How do you know when therapy is working?

[Bythesea1982]

Hi there. I’ve been seeing a person centred integrative therapist for a 4 months now but I’m not sure it’s really helping for the reasons I sought it for - relationship difficulties. This seems to have been skewed to talking about my partner a lot and when I mentioned wanting to talk more about other relationships at the end of one session they said we could do that next time and never did. I think I’ve been involved, been open when answering their questions and taken on board their insights but recently I’ve been feeling worse not better. It dawned on me recently that we haven’t set any goals which might make the progress feel more tangible and some sessions seem to take us a while to get into anything specific making it all feel a bit slow. The therapist I’m seeing is well trained and UKCP registered but I’m starting to question whether it’s working and whether it’s worth it - how do you know when therapy is working or when maybe the therapist isn’t the right fit? Is there something more I can do to feel more benefits of having it?
TIA to anyone who is able to constructively comment - please hold it mind that I’m feeling sensitive at the moment.

If I were to say, the therapist and the type of therapy (ie the therapeutical model being applied) don’t sound right for you, would you feel relieved?

Meanwhile, how’s your day going?

If it doesn't feel beneficial then don't be afraid to change therapists. Absolutely you should be seeing positive changes by four months in unless you have severe trauma/personality disorder or similar. A lot of therapists work like this and it doesn't work for everyone. It sounds like you might do well with CBT or similar which is much more goal and solutions focused. I would just tell her it's not working for you and get on with finding someone else.

@TheAutumnCrow I think in one way I’d feel relieved knowing that this isn’t right for me and validating in that sense and in another way overwhelmed by the prospect of starting over again. It was difficult finding this therapist due to therapist availability, their location, their fees and how I could match this to my work and family commitments. Thank you for taking the time to ask me about my day. It’s going ok, I hope yours is too.

@Rainbowchicken Thank you for your comments. I did previously have some CBT on the NHS but found the therapist to be a bit cold at times. I felt I needed more of a focus on why I think in certain ways rather than it just being focused on changing thought patterns. I didn’t feel a connection to them or that they were very understanding but it was online so maybe that didn’t help and maybe I should reconsider CBT in person.

If you’re interested in the ‘why’ behind things and what drives you etc, you might need to consider an approach like psychotherapy instead of CBT? I’m not sure if that’s what you’re doing now if you’ve found the therapist through the UKCP? I’m just a lay person but I think ‘integrative’ just means blending some techniques/models together to find what works best for the client, so I guess it depends what models they’re blending?

But whatever approach you go for, it’s always the relationship with the therapist that seems to be the most important thing.

I’ve never set goals in therapy or been asked to do so - that’s helped me find my own voice and direction from session to session. But it’s also felt scary and directionless at times as I’ve scrabbled about trying to work out what I want from therapy and life. I’ve been very used to having domineering people in my life, so that approach has been very healing for me.

when I mentioned wanting to talk more about other relationships at the end of one session they said we could do that next time and never did.

Do you open the sessions or does your therapist set the direction? Just wonder if you’ve never returned to this subject in session because you haven’t brought it up? It’s worth talking over this with your therapist - perhaps figure out together whether it’s a misunderstanding or whether you need to develop more assertiveness to ask for what you need and want etc.

Whatever’s going on, it’s always worth raising all your worries with your therapist directly because (with a good therapist) that’s how the relationship deepens, and it can give you lots of fodder for understanding what generally goes on in your relationships and areas you might want to work on. If you don’t feel a sense of connection and deepened relationship and direction through that chat, then it’s probably worth looking elsewhere.

In my experience, therapy should feel more structured and progressive than this - even when it’s person-centered and “led” by the client. Like with anything, we sometimes gel with people and we sometimes don’t - and that’s definitely true for therapy. I know it’s tiring to have to start again, but I think a fresh start with a new therapist could really help, especially as you say you’ve been feeling worse and not better. Perhaps searching for a new therapist with the specific things you think you’re lacking now (setting of goals, focus on systematic relationship issues rather than just one partner) would help. (You can have some dialogue with potential therapists about these things first before settling.)

@FloraBotticelli All excellent points - thank you for sharing your thoughts and own experience. I think that’s what it is - it feels directionless and then I also can feel somewhat frustrated with this especially since I know I can’t afford an endless amount of therapy. I just wonder if that’s what therapy, just like life in general, can be like at times.
It’s true that perhaps I do lack the assertiveness to bring up more regularly what I want to work on but then I do wonder if the therapist can see this happening that they could guide the session into being more focused. Some sessions I come away from thinking ‘what did i get out of that / what did I learn?’.
It’s also a good point to raise this with them. As you say this will go one of two ways - lead to better understanding between us where perhaps there’s been miscommunication or tell me that we’re not a good fit.

@moondip All good points worth thinking about. I don’t feel judged by the therapist I’m seeing but I have felt that some of my issues have been minimised - perhaps I’ve not been completely clear how much these things affect me. I think part of the problem is not knowing how to search for a good fit therapist as I like most people only have a bit of understanding of what some therapies involve and don’t know much at all about other modalities. This is where is would be really helpful for a trained therapist to be honest in saying that maybe you need a different type of therapy and refer you on to someone who can facilitate this.