Therapy is not magic. It does not fix your life in one visit.
So how do you know if it is actually helping?
This guide gives you simple signs to look for. It can also help you talk with your therapist if you are not sure how things are going.
If you are just getting started and want to know what the first visit looks like, you can read What to expect in your first therapy session (with Medicaid or insurance) as a starting point.
Therapy takes time, but it should not feel stuck forever
Therapy is more like building a muscle than flipping a switch. At first, it might feel strange or even a little uncomfortable. You are meeting someone new and sharing things you do not usually say out loud.
In the first few weeks, it is normal to:
- Feel tired after sessions
- Notice big feelings coming up
- Wonder, "Am I saying this right?"
But over time, you should start to feel at least a little movement. It might be slow and small, but there should be some signs that things are shifting.
Early signs therapy might be working
Here are some quiet signs therapy may be helping, even if your whole life is not "fixed" yet:
- You feel a bit more understood. You leave sessions thinking, "Okay, this person gets me," even if you still feel sad or stressed.
- You notice your feelings sooner. Instead of exploding or shutting down right away, you may catch the feeling a little earlier.
- You have a few new tools. Maybe you have simple breathing exercises, a short journal, or one small thing to try when your anxiety spikes.
- You feel a tiny bit more hope. You may still struggle, but you can imagine things getting better, even just a little.
These are not big, movie-style changes. They are small steps that add up over time.
Changes you might see in daily life
Therapy is not only about how you feel in the session. It is also about what happens in your daily life. You might notice:
- Sleep is a bit better, or at least not getting worse.
- You snap at people a little less, or apologize more easily.
- You have one or two moments in the week when you handle stress better than before.
- You start saying "no" sometimes, or setting small boundaries.
These shifts may feel tiny, but they are real progress.
If money or insurance is on your mind, you can read Using Medicaid and insurance for therapy to better understand how your plan works and how to make the most of your visits.
What if you feel like nothing is changing?
Sometimes you can be in therapy for a while and still think, "I do not feel any better. Is this even working?"
This does not always mean therapy is failing, but it does mean something needs to be talked about.
It can help to ask:
- Have I been going regularly, or skipping many weeks?
- Am I being as honest as I can, or holding back big things?
- Are we mostly talking about the same story, or are we working on tools and steps too?
You can bring this right to your therapist and say:
- "I am not sure therapy is working. Can we talk about that?"
- "What changes do you expect to see by now?"
- "Can we set clearer goals so I know what we are working toward?"
A good therapist will not be upset. This kind of talk can actually make the work stronger.
How your therapist might measure progress
Some therapists use simple forms or rating scales every few weeks. You might see tools like:
- Short mood or anxiety checklists
- Questions about sleep, appetite, or focus
- Simple ratings of how you feel most days
These are used to track change over time, not to judge you. Over months, your scores may slowly improve, even if you have bad days.
Your therapist might also ask:
- Are you having fewer panic attacks?
- Are your fights at home getting shorter or less intense?
- Are you able to use coping tools more often?
If you are not sure what progress looks like, ask your therapist to share how they see it and how you can track it together.
Staying in therapy when you worry about cost
If you use Medicaid, Medicare, or other insurance, cost might still be on your mind. You may worry, "Is this worth it?" or "What if my copay adds up?"
You are not alone. Many people feel this way.
You can:
- Ask the office to explain your costs in simple words
- Ask how many covered visits you usually get each year
- Plan your visits with your therapist so you use your benefits wisely
If money is tight, Getting started with therapy on a budget has ideas you can try to make care more affordable while still getting support.
When it might be time to adjust your goals
Sometimes therapy is "working," but your goals need to change. For example:
- At first, you just wanted to stop having panic attacks.
- Later, you also want to work on boundaries at work or in your family.
You and your therapist can:
- Review your original goals
- Talk about what has changed
- Set new goals that fit where you are now
You are allowed to grow and shift. Therapy should grow with you.
When you might think about changing therapists
There are times when another therapist may be a better fit. This can be hard to admit, but it is okay to consider. You might think about changing if:
- You feel judged most of the time.
- You often leave sessions feeling more confused and upset, without a sense of support.
- You have shared your concerns about therapy not working, and nothing changes at all.
- You and your therapist do not seem to agree on what you are working toward.
If this happens, you can:
- Talk honestly with your therapist first, if you feel safe doing so.
- Ask if they can help you think about what you need in a new therapist.
- Look for another provider who takes your plan.
If you want help finding someone who takes your insurance, How to find a Medicaid therapist near you gives step-by-step ideas, including using Lavni.
How Lavni can support your therapy journey
Lavni is a Medicaid-first online therapy platform. We help people use their Medicaid, Medicare, or commercial insurance to see licensed therapists who understand their communities.
With Lavni, you can:
- Find therapists who take your plan in your state
- Meet by secure video, often from home or another private place
- Get help understanding your coverage, instead of trying to decode it alone
Our goal is not just to help you start therapy, but to help you stay with it long enough to see real change.
Therapy is a journey, not a test
You do not have to "do therapy" perfectly. You do not get graded on how fast you heal.
Therapy may be working if:
- You feel a bit more seen and less alone
- You are building small tools you can use in daily life
- You can imagine a life that feels even a little lighter than today
If you are not sure, you can talk to your therapist, review your goals, and decide together on next steps. You deserve care that helps you feel safer, stronger, and more yourself over time.