The people I see are interested in working hard on the core issues interfering with their relationships and work. Therapy happens in real time in one's life, and should aim to resolve these issues without delay. When I see people initially, and when I teach other therapists, I emphasize that a feeling that something real is happening, that it is having an impact, should be part of the process from the beginning, even if one recognizes there is a lot of work to do. My experience includes more than 3 decades as Director of the Tufts University Counseling Center, overseeing counseling and psychotherapy services to more than 25,000 clients and training for hundreds of mental health professionals.