Does everyone get these sudden jumps in progress?

No. In the research, sudden gains were common but not universal. More than half of treatment responders had one, while others improved in a slower, steadier way. Both paths can end in a good place, so not having a jump is not a bad sign.

If progress comes in bursts, are the sessions in between wasted?

The evidence points the other way. Because a large share of total improvement can land in a single stretch between two sessions, the gaps are where much of the change shows up. The quiet work between appointments appears to be part of what sets those shifts up.

Is a sudden jump in how I feel something that lasts?

In the meta-analysis, people who had a sudden gain were still doing better than others at follow-up, with a moderate effect size of 0.56. So these shifts were not just a good day. On average they held up over time, though that is a group pattern, not a rule for any one person.

The Wait

Why does progress feel slower between sessions?

Short answer

Often because change in therapy is not smooth. It tends to come in jumps, not a steady climb. A large review found that a big share of a person's total improvement can arrive in a single stretch between two sessions. So the flat weeks can feel like nothing, even when the overall path is upward.

The research

Aderka, I. M., Nickerson, A., Bøe, H. J., and Hofmann, S. G. (2012). Sudden gains during psychological treatments of anxiety and depression: A meta-analysis. Journal of Consulting and Clinical Psychology, volume 80, pages 93 to 101.

Sample 1,104 people across 16 treatment studies

Published 2012

Journal Journal of Consulting and Clinical Psychology

Idan Aderka, Angela Nickerson, Hans Jakob Bøe, and Stefan Hofmann pooled 16 studies covering 1,104 people who were in psychological treatment for depression or an anxiety disorder. They focused on a pattern called a sudden gain, which is a large drop in symptoms across a single gap between two sessions. In the original work that named the pattern, these jumps averaged about a quarter of a person's symptoms and made up roughly half of their total improvement, and this review set out to test how much that held across many studies at once. People who had a sudden gain ended treatment in a better place than people who did not, with a moderate effect size of 0.62, and they were still doing better at follow-up, with an effect size of 0.56. The plain read of the numbers is that a lot of real change does not trickle in evenly. It lands in bursts, and long flat stretches sit in between.

Read the paper

What does this mean for you?

If you feel like nothing is moving between sessions, this research offers a different way to see it. Progress in therapy often does not arrive on a schedule. For many people it sits still for a while, then shifts in a single week. The quiet stretches are not proof that the work has stalled. They can be the flat part of a line that still climbs over time.

It helps to be honest about what this study can and cannot say. It looked back at trials of talk therapy for depression and anxiety, so it does not map perfectly onto every kind of session or every person. Not everyone has a sudden gain, and some people improve in a slow, steady way instead. The review also cannot tell you when your own shift will come, or say for certain that it will. What it does show, across more than a thousand people, is that uneven progress is normal and that a slow week is not a failed one.

There is one more useful point buried in the numbers. Because so much change can hinge on a single stretch between sessions, the days in between are not empty time. They are where a lot of the movement actually happens. Feeling slow is often just the view from inside the wait, not the shape of the whole road.

The takeaway

A slow week between sessions is common. It is often the flat part of a climb, not a sign the work has stopped.
Do not judge your progress by any single week. Change in therapy tends to come in uneven bursts, so the trend over months tells you more than the last few days.
If the flat feeling turns into worry or hopelessness, bring it to your care team. That is information worth sharing, not a setback to hide.

Terms in this page

Between-session support Mental readiness

This is the work Asendar™ was built for: staying with you through the flat stretches between sessions, so a slow week has support around it instead of silence. If you want a simple read on where your head is starting from today, take your Mental Readiness Score.

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