Positive mental health among college students is on the rise, according to the 2023-2024 Healthy Minds Study report. However, 78% of students expressed still needing help managing their emotions, though only about half (36%) received counseling or therapy in the last year.
Many factors can hinder the effectiveness of counseling, including the session duration, with many providers finding that shorter, 30-minute sessions do not allow for deep therapeutic work. According to an article published by the National Library of Medicine, a 50-minute psychotherapy session is standard practice for the treatment of psychiatric illness, and some evidence-based treatment models even recommend 90-minute sessions. Additionally, another study found that more therapy leads to better patient outcomes.
While briefer sessions may be used in integrative primary care settings to align with the “medical model” of treatment, this type of mental health treatment requires specific training and competencies to be effective. To date, there has not been any academic, peer-reviewed research supporting the efficacy of 30-minute telehealth treatment models. Additionally, briefer sessions are only appropriate for patients with less severe mental health issues. Effective, accessible, and equitable mental health care remains essential to student success. However, not all counseling sessions are created equal, particularly regarding session length.
The benefits of effective counseling
Counseling is critical for mental health support, offering patients a safe and unbiased space to explore their thoughts, emotions, and behaviors. By having the proper time with a trained professional, patients can gain insight into what they are thinking and how they are thinking. Rooted in evidence-based practices and backed by scientific evidence, therapy is based on the “weekly therapy hour,” and “weekly hour-long therapy sessions are among numerous treatment structures that can help patients achieve clinical gains.” This time helps patients make meaningful changes, often leading to better emotional regulation, improved behaviors, and healthier relationships. Here’s how counseling can benefit a patient.
Treat mental illness
Research shows that counseling that employs evidence-based treatments is highly effective in treating conditions like depression, anxiety, and family conflict. Specifically, Cognitive Behavioral Therapy (CBT) has proven to be a successful approach for managing both depression and anxiety, often providing better outcomes than medication alone.
Improve physical health
The connection between mental and physical health is real, and improvements in emotional well-being often lead to better physical health. This fact can also reduce overall healthcare costs for patients. For example, one study found that individuals with chronic physical conditions who received psychological treatment saw a $10 reduction in medical expenses for every $1 spent.
Build life skills
Counseling teaches critical life skills, including mindfulness, communication, and emotional regulation. Techniques like CBT help patients reframe negative thought patterns, improving mental well-being over time.
Foster resilience
Patients can build self-esteem, coping skills, and emotional flexibility through effective counseling. Techniques like stress inoculation therapy, a form of CBT, enhance resilience and provide long-term benefits in managing stress and anxiety.
Key components of a counseling session
A counseling session provides a supportive environment where individuals can explore their mental health, develop coping skills, and work toward their goals. Each session follows a structured format to ensure the patient and provider make the most of the time together.
1. Introduction and intake
Every session begins with an intake evaluation followed by an assessment of any immediate risk or safety concerns. These opening few minutes also enable the provider to check in on the patient’s current situation, creating a baseline for the session.
2. Information gathering
This next phase allows the patient to share their most pressing concerns, giving insight into their thoughts and emotions. The provider can begin offering their input, helping to guide the conversation toward therapeutic goals.
3. Exploration and processing
After setting up the situation and need, a provider can dedicate most of the session to skill-building and working through issues. The patient and provider collaborate to identify strengths, set goals, and, if necessary, discuss medication management to support mental health.
4. Conclusion
Near the end of the session, the provider will discuss the homework recommended to encourage continued growth outside the session. They’ll summarize the progress made and key points discussed.
5. Next steps
After the conversation, the provider documents the care plan and makes follow-up notes for the patient, ensuring continuity and personalized care for future sessions.
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The limitations of a 30-minute counseling session
Short, 30-minute counseling sessions often limit the depth and staying power of work that can occur. While this session duration may seem efficient, it has significant drawbacks that impact both the therapeutic process and patient outcomes. These are the drawbacks of a 30-minute counseling session.
Lack of a patient-provider relationship
Trust is the cornerstone of therapy, and a strong relationship between a patient and counselor is crucial. However, developing this relationship takes time. In a 30-minute session, the counselor must rush through an intake and assessment to get to the patient’s current concerns. This limitation doesn’t offer time to build rapport, making patients less likely to open up and slowing progress toward goals.
No exploration and processing
Therapy can bring up intense emotions, and patients need adequate time to explore and process. A 30-minute session cuts this short, leaving patients possibly feeling unresolved, overwhelmed, and stuck rather than moving forward.
Superficial insights
Shorter sessions allow providers time to prioritize only immediate concerns, ignoring deeper issues or patterns of behavior. As a result, patients walk away from the session with short-term answers rather than long-term solutions.
Inadequate documentation and care planning
For providers, shorter sessions mean less time for critical administrative tasks like documenting care notes, updating treatment plans, and managing medications. Without adequate time for these tasks, providers must rush through these tasks, resulting in incomplete or inaccurate records and a negative impact on continuity of care and future sessions.
Incomplete skill-building
One goal of counseling is to teach patients tools they can use in everyday life. However, a shorter session leaves little time to introduce new coping strategies or psycho-educational material and explore, practice, and review. This lack of reinforcement reduces the long-term effectiveness of counseling.
So, what’s the result of a 30-minute counseling session? While shorter sessions can be effective in some situations, patients often feel unheard, and providers don’t have time to properly document care plans and next steps. This hurried pace undermines the therapeutic relationship and diminishes the overall quality of care, leading to poor outcomes.
“Doing shorter sessions, I feel like it’s a disservice to the student. We need 50 to 60 minutes to be able to identify, explore, and then go to the working stage of what we can do to potentially fix it or make it a little bit better.”
Jillian Denman
Director of the Student Advocacy Center and Counseling
San Antonio College
The benefits of a 60-minute counseling session
By comparison, a 50-to-60-minute session provides a fuller, more complete experience for both the patient and provider. Higher education leaders like Jillian Denman, the director of the Student Advocacy Center and Counseling at San Antonio College, agree that more time is beneficial.
“It’s important that a student has a good 50 to 60 minutes per session to have the time to explore the situations or the problem that brought them to counseling,” said Denman.
More time enables a deeper therapeutic process that enhances patient outcomes. Other benefits include:
A strong patient-provider relationship
A full hour allows providers and patients to develop a meaningful rapport. Building this trust is essential for effective counseling, as patients are more likely to share vulnerable thoughts and feelings when they feel safe and supported. “It takes [some students] a little bit longer to open up, so you need the time to develop rapport with them to ask them the questions for them to talk about their thoughts and feelings,” said Denman.
A comprehensive exploration of issues
With more time, providers can gather all the necessary information to fully understand a patient’s issue without feeling up against the clock. This time can lead to more insights and more progress for the patient.
The opportunity to process
In longer sessions, patients have the opportunity to process their emotions fully. This extra time allows them to manage their emotions after discussing complex topics, providing a chance to reflect during the session.
Focused skill-building and goal-setting
More time in a session empowers patients to engage with new skills, such as mindfulness techniques or cognitive-behavioral exercises, and discuss goals for how to apply them outside of therapy. Implementing and reinforcing these skills can lead to long-term improvements in mental health.
Thorough documentation and care planning
For providers, a “therapeutic hour” means 50 minutes for the session and 10 minutes to accurately document patient progress, update treatment plans, and manage necessary medications. With time to properly document the session, providers ensure a higher quality of care for the patient.
What’s the impact of allotting 60 minutes for a counseling session? Longer sessions foster a stronger patient-provider relationship, create more opportunities for skill-building and insight, and lead to more tailored and thoughtful care plans. Patients feel heard, understood, and supported in their journey toward mental health, making them more likely to reach their treatment goals and achieve better mental health outcomes.
How counseling session duration impacts your campus
The length of a counseling session is more than just a scheduling choice—it directly impacts the quality of care. While shorter, 30-minute sessions may offer convenience in some situations, they often fail to provide the time necessary for meaningful therapeutic progress.
Schools that partner with TimelyCare have the opportunity to expand campus mental health resources, with options for shorter, on-demand mental health support and scheduled counseling sessions allotted for 60 minutes. These longer sessions allow for deeper relationship-building, more thorough exploration of issues, and more comprehensive care planning.
Contact TimelyCare to learn how investing in a comprehensive approach to mental health resources enables patients and providers to collaborate toward better mental health outcomes.
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