I often have clients ask, "Lily, what is the actual plan here? How do I know if therapy is working?"
You may have doubts about the legitimacy and efficiency of psychotherapy since there isn't an agenda or time scale. These are valid and important concerns. Here's what to expect from the therapeutic process..
What is the actual plan here?
Beginning
Throughout your time in therapy, though particularly at the start, you will be invited to make clear what you'd like to achieve from therapy. This helps to create a metric for whether therapy is going well. You will also share your experience regarding what has brought you to therapy and how it affects your life so that both you and your therapist have a greater understanding of your circumstance.
This is really a stage where you are getting comfortable with your therapists and could begin to trust them.
Middle
As therapy progresses, you and your therapist will work hard to find meaning in your experience. This involves tentatively breaking aspects down to learn how they are simultaneously independent and interrelated. The aim is to explore what is underlying and at the heart of whatever is it that has brought you to therapy and to remove obstacles that are affecting your quality of life.
Frequently during therapy you and your therapist will "check-in" with each other to step back and oversee how therapy and the therapeutic relationship are progressing. It is an opportunity to evaluate how you are working together, the goals set and any expectations. It's important that you speak out if you are not satisfied with the work being done.
How do I know if therapy is working?
I trust clients will know if therapy is working! But - therapists do have their own ways to measure if therapy is effective for a client. This is dicey waters to enter - I must say, because who gets to say if something is effective for another person. Nonetheless, us therapists have ways to observe the therapeutic process and see if our clients are shifting in the process.
We tend to use Carl Rogers' seven step model that he created, and later perfected, in 1961. These stages are fluid - meaning, a person could be one stage in regards to one part of their life and in a totally different stage in another part of life. That's normal! Likewise, it's normal to generally be at one stage and quickly slide to another totally different stage (up or down the stages).
Simplified, the stages looks like this ...
In stage 1 folks tend not to talk about their feelings so openly. They often blame others and don't take any responsibility for whats happened / is happening. It's not super common to have people fixed in this stage (they don't tend to come to therapy for a starts).
Stages 2 and 3 see a gradual shift towards taking responsibility for one's own situation and feelings.
Stage 4 is where clients tend to talk about their feelings and/or how things have personally impacted them. Their experience is talked about but may only be in parts and may come with a lot of shame and guilt. This is perfectly fine and your counsellor will take care to create a secure and trusting environment in which you can explore. Willingness to talk about things and push through with your therapists support is needed here.
Stage 5 is a time where clients tend to take ownership of themselves and their lives. Movement is fast and things can change rapidly. The client is confident about their decisions and can feel hopeful.
Stage 6 is where the butterfly comes out of the cocoon. Individuals are accepting of themselves and the feelings and thoughts they have. It's a general attitude of "I accept this pain inside me and what has happened. I understand what I did and what others have done. I feel a compassion towards myself and them, and this is where I'm at". This is a stage where therapy often ends.
There is a seventh stage. This person is almost never in therapy. They are fluid and flexible and are accepting of reality and open to change. Happy days for this person.
End
You should be free to end sessions whenever you like without questions asked, and you can come back for one-off sessions too. The last session may be prepared for and discussed at length or it might come suddenly due to unexpected circumstances. However, the therapeutic process ends when you feel secure and accepting of yourself, more able to face challenges and fulfil your potential.
Written by Lily Llewellyn
22nd May 2023
Lily is a psychotherapist trained and educated in person-centred counselling to master's level and achieved an MA in anthropology. Her areas of interest include our relationships with ourselves and others as well as the ways in which we relate to objects, such as food and money, and activities, such as shopping and work.
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