How Can You Tell If Your Therapy Is "Working"?
by Carol Campbell, MFT
No one wants to waste money, particularly on something that can be expensive, takes a lot of time away from other activities, and causes everything in your head to get stirred up from time to time. So sometimes people want to know how they can tell whether or not the therapy they have embarked upon is actually worth all the trouble.
Many times when I am the Marriage and Family Therapist for someone, I am the first to notice that we are getting somewhere. I might notice, for example, that someone who has been anxious and fidgety in their chair or on the couch starts to have some moments of calm in the room with me. Sometimes I might remark on such a change, but other times that might seem intrusive and distracting, so I would just keep the awareness to myself for the moment. But subtle changes like that are signs that the therapy is beginning to have an impact on how the patient experiences our relationship. Growth that comes from what happens in our relationship is the basis for growth in the patient's wider world.
The next set of clues that the therapy is working comes when patients tell me that they themselves have noticed that something seems different. The patient might say, "I started to give my girlfriend my usual lecture about wanting more space, but then I remembered what you and I had talked about last week. I just listened to her concerns for about three minutes, and then we both just seemed to feel OK. She smiled and said she was going to the gym and would be back in a couple hours. I was pretty surprised!"
The next stage of changes to watch for are when family and friends start telling the patients that they seem to be doing things differently. The message can be subtle or direct. When new behaviors are really taking root and affecting people around you, people start responding differently to you. For example, it might be that a child patient gets invited to a friend's birthday party, when in the past that was unlikely to happen, because the parents didn't want a disruptive guest. Or your spouse comments that you seem to be more cheerful lately, and that they appreciate that you are more patient with minor annoyances. For others to notice behavior changes would indicate to me that the patient has been consistently shifting how they think about things, a sign that the learnings of therapy are now shaping the new default responses to life.
Here then is the usual pattern:
- Therapist notices positive changes
- Patient notices positive changes
- The world notices positive changes
As long as I continue to see more and more behaviors and attitudes falling into these categories, I assume my patient is probably continuing to make good progress in psychotherapy.
If you are the patient, you can always ask the therapist what he or she is noticing about how things are going. A helpful therapist will guide you to watch for your own observations, which of course are the most important ones. Sometimes the therapist will be more in touch with confidence and hope for the therapy, because the patient may be more focused at the moment on the inevitable confusion that precedes growth.
The bottom line, though, is that it takes time for therapy to work. Permanent changes for the good tend to come only when there are also periods of confusion, defensiveness, even anger at the therapist. But there should also be signs along the way that suggest good progress is being made.
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Calls regarding appointments are welcome at my private voicemail: 650-325-2576.
Carol L. Campbell, MFT, is a licensed marriage and family therapist providing psychotherapy and psychoanalysis for individual adults and couples in Palo Alto, California. She has degrees from Brown University and Santa Clara University and has been licensed since 1991. Carol is a graduate of the Palo Alto Psychoanalytic Psychotherapy Training Program sponsored at Stanford by the San Francisco Center for Psychoanalysis and was a candidate at the Psychoanalytic Institute of Northern California in San Francisco from 2010-2011. She is also a clinical member of the California Association of Marriage and Family Therapists and the Northern California Society for Psychoanalytic Psychology.
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