How to Tell If Therapy Is Working
Updated: Oct 6
You have been attending sessions and making time for counseling. At some point, it is reasonable to ask: Is this helping?
That question belongs in therapy. You do not need to wait until you are frustrated enough to quit before bringing it up.
The National Institute of Mental Health identifies symptom relief, daily functioning, and quality of life as general goals of psychotherapy. It also recommends asking how progress will be assessed and discussing concerns if treatment does not seem to be helping.
Define what you want to change
“Feel better” is a reasonable starting point, but it can be hard to assess. Try connecting it to something you would notice in everyday life.
If anxiety is the concern, what would be different? Perhaps you would attend an appointment without canceling, spend less time seeking reassurance, or make a decision without revisiting it all evening.
If conflict is the concern, you might want to stay engaged in a difficult conversation or recover sooner after an argument. For grief, you might want to return to an activity while making room for the loss you are carrying.
These are examples of goals, not standards every client needs to meet. Your goals should reflect why you came to therapy.
Compare yourself with a starting point
Memory alone can make change difficult to judge. A particularly hard day may overshadow a week when several things went differently.
Consider keeping a brief note about one or two concerns. You might record how often a pattern happens, how intense it feels, how long it lasts, and what it prevents you from doing. Your therapist may also use appropriate questionnaires to help track symptoms.
The record does not need to become another chore. A few consistent observations can give you something concrete to review together.
Look for changes outside the session
Ask what is happening between appointments. Have you tried something you discussed? What happened when you tried it? Was the plan realistic in your circumstances?
For example, a goal to set a boundary may sound clear during a session but become difficult when you anticipate another person's reaction. That difficulty is useful information to bring back. It tells us where the plan needs more work.
In my approach, I want sessions to connect to the situations you are actually dealing with. You can read more in What Therapy With Me Looks Like.
Ask your therapist to explain the plan
You can ask direct questions: “What are we working toward?” “Why are we using this approach?” “How will we decide whether it is helping?” and “When should we review the plan?”
A useful discussion should leave you with a clearer understanding of the work. You do not need technical language or a perfect explanation before asking.
You can also say what does not fit. “The exercise is difficult to use at work” gives your therapist a chance to adapt it. “I keep leaving unsure what we are doing” raises a concern that deserves an answer.
Discuss concerns before drawing a conclusion
There is no single number of sessions that proves therapy should be working for everyone. The problem, treatment approach, circumstances, and goals all matter.
If you are not noticing useful changes, review that with your therapist. You may need clearer goals, a different approach, attention to a practical barrier, or another provider's expertise. The National Institute of Mental Health specifically advises talking with your therapist when you are not improving and considering other professionals or approaches when appropriate.
If your condition is worsening or safety concerns arise, tell your clinician promptly rather than waiting for a routine progress review.
What I want clients to be able to say
“I do not think this is helping” is useful information. So is “I want to work on something different” or “I understand the idea, but I cannot make it work in my situation.”
Therapy is a working relationship. I want us to be able to examine the plan together and make decisions based on what is happening in your life.
For adults considering counseling in El Paso, review my Counseling Services and contact me through the website to ask about fit and availability.
Sources and further reading
If you are considering adult individual counseling, review session information and decide whether the approach fits what you need. View availability on Headway for virtual appointments, insurance information, and cost estimates, or read what to expect when starting therapy.
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