By Dr. Sarah Parsons

You have been attending therapy, sharing difficult things, and making time in an already busy schedule. Then a reasonable question comes up:

“Is this helping?”

You are allowed to ask. Understanding the purpose of treatment and how progress will be assessed belongs in the conversation from the beginning.

Start with what you want to change

“Feel better” is an understandable goal. I also encourage people to describe what feeling better would make possible.

Perhaps you want to spend less time caught in worry, have fewer arguments, return to activities you avoid, or manage a difficult emotion without losing the rest of your day.

Specific goals give you and your therapist something to revisit.

Ask how the approach fits your needs

Psychotherapy includes several different treatments. Approaches are often tailored to particular conditions, symptoms, or concerns. A therapist should be able to explain the approach they recommend, why it fits, and what participation involves.

You might ask:

“What are we working toward?”

“What will we do in sessions?”

“Is there anything I should practice between appointments?”

“When should we review whether this is helping?”

You do not need professional terminology to have a useful discussion.

Make room for the changes you care about

When reviewing treatment, I would want to hear about everyday examples.

Did you handle a conversation differently? Were you able to do something you had been avoiding? Are symptoms becoming less disruptive? Do you understand a recurring difficulty more clearly—and have a plan for responding to it?

These questions help make the discussion concrete. Your therapist may also use questionnaires or other measures to track symptoms.

Tell your therapist when something feels unhelpful

You might feel misunderstood, unsure about the plan, or reluctant to disagree. Bringing that up can provide useful information.

A simple opening is:

“I value having this time, but I’m not sure we’re making progress on the things that brought me here. Can we review the plan?”

You can also say when an exercise feels confusing, impractical, or too difficult. Your experience matters when deciding what to do next.

Reassessment is part of care

If you have participated for a reasonable period without improvement, discuss it with your therapist. Depending on the situation, you may consider adjusting the goals, changing the approach, seeking another clinician, or reviewing whether additional treatment is needed.

If symptoms are worsening, raise that promptly rather than waiting for a scheduled progress review.

I want patients to feel comfortable asking questions about every part of their care. Therapy takes time and effort, and you deserve to understand how that effort connects to your goals.

Dr. Sarah Parsons is a psychiatrist at Mental Health 2 You in Louisville, Kentucky. This article provides general education and does not replace an individual medical evaluation.