How Do I Know If Therapy is Working?


You’ve built up the courage to start going to therapy despite your fears.  Your therapist is asking a lot of questions to get to know you and your goals for change.  You feel hopeful that you will get the help you need, but how do you know if this is really working?  Unfortunately, there’s no clear cut answer. 

Change is measured in a number of ways, both objectively and subjectively.  At the start of therapy, you may take a number of tests which ask you about your symptoms.  If you are experiencing depression, you’ll likely score high on a depression assessment.  The outcome of therapy can then be measured by taking the test at the end of therapy (or throughout the course of treatment) to determine if symptoms decreased and therapy worked. 

This is a great way to have an objective measure that shows us that therapy helped decrease unwanted symptoms.  But in my opinion, therapy is so much more than a list of symptoms, and to be honest, it’s more than checking goals off a list.  Therapy is a process that aims to give your life and relationships more depth and meaning, helps you look at the world through a different lens, and forces you to take a good hard look at yourself and love what you see – flaws and all. 

All those tests and treatment plans are great ways to have a statistical measure for the therapist to assess whether treatment is working, and you may find the results eye opening as well.  However, that’s only one piece of a complex puzzle.  What things are you feeling as therapy unfolds?  Here are some ways that you (as the client) will start to notice if therapy is working. 

  • You are feeling better:  This may seem really simple, but it’s often overlooked in therapy by both the therapist and the client.  Most people feel better after the initial session because they have had the opportunity to have their story heard and have someone empathize with what they are going through.  But after that session, the hard work really begins as the therapist assigns homework or challenges long standing beliefs you have about yourself and others.  You may wonder if therapy is helping during difficult moments or while trying new things your therapist suggested.  Therapy can also bring up difficult things, emotional scars you haven’t deal with in years, or maybe never even looked at.  I suggest you take a step back and look at your overall life.  Do you feel better in general?  Are your relationships going well?  Are daily tasks or chores less overwhelming?  Small changes lead to big changes, so if you are finding that even small things are getting better, big changes are coming in the future. 
  • You are experiencing some discomfort:  This may seem counterintuitive, but yes, discomfort means that therapy is working.  Therapy should be a challenging experience.  Yes, there is merit in being able to get things out, tell someone else what you’ve been through, and have your feelings validated; that’s a huge part of therapy.  But allowing someone to test your viewpoints and behaviors is also an important part of therapy.  Making change is super uncomfortable, and it is a lot harder than falling back into old habits. 
  • You are letting go of shame, anger, and resentments:  We all have certain hot buttons, and when others push them we react in a number of negative ways.  We lash out at that person, we yell, we cry, we blame them, we blame ourselves, we feel ashamed.  Through therapy, you start to understand that you have no control over what others are going to think, feel, or say; you only have control over your reaction.  Even if you are not specifically working on these issues in therapy, you will notice less shame, anger, resentment, etc. as therapy progresses.  Be mindful of these feelings and the changes you experience in therapy. 

Be open with your therapist about your concerns or thoughts about progress in treatment.  Ask them how they prefer to measure change, and what they see as important for making progress.  Check in regularly about your own perceptions regarding how therapy is going, what is helpful or not helpful, and then changes you are noticing.  Even if you don’t think something small is important or indicative of change, it is meaningful.  Every small step can make a huge impact on where you want to be. 

I’m a Marriage and Family Therapist located in the Clear Lake area of Houston, Tx.  I work with couples struggling with difficult times, constant fighting, infertility, and new parenthood.  If you are unsure about the process of therapy and want to explore how it can be helpful, don’t hesitate to call for a free phone consultation at (832) 827-3288.  I’d be happy to answer any questions you have and help you decide if therapy is the right step for you. 

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