Yes, there are significant differences between the two. People can be in therapy for years without actually doing therapy. There are several reasons that people choose one over the other or rotate between the two. Sometimes, knowing which one you are in can be difficult to tell; however, several signs can help differentiate between them.

People are in therapy when: 

• They seem only to have pleasant visits.
• They may feel some uncomfortable emotions, they are not too difficult, and they quickly pass. 
• Values, beliefs, goals, cultural systems, past, and other relevant contexts could never be mentioned or glossed over at best. People leave the therapy office not knowing anything more about themselves, people, thinking patterns, ways to do things more effectively, or life in general. 
• They go through the motions without feeling connected and challenged.

People do therapy when:

• They have visits where they experience great inner tension. 
• Sometimes they leave the therapy office feeling worse and sometimes better.
• There are times they like their therapists, and times they do not. 
• Problematic and abusive interpersonal patterns are not replicated in sessions; they are immediately addressed, not ignored or glossed over if they occur. 
• Patients trust the therapist to say things they might not want to hear because they know it helps them grow.
• Therapists are not defensive when patients say things they do not want to hear because they know it can help them grow. 
• The relationship is collaborative.
• Thought patterns, behaviors, relationships, emotions, values, cultural components, history, traumas, and other subconscious influences negatively affect patients' lives and are challenged empathetically and nonjudgmentally.
• For those who attend with other people, all people experience interpersonal tension and conflict to varying degrees.
• The "problem" is NEVER only one person.

People can shift between the two or be in therapy because of:

• Making complicated and difficult changes
• Mental and physical health symptoms
• Unforeseen life circumstances
• External factors, such as relationships and employment
• Poor goodness of fit between therapist and patient
• Stagnancy with the therapist and in need of a different toolset or perspective
• Many other factors

Whatever the reason, those who are in therapy are not benefiting to their full capacity. As you may have guessed, doing therapy is what works, and it takes effort to accomplish. Making significant life changes does not merely entail having a pleasant visit for an hour, leaving, and not doing anything different in your life. Doing therapy is arduous work. It is your choice and, ultimately, your responsibility, not of the therapist.

What might need to happen for you to begin or change to doing therapy?