Therapists do not know "when" anything. We are not gods and do not control time. A more balanced open ended question would be. "Do therapist notice if a client

Therapists do not know "when" anything. We are not gods and do not control time. A more balanced open ended question would be. "Do therapist notice if a client deteriorates during the therapeutic work". I would say yes. It does depend on the experience and training of the therapist and what client group you are talking about. Is it a client who has recently had a bereavement or clients who have long term serious mental health problems such as psychosis. In my experience the initial risk assessment and client history is a helpful guide as to whether the client is robust enough to manage the strains and difficulties of long term psychotherapy. Psychotherapy is not easy and until the work starts we do not know what will be uncovered during the work. There is always a decline of the clients wellbeing during the difficult work stages before any progress will be made. A classic example would be the client who comes into therapy believing that their parents were wonderful but during therapy comes to realise that their parents were in fact abusive and controlling, this has a profound impact on the client and can lead to depression and a loss of a sense of self amongst other symptoms. Generally though, in my experience, you can see the slight changes in the client before the client is aware that something is going on for them. Obviously, experience and good supervision are the key to holding the client and working with any changes during the therapeutic process. If you want to see how therapy really works then watch the french TV series En thérapie series one and series two. Being a retired psychotherapist this is the best example of psychotherapy shown on TV that I have seen and it will give you an idea of how real therapy works and how a psychoanalyst applies themselves to the dilemmas of therapeutic work. https://www.imdb.com/title/tt11080216/ https://www.imdb.com/title/tt11080216/