November 29, 2023

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How To Know If Therapy Is Actually Working, According To Mental Health Experts


Therapy is a wonderful tool for healing and self-development. But when you’re new to therapy, it’s common to feel apprehension and uncertainty as you’re essentially navigating unchartered territory.

One of the most basic things you might wonder when starting therapy is how to figure out if it’s really working.

This can be slightly tricky to answer since there’s more to therapy than simply lying down on a comfy couch and talking about your feelings.

It’s a highly subjective and non-linear process that’s hard to quantify. Moreover, there’s no one-size-fits-all approach to therapy as different people have different battles, needs, goals, preferences, worldviews and experiences.

It’s also important to keep in mind that “it’s very common for symptoms to worsen before you start to feel better because difficult feelings will likely emerge in the therapy process,” says Dr. Julie Hanks, licensed therapist, TEDx speaker and author of The Assertiveness Guide for Women.

So it’s not as simple as popping an aspirin when you have a headache. Because, unlike a symptomatic medication that only focuses on alleviating the symptoms, therapy is about identifying and addressing the underlying root cause of the problem.

That said, there are certain markers of progress and indicators of improvement

that you can use to determine if therapy is actually helping. Here’s how to tell if therapy is working for you, according to mental health experts:

#1 You’re becoming more self-aware. Therapy helps you understand your needs, desires and choices as well as identify your repeating maladaptive patterns, says Dr. Monica Vermani, Toronto-based clinical psychologist and author of A Deeper Wellness: Conquering Stress, Mood, Anxiety and Traumas. It also teaches you how to break those damaging blueprints and patterns by providing valuable coping skills to create healthier routines and make healthier and better choices, she explains. So if you find yourself gaining an awareness of your issues, symptoms and unhealthy patterns, you’re very likely headed in the right direction.

#2 You’re in better control of your emotions. You’d be able to identify your emotions, manage them and express them in ways that enhance relationships, says Hanks. Additionally, you begin to respond more thoughtfully in interactions and are less reactive to your close relationships, she adds.

#3 Your thinking has shifted. You’ll start having fewer negative or destructive thoughts and more positive, constructive ones, says Dr. Vermani. This will help you feel freer to enjoy the present instead of being pulled into rumination about past experiences or worrying about the future, notes Dr. Hanks. In addition, rather than fantasizing about things that aren’t attainable, you’ll start developing realistic, reachable goals, says Dr. Vermani.

#4 Your behaviors are changing for the better. “If you’re leaving unwanted habits behind and seeing the changes you wanted to make begin to happen, your therapy is working,” says Dr. Vermani. For example, if you entered into therapy to become more assertive and you’re beginning to establish personal boundaries and stand up for yourself, you’re making progress.

#5 You’re kinder to yourself. Your self-talk will become more compassionate, says Dr. Hanks. So you’d begin to embrace your imperfections and be patient with yourself instead of being overly critical and judgemental. You’ll also notice that your self-esteem is growing and self-doubts diminishing, says Dr. Vermani. Instead of feeling inadequate or ascribing your self-worth to external validation, you’d be able to accept and value yourself from within.

#6 Your relationships with others have improved. Therapy can facilitate healthy communication with yourselves and other people by equipping you with the tools and skills required to effectively communicate your wants and needs and work through issues in your relationships, says Dr. Vermani. So if you notice your existing relationships are getting stronger or you’re able to forge new ones more easily, that’s a positive sign.

#7 People are noticing the positive changes in you. If your friends, family members or coworkers are noticing the changes and acknowledging your progress, believe what they’re saying as they’re seeing the results of your hard work, says Dr. Vermani.

#8 You “click” with your therapist. You’ll feel that you can talk openly with your therapist about your worries, concerns, fantasies and goals. You’d also be able to give your therapist direct feedback. “It’s important to have a connection with your therapist because a strong client-therapist relationship is the single most important factor that predicts positive therapeutic outcomes,” says Dr. Hanks.

If you’re not sure whether your current therapist is the right one for you, Dr. Vermani suggests asking yourself the following questions to self-evaluate:

  • Is my therapist qualified to help in the areas I feel I need help in (eg; trauma, mood disorder, anxiety, relationship counseling, etc.)?
  • Do I feel comfortable revealing personal details and feelings to my therapist?
  • Do I feel that my therapist accepts me as I am rather than judging me or misinterpreting me?
  • Do I feel the need to pretend to be someone else when I am with my therapist?
  • Do I feel that my therapist understands or makes a sincere effort to understand me?
  • Do I feel that my therapist cares about me and my issues?
  • Do I feel I can be honest and transparent with them?
  • Do I feel heard?
  • Do they often interrupt me?
  • Am I learning from my therapist?
  • Am I able to communicate uncomfortable feelings or misunderstandings between myself and my therapist?
  • Do I feel that my life is becoming better over time while in therapy?

If your therapist spends more time talking about their own issues than yours, you might want to find a new therapist, says Dr. Hanks.

Similarly, poor boundaries (therapist acting more like a friend, not staying within the allotted session time, not abiding by their own policies, etc.), failing to have you sign consent for treatment and privacy policies before starting your first session and a lack of connection are also red flags, adds Dr. Hanks.

“If you don’t ‘click’ within the first three sessions, talk to your therapist and ask for a referral to another therapist,” she suggests.

Four simple ways to track your progress in therapy:

  • Try psychometric tools. Rating scales and other short standardized assessments can enable you to track symptoms over time, says Dr. Vermani. “Many psychologists use these to establish a baseline and track symptoms throughout therapy,” she adds. For example, you can use the Likert scale of 0-10 to rate the severity of your symptoms on a weekly basis (0 being no symptoms and 10 indicating intense symptoms). Start by picking one target symptom or issue that you want to work on in therapy, suggests Dr. Hanks. Over time, you’ll be able to assess your progress.
  • Ask your therapist. You can ask your therapist about how they’re going to track your progress and request feedback on how you’re doing via their tracking process, suggests Dr. Hanks. “Don’t be afraid to ask questions. You should know what your treatment goals are and your therapist’s plan to accomplish them,” adds the mental health specialist.
  • Keep a therapy journal. Track your progress in therapy by journaling your thoughts and feelings regularly, Dr. Hanks recommends. You can look back at what you’ve previously written to monitor how your perspective has changed over time, she adds. You can also use it to jot down short- and long-term goals that you want to achieve through therapy with which your therapist can hold you accountable, suggests Dr. Vermani.
  • Pay attention to your quality of life. If you feel like you’re able to manage your emotions, stress, personal and professional responsibilities and relationships, etc. in a better way, that’s an indicator of progress, says Dr. Vermani.

How to get the most out of every therapy session:

Regardless of what type of therapy you’re seeking or where you’re in your healing journey, experts say keeping these key tips in mind will make your sessions more wholesome and rewarding:

  • Research your therapist prior to starting therapy. “Know about their credentials, their experience, their theoretical orientation, their training and certifications to make sure they are well-qualified to help you,” says Dr. Hanks. Here’s what you should look for when finding a therapist.
  • Be open and honest with your therapist. A therapist is only as good as you allow them to be. “Be honest with your therapist about how therapy is going, any concerns you have in the process, if you feel that your therapist isn’t really ‘getting’ you or if you feel misunderstood,” says Dr. Hanks. “Only through providing your therapist with a clear picture of what you’re struggling with can they effectively help you address your issues and help you create the change you’re seeking,” agrees Dr. Vermani. Also, be clear about what you want to accomplish from therapy. Set clear goals and expectations with your therapist, adds Dr. Hanks.
  • Give therapy a fair chance. “If you are skeptical or resistant to the process, you’ll slow down or block your own progress. This will only compound your problems,” says Dr. Vermani. “If you want to learn to drive, for example, you wouldn’t give up after one or two uncomfortable or scary sessions behind the wheel. You’ll take the time and make the effort to learn,” she notes. Similarly, therapy needs time, effort, patience and determination as well. It’s a dynamic process of learning and growing, adds the psychologist.
  • Do your “homework” assignments outside of sessions. “Most of the change you experience will happen outside of the therapy office,” says Dr. Hanks. In order to tap into life-changing results, it’s important to put into use what you learn in therapy. “Therapy is work! It requires commitment and active participation,” agrees Dr. Vermani. So be diligent about completing whatever assignment your therapist gives you to practice the new skill or coping technique in your daily life.
  • Be specific. “Keep your sessions focused on your counseling goals by being as specific as possible during your sessions. If it helps, bring notes or other materials to refer to and ensure you get to the things you wanted to discuss,” says Dr. Vermani. In addition, “tell your therapist when a strategy isn’t working or when you’ve slipped up,” she suggests.
  • Give clear feedback to your therapist. Therapy is an interactive process. If you feel your therapist’s approach isn’t working out for you or if you have questions about their therapy style or strategy, don’t hesitate to give them your feedback, says Dr. Vermani. “It’s important that you feel heard, validated and understood,” she notes.

It’s crucial to keep in mind that therapy is not a quick fix. “[It] can last for months or even years, depending on the issues you want to work on and the therapist’s theoretical orientation,” says Dr. Hanks. “It can sometimes take several sessions for your therapist to complete their assessment and treatment plan and have an overall picture of what brought you in and where you need to go to find healing,” she explains.

However, if you feel like you’ve given therapy a fair try and it still doesn’t seem to be helping, Dr. Vermani suggests talking to your therapist about it. “Your therapist is there to support and assist you. If you’re not making progress, they can help you by referring you to another therapist,” she says. “Don’t give up on therapy. Even more important, don’t give up on yourself,” she adds.


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