In therapy? Here's how to assess effectiveness

You seem to feel better, getting things off your mind each week, but how do you know if you're actually gaining from seeing your therapist? There's a difference between feeling better and getting better. The former usually brings immediate relief. The latter results in lasting life change that will lead to healthy behaviors and new ways of coping with stress and problems. This comes only when you acquire tools and skills you can apply beyond the immediate crisis or concern that brought you to the therapist in the first place.

In psychotherapy, regardless of the school of thought, a collaborative effort should exist in which the client and therapist both work hard to achieve the desired outcome.

One of the first things that you should do is make a list of realistic goals and what you're hoping to gain from therapy. Share it with your therapist so that a specific treatment plan can be established. Reviewing the goals every few sessions will give you and the therapist an opportunity to monitor progress.

Ideally, as insight, support, and direction are provided, you should move closer to reaching the goals with each session.

Homework should be given, as this bridges what's learned in the session with what happens in real life. It gives the patient an opportunity to develop thoughts or concepts arrived at during sessions, to try out newly acquired skills and to implement exercises.

For example, if social anxiety is the problem, then homework may be practicing relaxation techniques and an exercise in which the patient approaches others casually, asking for the time or directions. The patient should keep a written record of his or her reactions to the exercise and bring it back to a session and review it with the therapist.

As treatment continues, information learned in sessions will be more accessible when a patient is away from therapy, and come more naturally. The patient will develop a set of skills that can be applied with confidence to situations that once proved to be problematic.

Over time, the patient will find the answers and rely less on the therapist's guidance, and the need for sessions will be less frequent, allowing the patient to develop a sense of independence.