Insurance, social media, and late capitalism shaping expectations of change with Travis Heath

In this Therapist Confidential short, Travis Heath tackles one of the most common—and most loaded—questions clients ask at the start of therapy: “How long is this supposed to take?” Travis breaks down the tension between brief, structured, goal-oriented therapy and longer-term work that focuses on patterns across time—attachment, relationship dynamics, meaning, and identity. He also names the forces that shape our expectations (insurance, social media, and late capitalism’s demand for measurable outcomes) and why the “right” length of therapy isn’t a rule—it’s a fit. Using real-world examples (panic while driving vs. repeating emotionally unavailable relationships), Travis argues that therapy length should match the depth of change someone is seeking: symptom relief, skill-building, support through a season of life, or deeper repatterning. He also highlights something we rarely name: therapist style and fit can influence how quickly change happens, and both clients and clinicians can carry quiet shame—whether they practice brief work or stay in therapy longer. This episode offers practical questions to ask—so decisions about staying or leaving are guided less by ideology and more by what’s actually useful.