When Therapy Doesn’t Work, Here’s What Experts Recommend
You might have been going to therapy for a while — and you may be leaving sessions feeling confused, angry, or stuck. If this sounds familiar, your therapy may no longer be working, and it can be difficult to know what to do next. While it's easy to freak out at this feeling, experts tell Bustle it may just mean it's time to reassess your therapeutic relationship. Looking critically at the help you need versus the help you're getting can help you determine a path forward, whether it's changing therapy types, moving to a new therapist, or something else.
Feeling resistant to your therapy sessions doesn't automatically mean that therapy isn't working for you; I went to a psychologist for five long years, and I can tell you from experience that if you feel uncomfortable and sad about going to therapy and relieved afterward, it may just mean that you're doing difficult but necessary work and you kind of hate it. However, if you really feel that your therapy isn't working for you, there are some proactive steps you can take. The first step, experts say, is to try and figure out what's going wrong.
You could discover that you're in the wrong kind of therapy. "Therapy is like medicine," clinical psychologist Dr. Josh Klapow, Ph.D., tells Bustle. "There are different types of therapy for different conditions. And just like medicine, a therapy that is not properly matched with an individual's needs, condition, and sensitivities may be ineffective."
Like medication, he says, therapy can take a while to work. You shouldn't automatically bail after one week, unless your therapist is violating your boundaries or giving you other signals that you're not being heard. Therapists should ideally be given at least two or three sessions before you decide it's not working for you. However, therapy can also lose its effectiveness over time, or stop being needed.
If this is the case, you may need a different kind of therapy. "The term 'therapist' is a very broad term that covers everything from licensed clinical social workers, to family counselors, to licensed professional counselors, to counselors, to clinical psychologists, to psychiatrists," Klapow says. These people are not all trained in the same way and they can't provide the same kinds of treatment. If you're with a therapist who isn't qualified to provide the kind of care you want, or if your needs are now outside their remit, you may find yourself struggling.
Another common reason therapy stops feeling effective is the client-therapist relationship. "This therapist might not be the right fit for you," licensed professional counselor Heidi McBain, LMFT, tells Bustle. "This often happens in the beginning stages of therapy as you and your therapist are getting to know each other." You may also have reached a stumbling-block or a wall where you feel that you and your therapist just aren't making any progress. Klapow says these blocks often pass, but that if they don't, you need to figure out the next steps.
Whatever your reasons — whether it's the therapist, the therapy, or a feeling you can't explain — it's important to not just bow out without a conversation. "Do not just end therapy or email your therapist that you’re finished, especially if you’ve been working together long-term," McBain tells Bustle. For one, it's rude, but more importantly, it prevents you from figuring out what's going wrong so that you can both work together to fix it. Stopping suddenly will also deny you closure and a chance to talk about your therapy wins, McBain says.
A good therapist, Klapow says, will welcome your feelings and have an action plan. "They should be able to recommend a different course of therapy, a break, or help you communicate why you feel the impact of therapy is not as great as it was," he says. A therapist who gets defensive or upset at this conversation, he says, is showing that they're not qualified to deal with your issues, and you're probably right to not want to work with them anymore.
Sometimes you can fix therapy issues with changes in how you receive therapy. "Sometimes clients actually need to change the day, time, or frequency of their therapy visits, and once this has occurred, the therapy process continues," McBain tells Bustle. Other times, however, you'll need to move on.
Changing therapists or therapy methods can be emotionally difficult, and ideally your old therapist should help you through the process. If you can't talk to your old therapist about what precisely went wrong, McBain recommends journaling about it or talking to a family member or friend. Learn from the process and think about what you really want and need from a therapist, and then look for one with those skills. "Talking to [a] potential therapist on the phone before an initial session may help you to know if you have a connection and a level of trust with them right from the start," McBain says.
When therapy stops working, it can signal small issues that need to be fixed or bigger problems that require more fundamental changes. Either way, it's important not to keep it to yourself. The more honest you are, the more help you can get, so be brave and have that tricky conversation.
Dr. Josh Klapow, Ph.D., clinical psychologist
Heidi McBain. LMFT, licensed professional counselor