It’s not just patients who have a hard time knowing if their treatments are helping them; sometimes the therapists themselves can’t tell.I would think that it should be obvious that some psychotherapy can be harmful. Maybe even most of it is. There are many studies reporting harm to psychotherapy, and the professional psychotherapy organizations acknowledge that it can be harmful.
In a study published last month in the journal Psychotherapy Research, Michael J. Lambert and Cory Harmon, psychologists at Brigham Young University, gave psychotherapy patients a questionnaire about how they were feeling and functioning. ...
The clear implication is that therapists are not always the best judge of how their patients are doing, perhaps because they are blinded by their own optimism and determination to succeed.
Some therapists might even view worsening during treatment as a sign of progress — a misguided "no pain, no gain" view of psychotherapy.
Nevertheless, I have found many people who persist in believing that psychotherapy is always beneficial. If you point to failures, they will often assert that the problem was with the therapist, and claim that a good one will always help. But there is no psychotherapist anywhere who can report uniformly positive results.