Whether you’ve been in therapy for years, have only been to a few sessions, or are just starting out and asking yourself if therapy is even right for you, you might be wondering how to tell if therapy works.
You go to sessions, talk to your therapist, maybe get some homework, and say goodbye until the next session. You knew you wouldn’t see changes overnight, but how are you supposed to know if you’re making progress at all?
First of all, it’s totally to normal to question whether therapy—and your therapist themselves—is effective. It can be hard to track progress throughout the ups and downs of therapy, especially when we don’t know what progress looks like, what our goals are, or what to ask our therapist to get them to meet us where we are when it comes to understanding and tracking our growth.
Here is some expert insight from our community of therapists to help you understand what success can look like in therapy, plus some self-reflective questions you can ask yourself and your therapist to make sure you’re getting the most out of your sessions.
Just like therapy is tailored to you and your needs, progress will look different for everyone. Reflecting upon your personal goals and expectations may help you come to a better understanding of your current progress.
“What feels like progress in therapy is unique to each individual client,” says Claire Nakajima. “Sometimes this looks like feeling more connected with a partner, or having more energy to engage in your passions. For others, progress means seeing their symptoms reduce and tracking that with validated measures. I work with clients to help identify how we will know together that therapy is working and make adjustments as needed to ensure we meet their goals.”
“I find it is very important to routinely evaluate and review how you are feeling throughout your therapeutic journey, as well as how you are feeling in the therapeutic relationship,” says Renee Hereth. “Depending on the client I will utilize assessment tools to track symptom improvement, adjust goals, and have open discussions for feedback from you on our sessions.”
“Sometimes progress will show up in distinct ways, such as a noticeable increase in mood or a decrease in depressive symptoms,” says Jacob Mergendoller. “Other times, it may be more nuanced and we’ll have to read between the lines (i.e. the subtext of your statements or subtle shifts in perspective). I adopt a strength-based approach to therapy to identify and bring attention to these positive changes, small or large. After all, the small steps pave the way for larger ones. The evidence of growth and change will be most apparent when there is a trusting, authentic relationship between you and your therapist.”
If you’re in therapy, take some time to self-reflect and ask yourself: what progress do you feel you’ve made toward your goal(s)? If you’re just starting out, doing this ahead of time can even help you find a therapist that fits you and your needs best.
“A lot of the progress is seen outside of the therapy room; it may be very small changes, like setting boundaries with a friend, or expressing a need you have that you could never do before,” says Nicole Barman. “You will be more aware of your feelings, emotions, actions, and decisions as you live your life. This awareness will help you navigate your world in a meaningful and relieving way.”
Awareness can be hard to quantify, so pay attention to your thoughts, feelings, and actions to see if you’re more tapped in than you might have been before you started therapy.
“Generally, you will be making connections between your emotions, thoughts, and behaviors in new and exciting ways,” says Jillian Biegel. “You might speak with deeper awareness, be able to intervene with or better identify thoughts or behaviors that are impacting you or feel like they don’t fit. You might feel more motivated and show up accordingly.”
“When dealing with complex emotions stemming from long-held beliefs, patterns, or circumstances, the vulnerability involved in talking about them and feeling them can be very uncomfortable or bring up more emotions you might not have known were there,” Jillian says. “This is normal, and even though there is discomfort, it is a growing pain that shows your expansion. At any point you can assess how you are feeling and we can talk about this.”
Before therapy, when something bad or triggering happened to you, you might have gone into flight, fight, or freeze mode. If therapy is working for you, notice if you have now cultivated more of a sense of curiosity around these things.
“I believe that main markers of successful therapy are safety and curiosity,” says Taylor Mefford. “If you feel safe in the therapy relationship and curious about the world around you, I know we're on the right track. I also make it a point to ask my clients explicitly about our progress to see if we're making the most of our time together.”
When a triggering event happens, an intrusive thought pops up, or a troubling symptom surfaces, how do you react now?
If therapy is working for you, “you would start to see a reduction in the symptoms that brought you into therapy,” says Madison Montalbano. “You would be more aware of your bodily sensations and what they're communicating to you, curious about your emotional experiences, speaking to yourself more compassionately, and communicating more effectively with those around you.”
Ask yourself: Do you feel like your symptoms have lessened, increased, or stayed the same?
“Benefiting from therapy will look different for every person,” says Lindsay Huckaba. “As a therapist, I can tell if a client is benefiting from working with me if they are applying the skills and resources gained in therapy into their everyday life. This can be observed through goals being met, change being achieved, and the client engaging and taking active steps towards their desired outcome. Through ongoing conversation, check-ins, and feedback-oriented dialogue, together we can assess how the therapy process is benefiting the client, and what we can do to make it fit their needs.”
Ask yourself: What skills have I learned in therapy and where have I been able to use them outside of my sessions?
“After a month or so of treatment, I often do check-in sessions towards treatment progress,” says Nicole Maldonado. “These are sessions where I ask you about your experiences in treatment and how you feel you are progressing on your goals. This helps both of us keep track of progress and readjust goals when needed.”
Again, because progress looks different for everyone, you and your therapist should talk about what it means for you and how and when you’ll measure it.
“My approach is solutions-focused,” says Kelly O'Sullivan. “This means you won’t have to be in therapy forever. Many of my clients find that they’ve met their goals in 3-6 months and no longer need therapy. I also have clients who choose to remain in therapy for much longer; they have seen improvements and still really enjoy having ongoing support and a place to process their thoughts and feelings each week.”
You might find that most therapists are open to adjusting and readjusting goals as you go along. Remember, nothing is ever set in stone and your sessions are for you!
“Every three months we'll check in and do a couple quick assessments to see if you're feeling less anxious or depressed,” says Kelly. “We'll also revisit the goals we've set to make sure we're making progress and that those goals are still important to you. If not we'll set new ones.”
“This is something we will revisit often, because I want you to make sure you are getting what you need from a therapeutic relationship, even if it's not with me,” says Lauren Larkin. “You can always ask if you need more or less activity: do you need me to just listen today or do you want some pushback, advice, or input? Do you want homework, or does that sound like the worst thing in the world to you?”
“We will discuss and check in on all of the options for the format that works best for you, and if you find you are not benefiting from the work (aka: you don't feel relief during sessions, sessions aren't making you think about your life in a new way, you're feeling completely stuck in your progress) let's address it and change our session style to work for you!” says Lauren. “And if it comes down to the fact that we're not a good fit, I will support you 100 percent in finding someone new.”
It can be scary to give feedback to your therapist, but it’s okay; therapists are trained in overcoming obstacles like this. They’ve worked with difficult clients before, so you won’t be the first to express concerns. A good therapist won’t take it personally. Sometimes working through your feelings about your therapist can help uncover an issue you needed to talk about.
“I really rely on your feedback and encourage it!” says Danielle Lovece. “Anything you are feeling or thinking regarding our sessions is valuable to me because it helps me tailor therapy to your needs. We will have a set of goals we identified upon your first few sessions that we can refer to when assessing how things are going and what we need to work on. In some cases, I may even employ the help of a brief inventory to track your progress.”
“Some begin feeling better within the first week or two,” says Chanda DeYoung. “But often, we go through ups and downs throughout the process before we find a leveling out. Each week you will be able to tell me how you are feeling and what you noticed has improved for you and sometimes more stuff may come to the surface to work on. But it is important to keep up the work and ride it out and you will begin to notice day by day, week by week that there is a better tomorrow.”
You might find that when therapy begins to work, you don’t need to go as often, but remember that it can take time to get to that point. Other people find value in seeing a therapist long-term.
Therapy is one of the few parts of life that is all about you. Therapists are not there to express their own needs—they are there to help you reach your goals. Like any other worthwhile endeavor, the benefits of therapy don’t happen overnight, but over time you should feel like your therapeutic relationship is nothing but beneficial to your wellbeing.
“Many of my patients tell me that the insights we explore in therapy positively impact their relationships, and that the strategies we discuss for managing anxiety and other emotions help them to feel more at ease and vitalized,” says Nikki Press. “Those are successes we celebrate and a sign that they are reaping the benefits of therapy! You will know that you are benefiting from therapy if you feel a greater understanding of yourself and your emotions AND that you have new ways of applying those insights to your life in stressful situations.”
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Caitlin is MyWellbeing's Content Lead, a writer, speaker, communication coach, and the founder of Commcoterie, a communication consultancy. She teaches teams how to use professional coaching communication techniques in their everyday conversations, helps leaders engage their teams with effective and inclusive communication, and partners with service providers to activate their programs and offerings with their own clients through inspiring communication strategies. Find out more, including how to work with her, at www.commcoterie.com.