Does therapy have to have a goal, and how to know if it's helpful?

I know that others have had the kind of experience you describe, but I have had conversations with my T about my specific situation and we have agreed that-- short of her moving, having a health issue, etc-- ending therapy will be MY choice. I also know that I will most likely be moving in the next 2 years because of my job and, when that happens, I will either terminate or switch to occasional phone sessions. I feel 100% confident that my T will follow through on what we have discussed. She knows, just as well as I do, how much therapy is continuing to benefit me-- she says so explicitly. I have absolutely no concerns about this in my specific case.

Yes, my insurance will continue to pay. I have insurance through the University and it is absolutely fantastic insurance. The University (which I do not want to name) is one of the biggest centers for psychological research in the US and has it written into its health care policy that faculty/staff/students can use in-network psychological services indefinitely with a $10 co-pay. My T has a private practice, but she is "affiliated with" the University and is "in-network." She has clients with my same University insurance plan who have been seeing her far longer than I have. She has some clients who have been with her for 8 years-- since the day she opened her practice here. She has not kicked them out, either. She said the only reason she has EVER terminated a client-- without their agreement-- was when they violated the boundaries of the relationship. She said that, in 17 years of practice, she has never kicked a client out because they did not have "big enough" problems or had "been in therapy too long." She does not believe in that.

If you know that's what you want, some therapists go with it. Like I said, this is a business after all. They give you what you want. As long as they follow the code of ethics and don't trick the client into thinking they need more sessions or have some deeper problems, they're not necessarily being unethical. So somebody goes to them and is aware they want a nice relationship and the therapist provides that, and that's that.

Other therapists of course, won't go for that. Especially if they have people on the waiting list to see them or if the insurance companies want progress to keep paying for it, even if the client has no goals the therapist will bring up the issue to see if the client is really there to make progress or just to spend time with the therapist just as we do with good supportive friends who make us feel better. I've had both kinds of therapists (though the distinction is not always black and white).

Yes, also a good point. What insurance companies consider "goals" or endpoint is of course not the same as the goals a client has. Basically the insurance companies don't want to pay for therapy that's not going anywhere. Think of it as medical treatment. Be it meds or exercises or surgery, the insurance company pays for something that gives results, so that the person with, say, back pain, is mostly pain free and able to go back to work and contribute to society.

Psychotherapy is more complicated because it's kind of like anything goes in terms of what counts as therapy and treatment, which leaves too much room for unethical behavior and exploitation of clients. So last couple of decades psychologists associated with universities done some research to decide which kinds of treatments work and have empirical support (partly in effort to try to get insurance companies to cover therapy). CBT is way more likely to be covered these days (it's structured, straight forward, time limited, has great research evidence supporting it), than if you go for therapy to, say, actualize your potential or find yourself or just go with no conscious agenda. Of course you can go for any reason you like, that's the freedom you have, it's just that many companies won't pay for it then.

Lastly, I agree, this is confusing, which is why the different opinions on this thread too. Based on the results of the poll, most people agree with some sort of goal, but many others value the relationship quite highly, third being the growth argument.