typically 6 to 12 sessions) may be suitable if you’re looking for support with specific challenges such as:

  • Stress management

  • Workplace conflict

  • Communication issues

  • Parenting concerns

  • Mild relationship difficulties

This focused approach allows us to build a strong therapeutic relationship and work towards meaningful change in a shorter time frame.

When is Longer-Term Counselling Needed?

Longer-term counselling is often more appropriate when dealing with deeper, more complex issues such as:

  • Trauma or abuse (past or ongoing)

  • Long-term mental health concerns

  • Chronic emotional or relational patterns

  • Issues tied to early life experiences

In these cases, extended support offers the space and time needed to unpack and process complex emotions, build resilience, and create lasting change.

Short Term Counselling

Short-term therapy typically involves 12 sessions or fewer. Some of my clients choose short-term counselling to explore a specific issue that’s weighing on them. This can be particularly helpful for individuals in leadership roles or positions of responsibility, where discussing personal challenges with colleagues or employees may not feel appropriate.

Short-term therapy can also support clients facing significant life decisions that are not necessarily rooted in deeper childhood wounds—such as whether to end a relationship, start a family, or pursue a new career path. It offers a focused, confidential space to gain clarity and make thoughtful choices.

Medium Term Counselling

A significant part of my work involves supporting individuals seeking counselling over a longer period — often as a couple of months, and sometimes more. This can be especially helpful when unhelpful patterns or habits have developed that negatively affect a person’s quality of life. For example, someone may be struggling with low self-esteem following the end of a relationship, the lasting effects of school or workplace bullying, the challenges of parenting, complex family dynamics, health concerns, or exploring aspects of their identity such as sexuality, culture, or race.

Long Term Counselling and therapy in Somerset

Some clients benefit most from long-term or ongoing counselling, particularly those with deep-seated childhood wounds. These wounds may stem from various forms of abuse, neglect, or growing up with a parent experiencing mental health challenges—such as personality disorders (including Narcissistic, Histrionic, or Borderline Personality Disorder), schizophrenia, PTSD, or other complex conditions. The lasting impact of these experiences can deeply affect a person’s sense of self and emotional well-being.

Chronic emotional neglect—often passed down through intergenerational patterns—can erode self-esteem and self-worth just as powerfully as more overt forms of abuse. Many clients are surprised by how significantly this kind of “invisible” harm has shaped their lives.

For those who have experienced trauma or abuse, particularly in childhood, learning to trust again can be incredibly difficult. Establishing a sense of safety in the therapy room may take time, and it’s crucial not to rush this process. Moving too quickly risks retraumatization. Competence, sensitivity, and patience are essential.

Longer-term therapy is often needed because the behaviours, thought patterns, and emotional responses that clients developed were once essential for survival. Changing these deeply rooted adaptations requires time, courage, and honest reflection from both client and therapist. This process involves exploring and transforming long-held patterns that no longer serve the client.

A key part of this work is building a genuine, trusting, and non-judgemental therapeutic relationship. This approach is often described as psychodynamic counselling, where the therapeutic alliance becomes a central tool for healing. Therapists, often described as “wounded healers,” must also engage in deep self-reflection. Without this, unresolved personal issues can inadvertently play out in the therapy room—a factor that underlies many instances of therapist misconduct.

Counselling for Maintenance

Some clients seek ongoing, long-term support and counselling, viewing it as a form of “maintenance” — similar to how some people regularly schedule massages or chiropractor appointments. Certain careers and work environments can particularly benefit from consistent therapeutic support. For example, just as I have fortnightly clinical supervision to maintain my own well-being, many clients in high-pressure roles find ongoing counselling valuable. This is especially true for professionals such as teachers, veterinary doctors, nurses, family law solicitors, personal trainers, and others whose jobs involve regularly supporting the emotional needs of others.

No matter the duration of therapy you choose, I honour the uniqueness of each client and am committed to working in your best interests. 

Often, people begin open-ended therapy and conclude after a few weeks once they feel their concerns have been addressed. Conversely, it’s common for individuals who start short-term therapy with a specific goal to later decide to extend the process to explore deeper issues.