It's a common question for anyone who has seen a therapist: How long until you start to notice a change in how you feel, and how do you know if therapy is (or isn't) working?

Even before you start therapy, it’s important to vet the credentials of the therapist you’ve chosen, says Simon Rego, director of psychology training at Montefiore Medical Center in New York City. “Do your homework and find out the person’s background. It’s also crucial that you and your therapist have a good relationship and that the two of you click well.”

Once you start therapy, you need to give it a chance to work. You should see some results after 16 to 24 sessions, Rego says. “But if you are not seeing any gains after that many sessions, then something isn’t working,” he says.

For example: “If you are anxious but have not learned any new skills to manage your anxiety, including acceptance, then this is another sign that the therapy isn’t working. You should notice things like feeling less concerned about feeling anxious or not being as sensitive to the symptoms of anxiety.”

Talk to Your Therapist

If you feel that you’re not getting much out of therapy, the first step is to bring this issue to the attention of your therapist. Discuss what you feel isn't working, what you would like to change, and what roadblocks may be preventing you from feeling comfortable and engaged in therapy. If these issues cannot be resolved, consider switching therapists.

“The therapy relationship is key to a successful outcome, so it may be that you and your therapist weren’t a good fit and another therapist may help you address the issues much more effectively,” says Ryan Howes, a psychotherapist, writer, and adjunct professor based in Pasadena, California.

“A therapist could have the best skills and treatments in the world, but if the client doesn’t feel comfortable enough to open up and talk, those skills aren’t worth a thing."

Consider Another Type of Therapy

If you have tried a variety of types of talk therapy, and it’s just not working for you, you may want to explore alternatives to one-on-one therapy. Group therapy or, if you’re having relationship issues, couples therapy, are other options. “Depending on the nature of your problem, these are worthwhile options to explore,” Howes says.

Should You Consider Medication?

“Consider medication as a supplement to your therapy, boosting your mood or easing some symptoms so that you are better able to take advantage of the benefits of therapy,” Howes says. He adds, sometimes an individual may be so burdened with anxiety and depression that it can be difficult to even focus on talk therapy. When medication is prescribed, the person is able to engage in the work of therapy and experience its positive results.

“Medication is like a cast for a broken bone,” Howes says. “It is an external entity that provides protection and stability while the healing of therapy takes place beneath.” Ideally, once the internal healing has taken place, the medication will no longer be needed, he adds.

Medication should aways be taken under the guidance of a health care provider and therapist.

Simon Rego, PsyD, reviewed this article.


Simon Rego, Psy. D. Phone interview August 29, 2015.

Ryan Howes, Ph.D., ABPP. Email interview August 21, 2015.