How to Know if Therapy is Working: 10 Signs of Progress You Might Be Missing

Written by Dr. Kait Rosiere, Licensed Psychologist and Eating Disorder Specialist in Orlando, FL

You've been going to therapy for a few weeks — maybe even a few months. And you're starting to wonder: is this actually working?

It's a fair question. Therapy isn't like taking medicine, where you can measure the results in a blood test. The changes are often subtle, internal, and easy to miss — especially when you're in the middle of them.

As an Orlando therapist who specializes in eating disorders, trauma, and anxiety, I've seen many clients question whether therapy is "doing anything" right around the time they're actually making the most progress. That's because real therapeutic change doesn't always look the way you'd expect.

This post will help you recognize the signs that therapy is working — even the ones that are easy to overlook.

Why Progress in Therapy Is Hard to See

Before we look at the signs, it's worth understanding why therapy progress is so hard to recognize from the inside.

You're in it every day. Change that happens gradually is hard to notice when you're living it. It's like watching a child grow — the people who see them every day notice it least.

Your standards shift as you grow. As you heal, you become more aware of what's possible. Things that would have felt like huge wins a few months ago now feel like the bare minimum.

Healing isn't linear. You'll have setbacks, hard weeks, and days where it feels like you're back at square one. That's normal. According to research on psychotherapy outcomes, most people experience temporary increases in distress during the process of working through difficult material (Lambert, 2013).

You may be comparing yourself to others. Social media, TV, and even friends can create unrealistic expectations about what healing "should" look like.

10 Signs Therapy Is Working

Here are some of the most common signs of progress that clients tend to miss:

1. You're more aware of your patterns. You might not have changed the behavior yet, but you notice it happening. You catch yourself people-pleasing, shutting down, or restricting. That awareness is a huge first step. In CBT, this is called cognitive awareness — the ability to recognize your automatic thoughts and patterns.

2. You're feeling more, not less. This one surprises people. If therapy is bringing up emotions you used to numb, avoid, or suppress — that's progress. It means your defenses are softening and you're learning to tolerate difficult feelings instead of running from them.

3. Your relationships are shifting. Maybe you're setting boundaries for the first time. Maybe you're having conversations you used to avoid. Maybe a toxic relationship feels less tolerable. These relational shifts are often some of the first signs of real change.

4. You're responding instead of reacting. You still get angry, anxious, or hurt — but there's a pause between the trigger and your response. That pause is everything. It means your nervous system is starting to regulate.

5. Your inner critic is getting quieter — or you're noticing it more. Either one counts. Some clients notice the harsh voice getting softer. Others start recognizing it as a voice rather than the truth. Both represent real growth.

6. You're making different choices. Maybe you chose to rest instead of pushing through. Maybe you ate the snack instead of skipping it. Maybe you said "no" to something you used to say "yes" to automatically. Small choices add up.

7. You're curious about yourself. You're asking "why do I do that?" instead of "what's wrong with me?" That shift from shame to curiosity is one of the most important markers of therapeutic progress (Neff, 2011).

8. You're grieving things you couldn't grieve before. Grief is a sign that you're finally safe enough to feel what you've been carrying. Whether it's grieving a childhood, a relationship, or a version of yourself — this is healing, even though it's painful.

9. Your symptoms are changing. Notice I didn't say "disappearing." Symptoms might shift in intensity, frequency, or form. Your anxiety spirals might be shorter. Your eating disorder urges might still come, but you're resisting them more often. Change often looks like reduction before resolution.

10. You're starting to imagine a different future. For people stuck in trauma, depression, or disordered eating, the future can feel blank or terrifying. When you start to imagine possibilities — even small ones — that's a sign something has shifted inside.

Therapy Progress and Eating Disorder Recovery

Eating disorder recovery is one of the areas where progress is most easily missed. That's because eating disorders are incredibly good at moving the goalposts.

Research shows that eating disorder recovery is a nonlinear process with frequent setbacks, and that a person's subjective sense of progress often lags behind objective improvement (Bardone-Cone et al., 2010). In other words, you may be doing better than you think.

Some signs therapy is working in eating disorder recovery include being more flexible with food, even a little bit; noticing body image distortions without fully believing them; engaging with meals more consistently; feeling emotions you used to numb with food or restriction; and being willing to challenge eating disorder thoughts in session.

What to Do If You're Not Sure Therapy Is Working

If you're genuinely questioning whether therapy is helping, here are some steps to take:

Talk to your therapist about it. A good therapist will welcome this conversation. They can help you identify progress you might not see and adjust the approach if needed.

Look back, not just forward. Compare where you are now to where you were when you started. Write down specific examples if it helps.

Ask yourself what "working" means to you. Are you expecting symptom elimination, or are you open to subtler forms of growth? Sometimes adjusting expectations helps you see progress that's already there.

Give it time. Research suggests that most people need at least 8–15 sessions to see meaningful change, and longer for complex issues like trauma and eating disorders (Lambert, 2013).

Consider whether it's the right fit. The therapeutic relationship is one of the strongest predictors of outcomes. If you don't feel safe, understood, or respected, it might be time to try a different therapist — not to give up on therapy altogether.

Therapy in Orlando

If you're looking for a therapist in Orlando who specializes in eating disorders, trauma, and anxiety, Bloom Psychological Services is here to help. We use evidence-based approaches like CBT, DBT, EFT, and psychodynamic therapy to help you heal at your own pace.

Learn more about our approach or schedule a free consultation today.

Frequently Asked Questions

How long does therapy take to work?

It depends on what you're working on, but most people start noticing subtle changes within 6–12 sessions. Complex issues like trauma and eating disorders often take longer. The most important thing is to communicate with your therapist about how you're feeling.

Is it normal to feel worse before feeling better in therapy?

Yes. Therapy often involves confronting things you've been avoiding, which can temporarily increase distress. This is a normal part of the process and usually a sign that you're doing important work.

What if I don't feel a connection with my therapist?

The therapeutic relationship matters. If you don't feel safe or understood after a few sessions, it's okay to bring it up or try a different therapist. Finding the right fit is part of the process.

Can therapy help with eating disorders?

Yes. Therapy is one of the most effective treatments for eating disorders, especially when it addresses the underlying emotional, relational, and trauma-related factors. Evidence-based approaches like CBT, DBT, and psychodynamic therapy are all used in eating disorder treatment.

About the Author

Dr. Kait Rosiere is a licensed psychologist in Orlando, Florida specializing in eating disorders, trauma, and anxiety. She is the founder of Bloom Psychological Services and provides evidence-based therapy to help clients heal and build healthier lives.

References

Bardone-Cone, A. M., Harney, M. B., Maldonado, C. R., Lawson, M. A., Robinson, D. P., Smith, R., & Tosh, A. (2010). Defining recovery from an eating disorder: Conceptualization, validation, and examination of psychosocial functioning and psychiatric comorbidity. Behaviour Research and Therapy, 48(3), 194–202. https://pubmed.ncbi.nlm.nih.gov/19945700/

Lambert, M. J. (2013). The efficacy and effectiveness of psychotherapy. In M. J. Lambert (Ed.), Bergin and Garfield's handbook of psychotherapy and behavior change (6th ed.). John Wiley & Sons.

Neff, K. D. (2011). Self-Compassion: The Proven Power of Being Kind to Yourself. William Morrow.