How do I estimate the number of sessions a client will need?

Q:     Hi,

How do I estimate the number of sessions a client will need? My second question: Is it correct to assume that phase one will be more difficult and longer than the other two phases?

A:      To completely and properly answer that important question, we have to go right to the beginning of when the patient/client presented to us.  This calls to our attention the importance of a thorough case history and a very thorough assessment/evaluation.  As a “general” rule, phase one will take longer because most patients have several underlying “weaknesses” and perhaps one or more barriers that have to be addressed at the very start of treatment.  If there are barriers, such as negative oral habits or airway issues or ankyloglossia, it will take longer to complete Phase One than with others who do not have any of the barriers.  Sometimes we have to address the barrier ourselves immediately such as with a thumb sucking habit.  Other times we have to wait for another professional to intervene such as with “tongue tie” being present.  Then we target whatever basics are necessary related to the musculature as directed in Phase one.  If there is “weakness” in the lips, it must be initiated in Phase One.  If there is a need to address the mentalis, masseter, buccinators, etc. then they are also targeted in Phase one.  If, on the other hand, most of these are within the normal acceptable range, then they obviously don’t have to be addressed.  Thus, “it depends” is the only honest answer to whether Phase one will be longer than the following Phases.