You have been going to therapy for a while. Some weeks feel helpful. Other weeks you leave wondering, "Is this actually doing anything?" That is a very normal question to ask. Progress in therapy is often quieter than people expect. This post looks at how to know if therapy is working, why it can feel harder before it feels easier, why the relationship with your therapist matters and what to do if things feel stuck.
This post is general information, not a diagnosis or a treatment plan.
Signs therapy is working that are easy to miss
Many people expect progress to feel like a big moment of relief. Sometimes it does. More often, it shows up as small, practical changes in daily life, long before you feel "better" overall.
Here are some signs therapy is working that people often overlook:
You catch a pattern sooner. You still get pulled into old habits, but you notice it in the moment instead of a day later.
You bounce back faster. A hard day still hurts, but it does not ruin the whole week.
You say something new out loud. You share a feeling or a memory you have kept to yourself for years.
You set a limit you used to avoid. You say no, ask for help or speak up, even if your voice shakes.
You are kinder to yourself. The voice in your head is a little less harsh after a mistake.
People around you notice. A friend or partner says you seem calmer or more open.
None of these mean the work is finished. But they are real signs of change. It can help to jot them down when you notice them, because small wins are easy to forget.
Why therapy can feel harder before it feels easier
Sometimes therapy feels worse for a while. That can be confusing, especially if you came in hoping to feel better.
Talking about painful things can stir them up at first. You might feel more tired after sessions, think about hard memories more often or notice feelings you used to push away. This does not always mean therapy is failing. Often, it means you are finally looking at things you have been carrying alone.
That said, you should not just push through in silence. If you feel worse for many weeks, or if sessions leave you feeling unsafe or overwhelmed, tell your therapist. A good therapist will want to know, and can slow the pace, change the focus or add more support between sessions.
The relationship is part of the treatment
One of the most studied parts of therapy is the working relationship between you and your therapist. Researchers call it the alliance. It includes feeling heard, trusting each other and agreeing on what you are working toward.
A 2015 review by psychologist Bruce Wampold looked at many studies of what makes therapy helpful. It found that shared factors, such as the alliance, empathy and expectations, are important to the benefits of therapy across different types of treatment (see Sources). A 2020 meta-analysis found that the alliance was linked with better outcomes, even after taking into account other things about the client and the treatment (Flückiger and colleagues, see Sources).
In plain words, it matters whether you feel safe and understood. A few questions can help you check the fit:
Do I feel my therapist listens and understands me?
Do we agree on what I came here for?
Can I tell them when something is not working?
Do I leave sessions with something to think about or try?
If you are just starting out, our post on questions to ask a therapist can help you get a feel for fit early on. Some people also develop strong feelings for their therapist, which is a different topic and also something you can talk about in session.
How you and your therapist can check therapy progress together
You do not have to guess about progress on your own. Many therapists build in ways to check therapy progress with you.
Some use short questionnaires every few sessions to see how you are doing. Others set aside time to review your goals together. Research on this practice, often called routine outcome monitoring, has grown over the past decade. A 2024 review found that collecting short check-ins and using that feedback in sessions appears to add to the benefits of therapy (McAleavey and colleagues, see Sources).
It is normal, and useful, to ask your therapist how they think things are going. You might ask, "Can we look at whether this is working toward what I came for?" or "What changes have you noticed since we started?" These questions can lead to some of the most helpful sessions.
You can also check in with yourself between sessions. Once a month, ask yourself, "Is therapy working on the things that brought me here?" Look back at how you felt when you started. Compare a typical week then with a typical week now. Writing down a few notes each month makes these changes easier to see, and gives you something concrete to bring to your next session.
How often you go can also play a part. Our post on how often you should go to therapy looks at weekly, every other week and other rhythms.
If therapy is not working, what to do next
Sometimes, even with time and effort, therapy is not working the way you hoped. That is not a failure on your part. Here are some steps to consider.
Say it out loud in session. This can feel awkward, but it is often the most useful thing you can do. You might say, "I am not sure this is helping. Can we talk about it?" Your therapist can only adjust if they know.
Adjust the goals or the approach. Maybe your goals have changed since you started. Maybe a different style, such as more structure or more space to talk, would suit you better. A good therapist can shift the plan with you.
Consider a different therapist. Not every match works, and that is okay. Changing therapists is a normal part of counselling. It does not mean you did anything wrong, and it does not mean therapy cannot help you. You can read more about the process on our how counselling works page.
If you want to try a new match, a free consultation can help. Our admin team will listen to what has and has not worked for you and help match you with a therapist who fits, in person or online across Ontario.
Cost, billing and your first step
Sessions with our therapists range from $130 to $200, depending on the clinician.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers. Coverage depends on your plan, so check with your insurer before you start.
Book a free 15-minute consultation with our admin team. We can help you find a therapist who fits what you need, in person or online.
If you're in crisis: if you or someone you love is in immediate danger, call 911. If you're thinking about suicide, call or text 9-8-8 any time, day or night.
Last reviewed: October 2026
Sources
Wampold, B. E. "How important are the common factors in psychotherapy? An update." World Psychiatry. 2015. https://pmc.ncbi.nlm.nih.gov/articles/PMC4592639/
Flückiger, C., Del Re, A. C., Wlodasch, D., Horvath, A. O., and colleagues. "Assessing the alliance-outcome association adjusted for patient characteristics and treatment processes: A meta-analytic summary of direct comparisons." Journal of Counseling Psychology. 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7529648/
McAleavey, A. A., de Jong, K., Nissen-Lie, H. A., and colleagues. "Routine Outcome Monitoring and Clinical Feedback in Psychotherapy: Recent Advances and Future Directions." Administration and Policy in Mental Health and Mental Health Services Research. 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11076375/