When Therapy Isn’t Working

Starting therapy can be a big step. Especially if you’ve been on a waiting list for a long time. If when you get there, you find therapy isn't working or helping you in the way you hoped, this can feel difficult. There can sometimes be as assumption that if the therapy isn’t helping, you must be doing it wrong. That self-blame certainly doesn’t help you feel any better!

This blog outlines some of the reasons therapy may not be working the wonders you hoped for, and some of the things you can do to either prevent this from happening, or manage it if it does.

Reasons Therapy Isn't Working

There are lots of reasons that you may find your therapy isn’t working or helping you in the way you expected. Here are five possible explanations.

The Approach isn’t Right

There are different approaches to treatment which can feel confusing if you’re not familiar with them - and why would you be until you need it? Cognitive Behavioural Therapy (CBT) is the clinically recommended treatment for most common mental health problems, including depression and anxiety disorders. This is therefore what is most commonly provided via the NHS.

Counselling is another approach recommended for grief and bereavement, relationship difficulties and for difficult life experiences you are adjusting to such as a serious or chronic illness. For multiple or complex mental health problems, a psychologist may be a more appropriate professional to work with as they may offer a mixed approach.

Your Therapy Goals Aren’t Clear

Agreeing therapy goals is a shared responsibility between you and your therapist and is one of the first things discussed in therapy. Your treatment should be informed by goals that are clear, specific and achievable in the number of sessions you’ve agreed to work to. They should also be regularly reviewed to monitor progress. Without clear goals guiding treatment, you may find there is a lack of focus, structure of clear progress with what feels most important to you.

Now Isn’t The Right Time for Therapy

We need to be ready and able to do the work. We need to have the physical time, the mental headspace and the emotional ability to work through our difficulties. If life is super hectic or you find one thing after another is thrown at you to deal with, being able to commit to and focus on therapy may be a struggle. The therapy may right, but the timing may be off.

You and Your Therapist Aren’t The Right Fit

This happens. We’re all just people and sometimes we don’t get on or gel. That’s ok. It’s important to feel comfortable with your therapist, to feel able to trust them, and to feel that they understand you.

It’s Complicated

Life can be messy. Maybe you’re noticing a combination of all of the above. Maybe you also have a physical illness to deal with, or an unexpected life event has thrown a curve ball at you and your goals and priorities have changed.

Here's How You Can Manage Some of These Problems

One of the challenges starting therapy for the first time, is not knowing what to expect. Here are some steps you can take to boost your confidence in accessing helpful therapy.

Be Prepared.

Before starting therapy, note down some of the main problems you want help with and what you want from your therapy. This way you already know what you’re looking for when you start looking for therapists or attend your first appointment. You may find it helpful to read Preparing for a Mental Health Consultation.

Be informed

Contact a couple of therapists for an initial phone call (usually offered for free). This allows you to get a sense of their style and communication, see whether you think you may be a good fit, and also ask about their approach and whether it will be a good fit for your problem. You may find it helpful to read Guide to Accessing Therapy.

Be honest

If you're finding therapy is just not working for you, tell your therapist. A good therapist will both welcome the feedback (not take it personally) and support you to make an informed choice about your other options. If you’re accessing treatment through the NHS or an insurance provider, you may have the option to change therapists. And if life stuff is getting in the way of your therapy, you may have the option to ‘pause’ your sessions and resume at a later stage.

Keep in mind that good therapists want you to help you, even if they aren’t the one to do the work with you.