How to Tell If Therapy Is Working for You

Starting therapy is winning one battle — a significant one, but only one. We win the rest through slow, gradual effort, setbacks, and progress. But just because therapy works slowly does not prevent us from having and celebrating the small wins along the way. After all, our successes are a sign of growth as much as our failures are.  

But because therapy proceeds the way it does, it can be difficult to tell when it’s actually effective.  When should we start feeling better? What changes should we take note of? What are the signs that therapy is actually working?

When to look for signs of improvement

The short answer is “not immediately.” – The impact of therapy on your life may be a gradual and unfolding process that becomes more evident over time.

In the initial weeks, someone new to therapy might find themselves feeling more uncomfortable due to leaving their comfort zone. Sometimes, symptoms might worsen before they get better due to this discomfort or due to revisiting difficult times during therapy. This discomfort, in the short-term, is actually a sign of success because it signifies the start of deep work towards understanding ourselves and better managing our emotions. 

Setting simple, measurable goals and timelines for change under the guidance of our therapist can help us take note of any progress. Achieving those goals enables us to think more deeply about whether therapy is working for us. A therapist might also have more objective measures to understand when treatment is working. This might involve questionnaires like the Patient Health Questionnaire, which checks whether a patient’s symptoms of depression have improved or worsened. 

A therapist might also ask us to keep a journal or do ‘homework’ related to our sessions. Looking through these notes to see how they’ve changed is also a good way to gauge improvement. 

What improvement looks like

Someone’s mental health improvement will not always be tangible, however. Though it is possible to track the number of anxiety attacks or mood changes, it is not possible to quantify how deeply we now think about problems or how much self-insight we have gained. 

It is, however, much easier to track how well we understand and use the skills learnt in therapy and what they enable us to do. This includes:

Understanding our triggers

Most people with mental health struggles, of any degree, experience the majority of their negative feelings and thoughts in response to a trigger or stimuli – something or someone occurs to prompt unpleasant emotions and thought patterns. In therapy, a therapist will guide a person towards identifying their triggers and understanding how and why they have such negative effects. 

The therapist will then help the patient develop skills to mitigate the related mental distress. Starting to recognise our triggers outside of therapy and responding to them with relevant skills are marked signs of improvement. 

Having clearer insight into ourselves and others

After attending therapy for a while, many people are struck by how certain people, situations, and concepts are far clearer to them. We also start to understand our own patterns of thought and behaviour and recognize them without needing a therapist’s help.

This clarity signifies a deepening self-awareness, which is a sign that therapy is working and moving in a positive direction. Understanding complicated emotions is the first step towards untangling them. 

Feeling more confident

Knowing our patterns and triggers helps us work towards handling them in real-life situations that previously would have made us feel powerless. Much of the work of therapy is learning the skills to handle these situations and applying them in the real world.

For instance, a therapist might help a person develop coping strategies for anxiety in social situations. The easier it is to adjust to various social situations, the more confident the person is in their abilities to manage the anxiousness themselves. This self-confidence is a sign that therapy is working. 

Knowing when to seek help

Therapy is not one long series of successes. Working on ourselves is difficult, and relapses and setbacks are a common and normal part of the journey.

Sometimes, our distressed feelings will be too extreme to control with the skills we’re still practicing. In this case, choosing not to withdraw and instead to seek help from people we trust is a sign that therapy is working. This choice shows that we value ourselves and trust other people to value and support us, too. 

Feeling better and calmer overall

This is both the least tangible and the most common means to measure improvement. When therapy has been successful, our self-talk becomes kinder and more nuanced. We have a more positive worldview than we used to. We have more civil, better relationships with the people we care about. Feeling better overall is a big win and a sign that therapy is improving our quality of life. 

What to do if you think therapy is not working for you

Therapy comes in a variety of modes, each informed by different principles, techniques, and aims. It’s possible that the school of therapy we’re learning from, or even the personality of our therapist, doesn’t feel right.

If we feel like our therapist is not providing a non-judgemental, open space for us to voice our private thoughts, it’s a good idea to address it with the practitioner. Setting ground rules or deciding to look for a new therapist might benefit our mental wellness journey in this case. 

If we are evaluating our improvement mere weeks or months after beginning therapy, it is likely that we are not giving ourselves enough time to do the work required to improve. In this case, it is best to wait and keep trying the tools the therapist provides. 

If we have a supportive therapist, but don’t see any improvement over a long period of time, it is best to ask the therapist about their process. It is likely that they are taking a slower approach in order to help us better adjust, or that our particular struggles might need more work and time to show improvement. The therapist will be able to give us a better idea of how to gauge improvement for our unique case.

In some cases, a person and their therapist may conclude jointly that the brand of treatment provided isn’t working, even over a long period of time. In such a case, the therapist will refer a person to an alternative or more intensive means of help, like a psychiatrist. Or, the therapist might refer us to another a specialist in a mode of therapy better suited to our struggles. For example, if a general therapist cannot help with post-traumatic stress, they might refer the patient to a trauma therapist, who specialises in this particular concern.