Therapy Statistics 2026: 50 Numbers on Use, Effectiveness, and Memory

In 2024, about 60 million U.S. adults received some form of mental health treatment or counseling, and 23.9% of adults reported any mental health treatment in 2023, up from 19.2% in 2019. Across decades of meta-analyses, people who complete psychotherapy fare better than roughly 80% of those left untreated, with about 65% experiencing meaningful improvement.

The catch is what patients retain: research on cognitive therapy shows patients accurately recall only 20–37% of session content shortly after sessions, and in some treatment areas clients forget up to 80% of recommendations. The numbers below are pulled from CDC, SAMHSA, Statistics Canada, APA, peer-reviewed meta-analyses, and major industry reports. Every stat is linked to its source in the consolidated bibliography at the bottom of this page.

At a glance

Six numbers that orient everything else on this page.

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How many people are in therapy: U.S. and Canada

Two big national pictures, one for the U.S. and one for Canada, plus the gaps in between.

• 60 million U.S. adults received mental health treatment or counseling in 2024 — roughly double the 27 million figure recorded in 2002.^¹
• 23.9% of U.S. adults received any mental health treatment in 2023, up from 19.2% in 2019.^²
• About 14% — roughly 1 in 7 U.S. adults — received counseling or therapy specifically from a mental health professional in 2024, the highest share on record.^⁷
• 23.4% of U.S. adults experienced any mental illness in 2024, more than 60 million people.^⁸
• 18.3% of Canadians aged 15+ met diagnostic criteria for a mood, anxiety, or substance use disorder in 2022.^⁹
• 43.8% of Canadians with a mental disorder received counselling — more than received medication (36.5%) or mental health information (32.0%).^¹⁰
• 41% of Canadian adults with a diagnosed mental health condition reported their care needs were partially or fully unmet in 2024.^¹¹
• Only half of Canadians referred to community mental health counselling in 2024–2025 received care within 30 days of their referral.^¹²
• Women remain about twice as likely as men to receive mental health treatment in the U.S.^¹³

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Does therapy actually work? What the research shows

Decades of meta-analysis support the same basic conclusion: psychotherapy works for most people who finish it. The harder questions are who benefits, how much, and how fast. If you want to read more about the lived version of this question, see how to know if therapy is working.

• ~80% of people who complete psychotherapy fare better than untreated controls, based on cumulative effect-size estimates spanning decades of meta-analyses.^³
• ~65% of treated patients can expect a positive outcome.^³
• ~50% of patients with adult clinical disorders return to normal functioning within 10–20 sessions, with an additional 25% experiencing substantial improvement at higher doses.^³
• Effect size d = 0.76 across 27 meta-analyses of child, adolescent, and adult psychotherapy research — a large effect by conventional standards.^¹⁴
• About 30% of patients experience 'sudden gains' — early dramatic improvement within just 3–5 sessions — and roughly 80% maintain those gains at one-year follow-up.^³
• The therapeutic alliance is one of the strongest and most consistent predictors of treatment outcome, with a correlation of r = 0.278 across 295 studies and over 30,000 patients.^¹⁵
• 5–14% of clients worsen during psychotherapy, and therapists struggle to identify which clients are off-track without structured feedback.^¹⁶
• Online therapy outcomes are roughly equivalent to in-person — the alliance-outcome correlation in 18 internet-based psychotherapy studies was r ≈ 0.28, statistically indistinguishable from face-to-face.^¹⁵

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The memory problem

Therapy works when its content is retained. But the body of memory-and-therapy research is striking — and rarely cited in mainstream mental health coverage. If you've ever walked out of a session and lost most of it by the next morning, the numbers below will feel familiar. For practical strategies, see how to remember what you talked about in therapy.

• Patients recalled only 20–37% of session content shortly after CBT sessions, and greater recall predicted better clinical outcome.^⁴
• Up to 80% of treatment recommendations are forgotten by clients in CBT for insomnia between sessions.^¹⁷
• More than half of patients' thoughts about and applications of CBT content during the week after a session are inaccurate reconstructions of what was actually presented.^¹⁸
• Ten years after behavioral couples counseling, up to 55% of clients cannot recall any of the skills they were taught.^¹⁷
• 40–80% of medical information is forgotten immediately after a consultation in general medical contexts, and nearly half of what's remembered is incorrect.^¹⁹
• When patients receive only spoken instructions with no written summary, they recall just 14% correctly.^¹⁹
• Structured 'memory support' strategies in cognitive therapy for depression improved patient recall, and greater recall predicted greater symptom improvement.^¹⁸

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Who stays in therapy, and who leaves

Therapy attrition is one of the most consistent findings in the literature, and one of the least discussed publicly.

• Across 669 studies and 83,834 clients, the weighted dropout rate from psychotherapy was 19.7%.^²⁰
• When dropout is judged by therapists or by failure to reach treatment goals (rather than just session count), estimates rise sharply — therapists report about 40% of clients discontinue prematurely.^²⁰
• 47% unilateral dropout was found in an earlier meta-analysis of 125 studies.^²¹
• Mean dropout rate of 34.8% with a wide range (10.3%–81.0%) across 146 Western studies, with U.S. studies averaging 37.9%.^²²
• Patient-rated alliance is among the strongest predictors of completion vs. dropout, with a weighted mean effect size of d = 0.55.^²³
• Personality disorder clients show a 37% noncompletion rate specifically.^²⁰
• In youth mental health care, dropout estimates range from 28% to 75% depending on definition.^²⁴

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Generational shifts: Gen Z and Millennials

Younger generations report higher rates of diagnosis and higher therapy uptake than older cohorts. The cultural shift is real and measurable, though much of it is also a re-labeling of distress that older generations didn't talk about openly.

• 42% of Gen Z Americans report currently being in therapy, a 22% increase since 2022.^⁵
• 46% of Gen Z have received a formal mental health diagnosis, and 37% believe they have an undiagnosed condition.^⁵
• Anxiety leads Gen Z diagnoses, followed by depression and ADHD.^⁵
• 47% of Gen Z globally rate their mental wellbeing as fair or poor, and 40% report feeling stressed or anxious most or all of the time.^²⁵
• 50% of U.S. adults ages 18–34 reported a mental health diagnosis in 2023, the highest rate of any age group.^²⁶
• 32.2% of U.S. young adults ages 18–25 (11.6 million people) experienced mental illness in 2024.^²⁷
• Only 23% of Gen Z adults rate their mental health as 'excellent,' compared with 34% of Gen X and Boomers.^²⁸
• 46% of Gen Z workers say stigma keeps them from pursuing mental health care.^²⁹
• Adults 18–44 drove most of the U.S. treatment growth: rates rose from 18.5% in 2019 to 23.2% in 2021, with no significant change among adults 65+.^¹³

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What therapy costs

Cost is the single most-cited barrier to mental health treatment in U.S. survey data. The numbers reflect a system under pressure on both the provider and patient side.

• $122 to $227 per session was the average U.S. therapy fee by state in 2023–2024, based on analysis of nearly 105 million sessions billed by 204,000 therapists.^³⁰
• $139 national average in 2024, up from $123 in 2019 — a roughly 13% increase in five years.^²⁶
• Most expensive state: North Dakota ($227 average), followed by Alaska ($212). Least expensive: Oklahoma, Tennessee, Vermont, South Carolina, Louisiana, Missouri — all under $130.^³⁰
• 52% of Americans cite cost as the top obstacle to mental health care; 42% cite difficulty finding a provider.^²⁹
• 82% of psychologists cite insufficient reimbursement rates as the reason they're not in-network with insurance.^³¹
• Per-patient outpatient visits rose from 10 per year in 2018 to 13 per year in 2022.^³²
• ~40% of the U.S. population lives in a Mental Health Professional Shortage Area as of late 2025, with only about 27% of need being met in those regions.^³³

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Telehealth therapy is now mainstream

Telehealth in mental health is no longer experimental. It's a dominant mode of care, with outcomes that match in-person therapy for most conditions.

• 62.3% of U.S. patients with a telehealth claim in February 2025 had a mental health diagnosis.^⁶
• 68.9% of telehealth claim lines nationally were for mental health conditions in April 2024.^³⁴
• Mental health visits made up 58% of all telehealth services in 2023, up from 47% in 2020.^³⁵
• 54% of Americans have completed at least one telehealth visit, and 60% are open to teletherapy specifically.^³⁶
• 86%+ of teletherapy users report satisfaction with the format.^³⁶
• 80%+ of virtual therapy participants in a 2024 JMIR Mental Health review reported outcomes comparable to or better than in-office sessions.^³⁵
• In Canada, video appointments are used by 45.1% of psychology patients, 37.6% of social worker / counsellor / psychotherapist patients, and 25.3% of psychiatry patients.^⁹

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Mental health apps and digital tools

Digital tools have become a normal layer of mental healthcare, with corresponding growth in usage and investment.

• $7.48 billion global mental health apps market in 2024, projected to reach $17.52 billion by 2030 (CAGR 14.6%).^³⁷
• U.S. digital mental health market projected to grow from $7.46B in 2025 to $47.13B by 2035.^³⁸
• 26% increase in mental health app downloads across North America and Europe in early 2024.^³⁹
• North America accounted for 36.4% of global mental health app revenue in 2024.^³⁷
• ~$1.5 billion in funding was raised by the 2025 HealthTech 250 cohort of early-stage digital mental health ventures.^⁴⁰

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Therapy and ADHD

ADHD is one of the most-studied audiences for adapted psychotherapy, and the evidence base for CBT-ADHD has matured quickly.

• 28 randomized controlled trials were combined in a 2023 meta-analysis showing CBT for adults with ADHD was effective in reducing both core ADHD symptoms and emotional symptoms (depression, anxiety).^⁴¹
• 17 RCTs of CBT specifically adapted for adult ADHD had been completed by 2023, with significant positive findings across diverse outcome measures.^⁴²
• Up to 25% of adults with ADHD do not respond to or cannot tolerate stimulant medication, strengthening the case for psychotherapy as part of treatment.^⁴³
• CBT for adult ADHD improves quality of life and reduces depression and anxiety alongside core ADHD symptoms, with effects sustained at one-year follow-up.^⁴⁴
• The UK's NICE recommends CBT as the psychotherapeutic treatment of choice for adults with persisting ADHD.^⁴⁵

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Why these numbers matter for people in therapy

The picture above points at one underrated problem: therapy works, but its effects compound only when people remember what came up and bring it forward. The memory data is the part most often left out of mainstream coverage. If you're sitting on a year of sessions you can barely recall, you're not unusual — you're statistically average. Holding onto more of what came up is part of what to do between therapy sessions. Undertone is a private therapy companion built specifically for that gap: it helps you revisit what mattered, notice patterns across sessions, and walk into your next appointment with continuity instead of starting fresh.

Reflection: where do you sit in the numbers?

• How much of your last therapy session can you recall in detail right now?
• What's one theme that has come up multiple times — and what would you tell a new therapist about it?
• If you could see all the threads of your therapy over the past year laid out in front of you, what would you look for first?

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Sources

1. SAMHSA / NSDUH via Statista — Mental health treatment or counseling among U.S. adults
2. CDC, MMWR — National Health Interview Survey: Mental Health Treatment Among Adults
3. Lambert, M.J. — Bergin and Garfield's Handbook of Psychotherapy and Behavior Change (summary chapter)
4. Lee, J.Y. & Harvey, A.G. (2015) — Memory for Therapy in Bipolar Disorder, PMC
5. Harmony Healthcare IT (2025) — State of Gen Z Mental Health Survey
6. Trilliant Health via Grow Therapy — Mental Health Trends in Telehealth
7. CDC, BRFSS — Mental Health Conditions and Care Data
8. Mental Health America — State of Mental Health in America 2025
9. Statistics Canada — Mental Health and Access to Care Survey, 2022
10. Statistics Canada — Survey Daily Release on Mental Health Care
11. Canadian Institute for Health Information — Mental Health Care Needs in Canada
12. CIHI — Taking the Pulse: Mental Health and Substance Use Services 2025
13. CDC NCHS — Data Brief on Mental Health Treatment by Demographics
14. American Journal of Psychotherapy — 45-Year Analysis of Practice-Based Outcomes
15. Flückiger, C. et al. (2018) — The Alliance in Adult Psychotherapy: Meta-Analytic Synthesis
16. Lambert, M.J. & Lo Coco, G. — Research in Psychotherapy
17. Chambers, M. & Lee, J.Y. & Harvey, A.G. — Treatment Recommendation Recall, PMC
18. Gumport, N.B., Williams, J.J., & Harvey, A.G. (2015) — Memory Support in CBT for Depression, PMC
19. Kessels, R.P.C. (2003) — Patients' Memory for Medical Information, summarized via Dya Clinical
20. Swift, J.K. & Greenberg, R.P. (2012) — Premature Discontinuation in Adult Psychotherapy: A Meta-Analysis
21. Wierzbicki, M. & Pekarik, G. (1993) — Meta-Analysis of Psychotherapy Dropout (ProQuest)
22. Wikipedia — Psychotherapy Discontinuation (aggregated meta-analyses)
23. Sharf, J. et al. — Meta-Analysis of Psychotherapy Dropout (ResearchGate)
24. ScienceDirect — Meta-Analytic Review of Youth Mental Health Care Dropout
25. Deloitte / NCHStats — Global 2025 Gen Z and Millennial Survey
26. SimplePractice — How Much Does Therapy Cost?
27. NAMI — Mental Health by the Numbers
28. Grow Therapy — Gen Z Mental Health Statistics
29. Grow Therapy — Mental Health Statistics 2025
30. SimplePractice — Average Therapy Session Rate by State
31. Blueprint AI / APA Practitioner Pulse — Private Practice Costs and Insurance Participation
32. The Hope Institute NJ — Mental Health Therapy Cost Analysis
33. HRSA via Inner Well — Mental Health Workforce Shortage Areas
34. FAIR Health via TechTarget — Telehealth Use by Region and Specialty
35. Agents of Change — Telehealth Trends in 2025 and Beyond
36. Crown Counseling — Teletherapy Statistics 2024
37. Grand View Research — Mental Health Apps Market Report
38. Towards Healthcare — U.S. Digital Mental Health Market Sizing
39. SNS Insider — Mental Health Apps Market 2024
40. Stem Search Group — Key Telehealth Trends in 2025
41. Liu, X. et al. (2023) — CBT for Adults with ADHD: Meta-Analysis
42. Ramsay, J.R. (2024) — CBT for Adult ADHD: Efficacy Review, PMC
43. PMC — Stimulant Response and Non-Response in Adult ADHD
44. PMC — CBT for Adult ADHD: Secondary RCT Analysis
45. Frontiers in Psychiatry (2024) — Psychotherapy for Adult ADHD: NICE Recommendations