If you’ve been asking yourself whether your child or teen’s therapy is actually working, you’re not alone, and the answer is probably more complicated than yes or no.
Finding a therapist for your child or teen takes real effort. So, when you finally get there, when your child is actually going, and talking to someone, there’s real relief in that for most parents. For a while, just having a plan in place feels like progress.
And then it becomes routine. Which is, in some ways, a good thing. The appointments are on the calendar. Your child goes. Life keeps moving. But somewhere in that routine, a question starts to surface, quietly at first, easy to push aside. You’re not seeing the seismic shifts you were hoping for. Things at home feel mostly the same as they did when all of this started. And you begin to wonder: whatever is happening in that room each week or every other week, is it actually making a difference with the thing that brought you there?
Here’s what I’ve come to believe: the answer is rarely as straightforward as we would want.
The Problem With “Is It Working?”
Most parents who ask this question are measuring against something they never explicitly defined, an image in their head of what their child would look like if therapy were helping. And that’s not surprising. When you’ve worked hard to find someone and your child is finally going, the last thing on your mind is stopping to ask what the process is actually supposed to look like. You’re just grateful to have gotten there.
Often, there is some version of a goals conversation early on, you talk about what brought you there, what you’re hoping will be different. The destination gets named. What rarely gets discussed is what the road looks like to get there. What might early progress look like for your child specifically? What should you be noticing at home, even in small ways, three months in? What would tell the therapist that something in the approach needs to change? Those questions often go unasked, not because anyone is avoiding them, but because in those early appointments, everyone is still finding their footing. And frankly, therapy is often new for everyone involved (minus the therapist). We just don’t know what we don’t know.
But without that conversation, about what this might really look like, you’re left measuring against something you invented in your head. And that’s an almost impossible standard to meet, because what you’re watching for at home may look nothing like what’s actually happening in the room each week.
A child can be doing real work in therapy, learning to name what they’re feeling, building trust with an adult outside the family, developing language for things they’ve never been able to say out loud, and none of that shows up immediately in what you are seeing from day to day. Progress in therapy is often internal before it’s ever visible. It’s one of the main reasons this question is so hard to answer from where you’re standing.
What “Working” Looks Like Evolves
The reality is that what you’re looking for changes over time, and it should.
Think of it less like a light switch, on or off, working or not, and more like a process with different markers at different points. Early on, something like your child showing up and beginning to trust their therapist is meaningful, even if what brought you there has not changed. Later, you might start to notice something smaller than a seismic shift: they reach for a strategy when things get hard, or they name what they’re feeling instead of exploding, or they actually want to go to that therapy appointment to talk through something they are dealing with. Later still, you might see the more visible changes you’ve been waiting for.
None of those are the same thing. And knowing which one makes sense to look for right now, given your child, their specific challenges, where they are in the process, is not something you can figure out on your own from the waiting room.
That’s exactly why this is a conversation to have with the therapist. Not as a challenge, not as an ultimatum, but as a genuine check-in: what are we working toward together, and what might I look for at home? From my experience, a good therapist will welcome that question. It gives them information too.
The Conversation Most Parents Haven’t Had
Many parents don’t raise these questions because they’re not sure they’re supposed to. There’s an unspoken sense that the therapy space belongs to the child, and that asking too many questions might disrupt something. You don’t want to seem like you don’t trust the process. You don’t want your child to feel monitored. You don’t want to be the parent who makes things harder.
So you wait. And wonder. And keep driving to appointments.
That hesitation isn’t entirely wrong, especially with older kids and teenagers, there’s real value in giving them some ownership of the space. Checking in every session, or pushing for detailed updates, can undermine exactly the kind of trust the therapist is trying to build. And if you’ve ever gotten gentle feedback from a therapist that your child needs a little more space from parental involvement, please listen. I know that parent questions (and anxiety) usually come from the same place of wanting the work to succeed, but more isn’t always better. It’s the right kind of involvement, at the right moments.
What that looks like in practice might be a separate conversation with the therapist, not carved out of your child’s session time, but scheduled on its own. Most therapists will do this periodically, particularly when parents request it. Sometimes they suggest it on their own. It’s worth knowing that depending on your insurance, this may be billed as a separate session, sometimes out of pocket. That’s worth asking about upfront so it doesn’t catch you off guard.
In that conversation, you’re not asking for a play-by-play of what your child has said. You’re asking for orientation: what are we working toward, what might I look for at home, is the current approach still the right one? It is also an opportunity to share what you are seeing at home. I think that a good therapist will usually welcome this. A parent who’s quietly losing faith in the process isn’t helping anyone, and most therapists know that.
You don’t need a formal agenda. Something like: I’d love to schedule a little time to talk separately. I want to make sure I’m supporting what you’re working on together, and I have some questions about what to look for at home. I also have some things I want to share about what we are seeing at home. That’s enough to open it.
When the Uncertainty Feels More Urgent
There’s a difference between “I wish I could see more progress” and “my child is really struggling, and I have no sense of what’s happening or where this is going.”
If your child is in significant distress, refusing school, unable to function day to day, in a level of crisis that isn’t shifting, waiting and wondering is not the right response. In those situations, I think you are entitled to a direct conversation about what the therapist is seeing, what they’re trying, and what the thinking is if the current approach isn’t enough. In those cases, it feels more like advocacy, and less like impatience.
It’s also worth knowing that the therapist who is the right fit for ongoing, longer-term work may not be the right fit for a more acute moment of crisis. Level of care matters, and a good therapist will help you think through whether what your child needs right now matches what they’re able to offer.
The Part That Stays Murky
Even when you have the conversation, even when you’re advocating in the right moments and giving space in others, it’s worth being honest: sometimes this question still doesn’t resolve cleanly.
Some parents have the conversation with the therapist and come away with more clarity than when they walked in. Others have it and still find themselves uncertain or less than satisfied with what they hear. After all, progress is uneven because what “working” means shifts as a child grows and changes.
It is also worth noting that what may initially bring your child to therapy may not be exactly the same as what keeps them there. New insights may be revealed. What your teen wants or needs to work on may change. What I have come to believe, having been in this long enough, is that the benefits of having a safe place to process whatever the world is throwing at them are real, even if they are hard to see from the outside. The world is complicated. Having somewhere to make sense of it, on their own terms, matters. For most kids, that’s worth more than we can easily measure. And I am a firm believer that learning how to process their lives now will help them do the same when they are adults.
A Place to Start
If you’ve been sitting with this question and haven’t done anything with it yet, here’s a small place to start: get clearer on what you’re actually measuring against. Is it something you and the therapist have talked about together? Or is it something that’s been living entirely in your head?
If it’s the latter (and for most parents it is), that’s the conversation I would encourage you to have. Not to issue a verdict, not to threaten to leave, just to make sure you’re all oriented toward the same thing.
You don’t need a better reason than I’m not sure what I’m looking for, and I’d like to understand.
You’re not alone in this.
Laurie
- If you’re still in the process of finding the right therapist — or wondering what to ask before you even begin check out my post on Questions to Ask a Child Therapist Before You Hire Them
- If you think your child needs help, I talk about How to Find a Therapist for Your Child or Teen: A Practical Starting Point.
- I also talk about what it is like to be a parent navigating this journey with your child at The Parent Journey, including why managing your child’s mental health feels so overwhelming.
Parent. Founder of Together We Navigate. I spent years navigating support systems for my kids and built TWN so other parents don’t have to figure it out alone. PhD in Community Psychology.