I’ve been sitting with something heavy this week. A colleague shared an article about VA mental health providers being pressured to shorten therapy sessions, and I haven’t been able to shake the knot in my stomach. Maybe you’ve felt it too – that particular ache when you know someone who needs help might not get enough of it.
I remember Sarah (not her real name), a veteran who first walked into my office seven years ago. She’d been to three therapists before me, each bound by session limits that felt like trying to defuse a bomb with a timer counting down. “I just get to the point where I can breathe again,” she told me, “and then they tell me my sessions are up.” The tremor in her voice that day still echoes in my mind.
What breaks my heart – and likely yours – is that we know better. We know that trauma doesn’t resolve itself in six sessions. Depression doesn’t lift because a treatment manual says it should. Anxiety doesn’t check the calendar before deciding to ease its grip.
The language of “evidence-based best practices” can feel so clean and reassuring, can’t it? Like there’s a formula we can follow, a recipe for wellness. And yes, research matters deeply. I’ve spent countless hours studying it, integrating it into my practice. But evidence-based doesn’t mean one-size-fits-all. It never has.
Here’s what two decades of sitting with people in their darkest moments has shown me: healing happens in the space between what the research says and what the human in front of you needs. It happens when we honor both the science and the sacred individuality of each person’s journey.
I think about Marcus, a Marine who needed eighteen months of weekly sessions before he could talk about the night that changed everything. Eighteen months. By session six, we’d barely scratched the surface. By session twelve, he was just beginning to trust that I wouldn’t disappear. The real work – the transformative, life-saving work – didn’t begin until month eight.
Would shorter sessions have been “evidence-based”? Perhaps, according to some manual. Would they have saved his life? I have my doubts.
This isn’t about therapists wanting to hold onto clients longer than necessary. Every ethical practitioner I know celebrates when someone is ready to fly on their own. We live for those moments when a client looks up and says, “I think I’ve got this now.” But forcing that moment? Rushing toward it because of administrative pressure? That’s not healing. That’s abandonment dressed up in professional language.
If you’re reading this and feeling that familiar tightness in your chest – maybe you’ve been told your sessions need to end before you’re ready, or you’re watching someone you love struggle to get the help they need – I want you to know something: your instincts are right. That voice inside saying “this isn’t enough” isn’t being difficult or demanding. It’s being truthful.
So what do we do with this truth? How do we navigate systems that seem designed to minimize the very thing they claim to provide?
First, we name it. We say out loud, “This timeline doesn’t feel right for me.” We give ourselves permission to advocate for what we need, even when – especially when – the system pushes back.
Second, we get creative. Maybe that means finding support groups to supplement limited therapy sessions. Perhaps it means seeking providers who operate outside the system, if that’s financially feasible. Maybe it means learning to be radically honest with your therapist about what you need, even if it makes you uncomfortable.
Third, we remember that healing doesn’t only happen in therapy offices. It happens in midnight phone calls to friends who get it. In journals filled with words no one else will read. In moments of unexpected grace when a stranger’s kindness reminds us we’re not alone.
I’ve watched clients build their own healing networks when systems failed them. They’ve created support that wouldn’t fit in any treatment manual but saved their lives nonetheless. They’ve proven that while professional help matters immensely, it’s not the only path to wholeness.
But here’s what I need you to hear most clearly: needing more time doesn’t make you broken. Requiring more sessions doesn’t mean you’re not trying hard enough. Healing on your own timeline – not the one dictated by policy or insurance – is not a failure. It’s wisdom.
The veterans in that article, the ones whose sessions are being curtailed? They’ve already given so much. They’ve earned the right to receive care that honors the full scope of their experiences, not care that’s been trimmed to fit a budget or a bureaucratic ideal.
If you’re one of them, or if you love one of them, I want you to know that therapists across this country are fighting for you. We see you. We believe you deserve better. And while we work to change these systems, we’ll keep showing up in whatever ways we can.
Sometimes I wonder what would happen if the people making these policies had to sit where I sit. If they had to look into the eyes of someone who’s just beginning to believe they might survive, only to tell them their time is up. I think – no, I know – those policies would change overnight.
Until then, we do what humans have always done: we take care of each other. We refuse to let efficiency metrics define the pace of our healing. We remember that every person’s journey deserves respect, time, and witness.
Your story matters. Your timeline matters. And anyone who tells you otherwise? They haven’t earned the right to that opinion.
So today, wherever you are in your healing journey, I’m asking you to trust yourself. Trust the part of you that knows what you need. Trust the voice saying “not yet” when the world says “hurry up.” Trust that your healing is worth fighting for, even when the fight feels exhausting.
Because it is. You are. Always.
