The Difference Between "Good" and "Great Therapy"

Let me say this first: good therapy is still good. It’s not trash. It’s not useless. It’s the kind of therapy that makes you feel seen, supported, and validated. For many of us—especially if you’ve experienced invalidation, emotional neglect, or trauma—that kind of gentle, affirming space can be the first experience of psychological oxygen.

You finally exhale. You’re held. You feel safe.

But here’s the thing no one told me (or maybe I didn’t want to hear):

Good therapy might help you feel better. But great therapy will help you become better.

And the space between the two? That’s where the real magic—and real discomfort—lives.

I’ve done both kinds. I’ve been both kinds. I’ve sat on the couch, tearfully explaining the same relational pattern over and over again, only to leave feeling soothed but unchanged. And I’ve also sat across from a therapist who looked me in the eye and gently said, "I think you're being avoidant here with me, and it's playing out in your life in all of your relationships, too." It made my stomach drop—but damn if it didn’t change my life.

Let’s talk about what makes the difference:

1. Comfort vs. Challenge

Good therapy feels good. It’s warm. It’s validating. It builds trust.

Great therapy? It challenges you—without abandoning you. 

It invites you inward rather than outward. It reflects your blind spots and remains with you as you confront them. It is both supportive and stimulating. It’s an environment where your nervous system can relax, yet your patterns won’t be able to stay hidden indefinitely. Good therapists often know 'how' to do the work, but they don't always know how to 'deepen' your experience in the room.

This is where so many therapists (and clients!) get stuck. If every session feels like a cozy vent sesh, you might be doing good therapy. But if no one’s ever gently interrupted your spiral to ask, “What do you notice happening right now as you tell me that?”—you haven’t touched great therapy yet.

2. Content vs. Process

Good therapy tracks your story. Great therapy tracks how you tell it.

Look, I can hear a client talk about their mother’s harsh criticisms for six months straight. But the moment I start to notice that same self-criticism bleeding into the session—maybe they apologize every time they take up space, or they freeze when I gently offer a different perspective—that’s where the work is. It's seeing the client shrink away from me when I offer feedback. Therapists who aspire to greatness in their work are peeling back the layers of content to get to the process underneath. After all, we act out in the therapy room what we are doing in real life.

Great therapy lives in the process—not just the plot. It sees the reenactments. It calls attention to the shame that walks into the room with you. It notices how you move through connection and rupture. And it’s not afraid to name it.

3. Scripts vs. Creativity

Good therapy sticks to the script. You learn coping skills. You label your emotions. You get handouts. And yes, those things can be really helpful—especially early on.

But great therapy knows when to toss the script out the window.

It leans into silence. It follows the energy in the room. It holds space for nuance and humanity. It might mean sitting together and not "doing" anything at all. There’s an aliveness in the session that goes beyond the worksheet—and that’s often where the deepest healing happens.

Because people aren't machines, even if insurance would like to think so. Great therapy also involves a therapist who believes in themselves, not necessarily just the right modality. Great therapists are original, and they don't copy. They co-create with you to write new ways of being.

4. Clinging vs. Liberation

Let’s talk about this one because it makes me CRINGE:

I’ve heard therapists say, with pride, "That client will be with me forever."

...Why? Is it a lack of trust? Is it avoidance by the therapist? Do they not want you to be better? Are they holding onto a different vision of what healing looks like for you? Can they not refer out when they know they've met their match?

Great therapy doesn’t want to keep you. It wants to free you.

You might be in therapy for years (I have been), but the goal should never be dependency. We’re not here to be your emotional crutch. We’re here to walk beside you until you trust your own legs. Until you’ve built a community that can hold you. Until your inner compass is louder than your inner critic. There are many skilled therapists who may not recognize the right moment to encourage you to leave the comfort zone, much like a baby bird needs to leave the nest to strengthen its wings and learn to fly. Using another metaphor, young trees require the challenge of the wind to build resilience. If, as therapists, we act like the supports tied to young trees to keep them stable, we prevent your strength from emerging and growing.

5. Technical Skill vs. Self-Awareness

Good therapy comes from technically competent therapists. They know the models. They follow the ethics. They stay in their lane. They often consider themselves the 'expert' in the room. (LOL, as if any of us have life completely figured out)

But sometimes, those therapists are deeply disconnected from their own humanity.

They haven’t processed their own wounds, and that unexamined pain leaks out. Suddenly, clients are being labeled as "resistant" or "too much" or "manipulative"—when really, the therapist is triggered and doesn’t know it.

Great therapy comes from therapists who do their own work. Who sit in supervision and say, “This client is bringing something up in me, and I want to understand why.” Who notice when they feel annoyed or checked out or overly invested—and stay curious about it. Who have enough ego strength to admit when they’re wrong. Great therapists are those who consistently discover new ways to be present with themselves, rather than seeking another method that claims to heal in 8-12 sessions. Good therapists frequently pursue additional training; great therapists seek to understand their own inner selves and trust who they are, not what they can do.

Final Thoughts: What You Deserve

If you’re in therapy right now, and it’s helping, I’m genuinely glad. This isn’t about shaming “good enough” therapy. It’s about raising the bar.

You deserve a therapist who can hold your pain and your potential. Who can sit with your story and help you edit the next chapter. Who can be warm and real and human—but also clinical, sharp, and brave enough to meet you where you really are.

Good therapy is a start. Great therapy is a portal.

And if you’re ready, you’re allowed to walk through it.

Take exquisite care of yourself,

Megan