How Do I Know if My Therapist is Effective?

It can be a challenge to find the “right” therapist for you. You might come across someone who has a degree from an impressive school, writes extensively on psychology and mental illness, gives lectures and talks, and still isn’t an effective therapist. And while it is important for therapists to be educated, trained and up-to-date on current practices, there is so much more to a good therapist than just their background and education.

Because the science of therapy is subjective, it can be challenging to tell if your therapeutic relationship is truly “working.” Here’s a list of how effective therapists practice to help you determine whether you’re receiving the best possible care.

Do They Guide You to Your Goals?

Be wary of any therapist who makes promises like: “I can get you to recovery in six months” or “I can help you get rid of your anxiety.” Therapists should guide you towards reaching your goals, not make guarantees about when and how you will reach them. How you improve should be at your own pace. Additionally, they are not there to set your goals for you. This is your treatment—you’re in the driver’s seat.

Do They Show Acceptance and Compassion?

It’s one thing for your therapist to show concern or recommend against certain behaviors, but you shouldn’t feel judged or ashamed after a therapy session. Christine, a young adult living with Borderline Personality Disorder (BPD), tells a story of when she felt shamed by a therapist:

“I went to a therapist to talk about a relationship I was having a hard time getting over. I told her I would do outlandish things to keep this relationship alive, even though this guy made it clear he wanted nothing to do with me. This therapist responded by saying, ‘Christine, men don’t like clingy women. You need to be coy and play hard-to-get.’ She completely invalidated that my fear of abandonment had been triggered; to her, this situation had nothing to do with BPD, I was just making myself too available.”

The most effective therapists make you feel accepted and validated, showing understanding and sympathy/empathy for whatever you’re going through. They will approach you with compassion and kindness, and build enough trust for you to share your darkest thoughts and memories with them.

Do They Challenge You?

It’s important to recognize that therapy is not synonymous with friendship. An effective therapist will challenge you and help you see things from a different perspective, even if it’s hard to hear. They will give you homework that you may not like. For example, when I feel anxious, my reaction is to try to get rid of that anxiety any way that I can. So, my therapist often tells me to “sit with anxiety, accept that anxiety has visited you and observe how you feel.” She pushes me out of my comfort zone to help me overcome my fears and work towards my goal of managing anxiety.

Do They Check-In with You?

It’s important for your therapist to check-in with you about how you think therapy is going. After giving me challenging homework, my therapist will often ask me how it went or if I found it helpful. Since each session is tailored to you, a good therapist should adjust treatment based on your feedback. For instance, if you feel like they pushed you to do something you weren’t ready to do and you say you want smaller, more achievable steps, your therapist should take this into consideration for future exercises.

Do They Help You Learn?

An effective therapist offers different ways to help you learn skills (such as managing difficult emotions, handling stressful situations or practicing acceptance), understand yourself better and encourage healthy communication with the people in your life. “One therapist helped me see that when I like a person, whether it’s a relationship or a friendship, I have a hard time seeing red flags,” says Christine. “She helped me realize this about myself, and now I push myself to see people in a more realistic way.”

At the same time, this doesn’t mean telling you what to do each step of the way. Rather, they help you learn how to handle the stressful situations life throws at you. It’s problematic if you feel dependent on your therapist.

Do They Practice Cultural Competence?

Therapy should be tailored to your specific culture, background and needs. A good therapist is understanding of any cultural barriers you face and should keep those in mind while advising you. “When I met with my therapist in the first couple sessions, they were interested in learning about my culture and how it has impacted my experience,” says Ryann, a person with lived experience. “Culturally competent therapists say validating statements rather than questioning my upbringing.”

Do They Treat You as an Equal?

An effective therapist works with you and supports you. They’re your partner in bettering your mental health. They’re not the teacher instructing the “right ways” to behave or the parent asserting discipline over a child. There shouldn’t be any kind of power struggle or “doctor-knows-best” attitude in their demeanor. While it is important to respect their wealth of knowledge, you shouldn’t feel inferior to your therapist.

Therapy is one of the few parts of life that is all about you. Therapists are not there to express their own needs—they are there to help you reach your goals. Like any other worthwhile endeavor, the benefits of therapy don’t happen overnight, but over time you should feel like your therapeutic relationship is nothing but beneficial to your well-being.

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Laura Greenstein is communications manager at NAMI.