How to Tell If Therapy is Working

If you’re working with a therapist regularly now, you’ve likely already spent some time finding a therapist or counsellor who is a good fit for you and you’ve invested time, energy, and money into your work together.

Over time, you might start to wonder, is this actually working? What are the signs therapy is helping me? What if it’s not going well, do I make a change or stick it out? Is there an end to therapy? 

It’s good practice to step back every so often and consider how things are going, even if you’re feeling really good. It may take some time to understand how therapy is impacting you, and if you’re getting what you hoped out of it. You don’t have to change anything just  because you’re doing a gut check, but being active about your experience will help you and your therapist ensure you get the most out of your time together. 

How to know if therapy is going well

Therapy's effectiveness will depend on your goals and your personal mental health plan. It also depends on what type of therapy you’re doing: some types of therapy have clear timelines and milestones with an endpoint, others are more fluid and ongoing.

Yes, it’s true: some therapy is not meant to go on forever. It can be finite; it’s about building tools and a new capacity to process your experiences in a healthy way. 

“The most fundamental marker of  success in therapy is seeing change,” says Sofia Forman, Registered Psychotherapist. “Change in thoughts, behaviour and feelings, but most importantly change in the thing they came to therapy for.”

Sasha Lizarraga, Registered Social Worker and Psychotherapist adds that for clients it’s when they can confidently say, “When challenging moments occur and I am confident in managing my own situations, relying less on my therapist and more on myself and my intuition.”

You’ll never see your problems completely disappear because of therapy, and therapy itself cannot solve all of your challenges. It’s about navigating those challenges confidently in daily life. 

Jacob Emanuel, Registered Psychotherapist (Qualifying), explains, “Often clients express the belief at the onset of therapy that solving their specific set of problems would equal success. As time moves on and rapport is established though, success becomes clearly defined by the client's ability to live and make decisions with autonomy.”

It’s personal, and one person's timeline won’t look like another’s. Check in with yourself and check in with your therapist to discuss how you’re doing. 

Some simple signals that therapy is working include:

• You are feeling better than you were before
• You have a good relationship with your therapist 
• You have set goals with your therapist, and you have evidence you’re meeting them
• You are choosing new, or healthier coping mechanisms (and you feel good about it!)
• You’re handling problems on your own, with autonomy (i.e. without your therapist)
• You notice you’re reacting to difficult situations well, or differently than you did before
• You’re sleeping, eating, work or social habits are flowing and fit into your lifestyle

How to know if therapy is not going well

When you assess how therapy is going, you might find that you’re not really handling challenges with more ease, or that your relationship with your therapist is not filled with trust and shared accountability, or that your needs are not being met.

There is research, though limited, aiming to understand how negative experiences in therapy can be harmful. While these instances appear to be rare, the reasons for negative outcomes occur when expectations are not being met, there is a lack of important context (such as cultural validity), the therapist is too rigid or controlling, or the client (you!) doesn’t feel valued.

“If you are not having any change towards feeling better or find that the methods you’re using together just don’t resonate, you might consider taking a different approach,” says Margaret Hux, Registered Psychotherapist.

Helpful guiding questions to ask yourself when assessing your experiences in therapy:

• Do I believe my therapist understands my goals?
• Has my therapist demonstrated they understand my background and the context around my challenges? 
• Am I being honest in my sessions?
• Do I feel any better?

If you’re not feeling progress, it’s not a failure nor a judgement. These are cues to help guide you to take actions, or to consider a different approach if you’ve identified something isn’t working. 

What’s next?

Bottom line, it’s worthwhile to do a check-in regularly to assess how therapy is going, and there are a few ways to think about what “good” means. 

Whenever you start to think about your progress, ask your therapist to do a check-in. Part of building a strong relationship with your therapist (the number one predictor of success, overall), is being able to establish mutually-agreed-upon goals, so they’ll be happy to reassess those on an ongoing basis.