Progress Check: Evaluating Your Therapy Journey

Well done on showing your commitment to yourself and your therapy! Now could be a good time to evaluate the process so far.

Table of Contents

• Why evaluate your progress in therapy?
• So how can you measure progress?
• How often should you track your progress?

Why evaluate your progress in therapy?

Research shows that tracking progress improves treatment outcomes; it also helps both clients and therapists make informed treatment decisions ¹².

Here are a few tips to help you evaluate how helpful therapy has been so far:

• Try not to judge: yourself, your therapist, the type of therapy, or even the entire process.
• Rather, focus on: 1) if the therapeutic approach needs adjusting; 2) whether the frequency of sessions should change, and 3) if any other factors need to be considered, for you to gain the most from therapy.

Remember: Progress in therapy happens across multiple dimensions at the same time.

So how can you measure progress?

Measure the reduction in problematic symptoms. Start by listing the symptoms (or reasons) that led you to therapy, and track improvements in different areas of your life by asking yourself these questions.

• Emotionally: Are you in better control of your emotions?
  • Are you becoming more aware of your emotions?
  • Can you tolerate difficult emotions by sitting with them?
  • Can you share your emotions more appropriately in your relationships?
  • Do you opt for healthier coping mechanisms to deal with difficult emotions?
• Regarding your physical health:
  • Do you feel you sleep better (more soundly, better quality, less or more, depending on the exact initial problem with sleep)?
  • Is your appetite more "normal" than it was before starting therapy?
  • Are there any positive changes in your overall physical health?
• Relationship changes: Are you finding it easier to engage with others?
  • Do your relationships feel more positive?
  • Are you finding it easier to communicate your needs to others?
  • Are boundaries easier to establish?
  • Are conflicts easier to resolve?
  • Do you feel more comfortable in social settings?
• Thought processes and thinking styles:
  • Can you focus and concentrate better at home, work or school?
  • Are your thoughts more positive overall and less harmful?
  • Can you identify negative thoughts more readily, and then challenge these thoughts with kinder and more realistic thoughts?
  • Are you more aware of your triggers and patterns of thinking?
• Looking at your behaviours:
  • Are your daily routines healthier?
  • Are you engaging in regular self-care habits, like eating healthier and exercising while reducing harmful practices, like over- or under-eating?

Apart from feeling better in your day-to-day functioning and noticing improvements, there are some helpful, freely available, standardised measures which could help you determine if your therapy is working ³:

• To measure mood changes: the PHQ-9 is useful.
• To assess anxiety-related problems: consider the GAD-7.
• The DASS-21: measures anxiety, depression and stress factors.

Remember: Although standardised measures show progress, they don't capture your lived experience. Use them as guides, not the whole story ⁴.

Now that you have all this information, the next step is to work with your therapist to look back at the progress made, firstly, and then to look forward to what you want to gain from future therapy sessions.

Start by listing your goals, determining what progress would look like and regularly assessing whether goals need to change.

Also, monitor your own progress and track aspects of your functioning. This increases self-awareness.

• You could notice patterns and changes over time by keeping note of changes in your mood, anxiety, symptoms and activities.
• Tools like journalling and mood tracking apps are helpful.

Remember to use these measures at regular and similar intervals. Then acknowledge your successes and note where you would like more positive changes.

How often should you track your progress?

• Ideally, you and your therapist would have established some therapeutic goals at the start of therapy.
• If you didn't, you could do so at your next session.
• While some research shows the average course of outpatient therapy is around 13 sessions ⁵, other studies recommend structured check-ins at specific intervals, such as every 4-6 sessions ⁶. Ultimately, the most important factor is finding a regular cadence that works for you.
• Find a balance between standardised measures (like the GAD-7 or PHQ-9) and personal reflection.
• Measurement tools chosen should align with your own goals and preferences. This aligns with evidence showing that the frequency of tracking can vary based on the treatment approach and client preference ⁶.
• Personalise the frequency with which you want to assess your progress:
  • daily for some measures,
  • weekly for others,
  • or monthly for comprehensive tracking.

Note, though: if you find progress tracking is overwhelming or impractical, simplify it.

It is better to use fewer good quality measures and at more manageable intervals.

Remember, progress in therapy does not follow a straight line or linear process ⁴. It is entirely normal to have good and bad days, even if you are making progress. Fluctuations are normal!

Expect setbacks during difficult periods. Therapeutic growth should look like a spiral. Some issues are revisited over different sessions. But the level of insight you show towards these should be greater each time.

Areas of your life and functioning will progress at different rates. Some symptoms improve quickly, and some skills come more easily than others, with gradual improvements noted instead of sudden change. Understanding something intellectually often happens before we can make the necessary emotional or behavioural changes.

Plateaus aren't failures—they're proof that your progress is taking hold. Skills are strengthening and insights deepening.

When progress seems still, remember: plateaus mean your gains are settling in. The next breakthrough is being built right under the surface.

With kindness

Vicky Downing
Educational Psychologist

Disclaimer: This content is for educational purposes only and does not constitute a substitute for professional medical or psychological advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition or mental health concern.