Although researchers evaluating therapy outcomes necessarily rely on measures of symptom relief and behavior change, practicing clinicians – and many patients – often have a more ambitious vision of meaningful change and growth. In this conversation hour, we will talk about the therapeutic goals of increased attachment security, sense of agency, affect tolerance, flexibility and maturity of defenses, self-reflection, mentalization, realistic and reliable self-esteem, vitality, capacity to mourn what cannot be changed, and overall engagement in love, work, and play.