How Do I Know if Therapy is Working?
You've been going to therapy for a few weeks—maybe even a couple months—and there's this nagging question in the back of your mind: "Is this actually helping?" You might not say it out loud to your therapist, but the thought is there. And honestly? That's completely human and understandable.
Therapy is a significant investment of your time, money, and emotional energy. Of course you want to know if it's worth it. Maybe you had a panic attack at last Sunday's Chiefs game even though you've been in therapy for four weeks. Or perhaps you still felt overwhelmed during your commute through downtown Kansas City traffic, despite learning those breathing techniques. It makes sense to wonder if therapy is really making a difference.
The frustrating truth is that therapy progress isn't always as obvious as we'd like it to be. Unlike taking medication for a headache where you feel relief in 20 minutes, therapeutic change often happens gradually and sometimes in ways you might not immediately notice. But that doesn't mean you should have to wait forever to see improvements, and it definitely doesn't mean therapy isn't working.
As therapists at Aspire Counseling, we believe in evidence-based treatment that balances the best available research with our clinical expertise and, most importantly, your individual needs and preferences. This approach helps ensure that the therapy you're receiving has a strong foundation for creating real change in your life.
What Does "Therapy Working" Actually Look Like?
Therapy "working" looks different for every person, and the changes might be more subtle than you expect. For someone dealing with panic attacks, progress might mean going from daily panic episodes to having them once a week. For someone working through trauma, it might mean sleeping through the night without nightmares. And for someone struggling with depression, it might mean feeling motivated to shower and get dressed most days.
Here's what's important to understand: progress in therapy isn't always linear. You might have a breakthrough one week and feel like you're sliding backward the next. This doesn't mean therapy isn't working—it means you're human, and healing involves ups and downs.
Some signs that therapy is working might include:
You're handling stressful situations differently than you used to
You're more aware of your thoughts and emotions
You feel more hopeful about the future
You're using coping skills you've learned in therapy
People in your life have commented that you seem different
You're more willing to try new things or face challenging situations
Maybe you noticed that when your flight got delayed at KCI Airport last month, you didn't have the same level of anxiety spiral you would have had before therapy. Or perhaps you were able to enjoy a night out at Power & Light District without constantly worrying about what could go wrong.
Why Don't I Notice Changes Right Away?
You might not recognize improvements immediately because you're living inside the changes as they happen, which makes them harder to see. It's like watching your hair grow—you don't notice it day to day, but after a few months, the difference is obvious.
This is especially true for people who are naturally hard on themselves or tend to focus on what's still wrong rather than what's improving. High achievers, in particular, often struggle to recognize and celebrate their progress because they're so focused on their ultimate goals.
Changes in therapy often start internally before they become visible externally. You might begin to notice that you're having different thoughts about yourself or situations before your behavior actually changes. Or you might find that you're feeling less overwhelmed by emotions, even if you're still experiencing them.
How Long Should I Expect to Wait?
Most people start noticing some difference after about 8 sessions when they're attending therapy weekly (or following whatever treatment frequency their therapist has recommended). This doesn't mean you'll be "cured" after 8 sessions, but you should start to feel like something is shifting.
The importance of consistency can't be overstated here. Regular therapy attendance, especially in the beginning, helps build the therapeutic relationship and allows you to practice new skills and insights between sessions. If you're not seeing your therapist regularly, it may take longer to notice changes.
For some specific types of therapy, the timeline might be more defined. Cognitive Processing Therapy for trauma, for example, typically involves 12-18 sessions, and many people start to feel relief around the halfway point. Exposure therapy for specific phobias might show results even more quickly.
This is where measurement-based care becomes really valuable. At Aspire Counseling, all of our therapists send clients at least one assessment per month to help track progress objectively. Most of our clients complete these through an app or on our website before sessions, though sometimes we do them during the session. The point is that your therapist should have actual data to review with you periodically about how things are going.
Should I Be Doing Anything Between Sessions?
Absolutely! Therapy doesn't just happen during your 50-minute session each week. The real work often happens between sessions as you practice new skills, notice patterns, and apply what you've learned to your daily life.
Your therapist might give you specific homework assignments, suggest you practice certain coping skills, or ask you to pay attention to particular thoughts or behaviors. Taking these suggestions seriously can significantly speed up your progress.
Even if your therapist doesn't give you specific assignments, you can actively participate in your healing by reflecting on what you discuss in therapy, trying to implement new strategies, and being honest with yourself about what is and isn't working.
What If I'm Not Sure Therapy is Helping?
If you've been in therapy for at least 8 weeks and you're genuinely not sure if it's helping, that's a conversation worth having with your therapist. Sometimes what feels like "not working" is actually the difficult but necessary process of facing uncomfortable truths or emotions.
Here are some questions to ask yourself:
Am I being honest with my therapist about what I'm struggling with?
Am I doing the work between sessions, or just showing up for the hour?
Do I feel comfortable with my therapist, or is there something preventing me from opening up?
Are my expectations realistic for where I should be in the process?
Remember, feeling reluctant to go to therapy sometimes is completely normal and doesn't necessarily mean it's not working. Sometimes the sessions where you least want to go are the ones where you make the most progress.
Your therapist should also be able to show you objective data from those monthly assessments we mentioned earlier. If your depression scores have dropped from a 15 to an 8, or your anxiety levels have decreased measurably, that's concrete evidence that therapy is working—even if it doesn't feel that way day to day.
What If I Need More Than Weekly Sessions?
For some people and some conditions, weekly therapy isn't enough to create the momentum needed for change. Twice-weekly sessions can be incredibly beneficial for certain types of treatment, especially intensive trauma work or when you're dealing with severe symptoms.
If you feel like you need more support than weekly sessions provide, don't hesitate to discuss this with your therapist. They can help you determine if increasing session frequency would be beneficial or if there are other ways to increase your support between sessions.
How Do I Track My Progress?
One of the most helpful things you can do is keep some kind of record of your progress. This doesn't have to be complicated—it could be as simple as rating your mood or anxiety level from 1-10 each day, or writing down one thing you did differently than you might have before therapy.
Some people find it helpful to keep a therapy journal where they write down insights from sessions or track specific goals. Others prefer to focus on concrete behaviors, like how many social events they attended or how many panic attacks they had.
At Aspire Counseling, we use formal assessment tools to help track progress more objectively. We call this providing measurement based care in counseling. Some of our clients might roll their eyes when we send out yet another 2 minute assessment to complete. But the truth? These are a powerful way for both you and your therapist to make sure you are getting the most out of counseling. These provide clear data about how you're doing over time, which can be especially encouraging when you feel like you're not making progress. When you can see that your GAD-7 scores (a measure of how much anxiety is impacting your life) have dropped from severe to moderate anxiety levels, it validates that the work you're doing is paying off.
When Should I Be Concerned that Counseling isn’t Working?
While therapy progress isn't always immediate or obvious, there are some red flags that might indicate you need to have a serious conversation with your therapist about the direction of your treatment:
You feel worse consistently after several months of therapy
You don't feel comfortable or safe with your therapist
Your therapist doesn't seem to understand your concerns or goals
You feel judged or criticized in sessions
There's no clear treatment plan or direction to your therapy
You're not learning any new skills or gaining new insights
Your therapist isn't using any measurement tools to track your progress
I know it might sound stressful to talk to your therapist about this. But the truth is, your therapist WANTS to know if you don’t feel like therapy is helpful. Their job is to help you. We got into this field because we care about helping. So if you don’t feel like counseling is helping you reach your goals? Give your therapist a chance to help adjust your treatment.
Begin Therapy in Missouri with Evidence-Based Treatment
At Aspire Counseling, we believe that effective therapy combines evidence-based treatment approaches with personalized care that meets each client exactly where they are. We use measurement-based care to ensure that your therapy is actually working—not just hoping it is.
Our therapists are trained in proven approaches like EMDR, CBT, DBT, and Exposure Response Prevention that have strong research support for treating anxiety, trauma, depression, and OCD. But we also understand that every person is unique, which is why we customize our approach to fit your specific needs, goals, and preferences.
We serve individuals and families throughout Missouri, with offices in Lee's Summit (convenient to the Kansas City metro area) and Columbia, plus secure online therapy for anyone in the state. Whether you're dealing with trauma, anxiety, depression, OCD, or life transitions, our team is here to provide the compassionate, effective support you deserve.
All of our therapists use measurement-based care, meaning you'll complete brief assessments regularly to track your progress objectively. This ensures we can adjust your treatment as needed and gives you concrete evidence of the positive changes you're making.
If you're ready to start therapy or wondering if our approach might be a better fit for your needs, contact us today for a free consultation. We're committed to helping you find the support that truly works for your unique situation and goals.
About the Author
Jessica (Tappana) Oliver, LCSW is the founder and Clinical Director of Aspire Counseling. With extensive experience in trauma and anxiety treatment, Jessica is passionate about providing evidence-based care that creates real, lasting change. She specializes in trauma therapy intensives, EMDR, and helping clients navigate complex life transitions.
Jessica founded Aspire Counseling with the mission of making effective, compassionate mental health care accessible to individuals and families throughout Missouri. She previously founded Simplified SEO Consulting, where she spent years helping mental health professionals grow their practices. When she's not in session with clients or supporting her team, Jessica enjoys cheering on the Chiefs, visiting Union Station’s Science Center with her family or traveling.
Aspire Counseling offers evidence-based therapy for anxiety, trauma, depression, and more at our Lee's Summit and Columbia, MO offices, as well as online throughout Missouri. Our therapists are trained in proven approaches that create real, lasting change, and we use measurement-based care to ensure your therapy is working. Contact us today to learn more about how we can support your mental health journey.
