How Do I Know if My Therapist is Effective?

FEB. 14, 2018

By Luna Greenstein


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.


Social worker? Psychologist? Therapist?
Having a hard time navigating the complicated world of mental health care professionals?
Learn more here


Laura Greenstein is communications manager at NAMI.


JUL, 26, 2018 11:25:12 AM
My first session was last week with therapy...doc is 30 years old...i am 58 lost my father stepson and now my mother 86 helping her plus family issue...its life and i understand my doctor has to start somewhere and might have been trained but life experiences he has no clue...the first 5 minutes instead of us getting comfotable and knowing how i am as a person was *****y etc...had me in tears...never will return...

JUL, 18, 2018 02:37:13 AM
Lourdes T.
Please, do you know a good therapist ( psychiatrist) and a psychologist in Chicago area? Thanks.

MAR, 04, 2018 10:02:22 PM
I have tried a few therapist to help me with my issues and how to direct my bipolar in a better way. I just couldn't connect. I almost gave up. I now have one that is understanding, helpful, just someone to hear me and help me with all my thoughts. Thank you for letting myself and others know what is a good therapist.

FEB, 28, 2018 06:18:53 PM
As a therapist this article was insightful .

FEB, 28, 2018 01:59:22 PM
Steve Darrow
I too liked the article and thought it was right on. As a practicing therapist I strive to provide my client with those exact experiences so that they will be able to make the best decisions for themselves and their lives. There is a balance for a good therapeutic relationship to strike in terms of support and the right level of challenge for each client. In my opinion, a good therapist is continually sensitive to this balance.

FEB, 28, 2018 12:55:20 PM
Great article! As someone in therapy myself, most all of the points have been addressed in my relationship with my own therapist. I referred this article to my son, who has a co-occurring disorder with substance use and psychosis. I asked him to look at the article and think about his own therapist. He told me he found it helpful. Thanks again.

FEB, 28, 2018 11:43:06 AM

FEB, 23, 2018 06:44:44 PM
Nancy L. Atkinson
I have been very lucky to have a GREAT therapist

FEB, 21, 2018 01:45:30 AM
Marty Rey
Thank you for putting things in perspective of what a therapist role would look like, I have yet to encounter a Therapist with the tactics you have shared in this article. It is very beneficial to realize that sitting and discussing my feelings with some feedback, is not what felt fine to my recovery. Liking my therapist is great, but I need more guidance
Thank you,

FEB, 16, 2018 11:29:36 PM
Great article-completely on point. More therapists need to remember not to judge others or dump their personal "stuff" into a session😀

FEB, 16, 2018 08:11:56 AM
Excellent article...Thank you.

FEB, 16, 2018 07:43:56 AM
Sibley Biederman
I think this is a very important article and makes a lot of sense. I have seen many different people over the years and most have worked out but some have not. I have had to “move on” a couple times when I didn’t feel we were making a connection.

Submit to the NAMI Blog

We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.

Check out our Submission Guidelines for more information.