Top Four Reasons Why Your Therapy May Not be Working Out

I often hear from clients, friends, and family some version of “I tried therapy and it didn’t work.” When I hear these words, I cringe inside.

Don’t get me wrong! I’ve had my fair share of terrible therapy experiences, too.

One time, about two years ago, I showed up for an initial assessment and told the therapist my presenting concerns only to feel like a freak. The #therapist did not do a good job of creating a safe, judgment-free environment. I half-expected her to grab a bag of popcorn as I “entertained” her with my story!

So I get it. I know bad experiences in therapy happen. But I believe strongly in #therapy and its power to help heal people. And I worry that giving up on therapy because of one bad experience — or even a few — furthers the #stigma in our society around seeking mental health treatment.

Here’s the bottom line: Therapy is far too important and far too transformative to give up after a few bad experiences.

The truth is, there are many reasons why therapy might not be effective the first time, or even the second or third. And if you understand those reasons, you’ll be better equipped to find success next time around. So, if therapy hasn’t worked out for you yet, here are some things to consider before you give up.

1) The Therapeutic Relationship

The therapeutic relationship refers to the connection that a person has with their therapist. This relationship is so important in fact, that clinicians in training are taught to think about it when they are learning how to be more effective with clients.

If you are like most clients, you probably have sought therapy with a desire to heal from relationships that were harmful or traumatic, whether you are aware of this or not.

Psychodynamic theorists such as Freud, Ainsworth, and Bowlby believed that the therapeutic relationship can be healing and reparative in and of itself. Research has shown that the relationship an individual has with their therapist can account for up to 34% of successful therapy outcomes.

Therapy requires that you be open and vulnerable. It is a scary situation to be in, as many of us live our lives in protective shields, careful of who we allow to bear witness to our pain. A therapist’s job is to ask questions to get at the origin of psychosocial distress, and this can feel unsettling, especially if it is your first time in therapy.

You are much more likely to open up, be vulnerable and look at yourself in the mirror if you have a human connection that is safe and nurturing.

If you do not feel comfortable with your therapist or do not feel safe enough to be open and vulnerable, therapy likely won’t work.

2) The Treatment Modality

There are many different types of therapy approaches that therapists use with clients. Not all of them work the same for everyone.

Your therapist should mold therapy to your unique personality and situation. The goal of many of these approaches will be to help you to retrain how you think about, approach, and cope with your problems.

Other approaches will focus on helping you to process traumatic memories so that they no longer feel as upsetting as they once did. Common types of therapy include Cognitive Behavioral Therapy (CBT), Solution Focused Therapy (SFT), Dialectical Behavioral Therapy (DBT), Narrative Therapy, Eye Movement and Desensitization and Reprocessing (EMDR) Therapy, among many others.

Ask your therapist about the approaches they are using and explore other ones that may work better. If you understand the purpose behind the chosen approach, you are likely to get more out of it.

3) Homework

Attending sessions is just a small part of the work of therapy. The real work occurs in between sessions.