• Kimberly Woodard, LCPC

What to Do When It Seems Like Therapy Just Isn’t Working


Clients often complain to others around them about their dissatisfaction with therapy. Not always, but quite often, clients do not share their concerns about therapy with their therapist. Instead, the client will terminate therapy, or just “ghost” their therapist, by cancelling one appointment, and never responding to their therapist’s efforts to follow-up with them. If you are dissatisfied with your therapy, I challenge you to explore why you’re dissatisfied, instead of ending therapy.


Here’s how talking to your therapist can help you resolve three common complaints that clients have about therapy:


When It Feels Like Nothing is Changing

You may be frustrated because it does not seem that you are witnessing the changes in your life that you anticipated would come with starting therapy. This may be a good time for you, and your therapist, to reflect on the question- What’s different now, as compared to when I started therapy? You might be surprised to find that there have been small, incremental changes, in your life that you might not have noticed, or may not have attributed to therapy. If you struggle to name a single change, consider the question, Have I given this process enough time?


When we have been suffering with a problem for a long time, it can be easy to fantasize that there is a single thing that we can do that will enable us to find a quick and easy relief from our suffering. Sadly, the idea that lasting, meaningful change can happen overnight remains a fantasy. Change is slow and it can be incredibly difficult. It has likely taken, months, years, or maybe even a lifetime of suffering to create the problems that have prompted you to enter therapy, and it will take time, patience, and the unwavering support of a neutral party (your therapist) to help you find the relief that you are seeking.


When You’re Upset With Your Therapist

Your relationship with your therapist has the most influence on the success of your therapy. Whether you know it or not, how you interact with your therapist mirrors how you interact with others in your life outside of therapy. If, for example, you struggle to express your emotions outside of therapy, you will have the same struggle with your therapist. If you’re angry with your therapist, you should tell your therapist that you’re angry, and explain why. If the thought of expressing your anger to your therapist makes you anxious, or you find yourself making excuses about why you don’t need to do it, then that’s all the more reason to challenge yourself to do it. Keep in mind that therapy presents you with an opportunity to experiment with new behaviors within the relatively safe confines of the therapeutic relationship.


For instance, the experience of telling your therapist, I’m angry with you because you want me to pay a no-show fee, can be life-altering, particularly if you have the chance to see that you can express your anger to someone, and your relationship won’t end because of it. You can process what it felt like to express your anger with your therapist, and then use that as a stepping stone to start expressing your feelings to others outside of therapy. It does not matter why you are upset with your therapist; what matters most is that you express your displeasure to your therapist, listen to how your therapist responds, and pay attention to how you feel about the conversation afterwards. Just like with your relationships outside of therapy, it can take more than one conversation, to feel like the rupture in your relationship with your therapist has been repaired.


When You’re Dissatisfied With Your Therapist’s Approach

Sometimes clients feel frustrated with the techniques or interventions that a therapist uses. There are dozens of iterations of psychotherapy that a therapist can use to help you. Some are focused on insight, while some emphasize action. Some are focused on understanding how the past influences the present, while others are interested only in the here and now. Some encourage you to explore your feelings, while others are designed to change your thoughts, or just your behavior. Keep in mind, however, your therapist’s approach to therapy is not nearly as important as your relationship with your therapist in determining a positive outcome for the therapy.


Your therapist should be able to clearly articulate their approach to therapy and how it is intended to help you address the problems that you are having. If your therapist is asking you to engage in an activity that causes you distress, or makes you uncomfortable, it is important that you tell your therapist. For clients who have a personal history that includes abuse, letting your therapist know that you are uncomfortable or upset, can be an important exercise in setting personal boundaries. Ideally, your therapist will respond to your disclosure by helping you understand the source of your discomfort, and either slow down the pace of treatment or find an alternate approach to use with you that can help you achieve the same outcome. You should always be wary of a therapist who insists that there is only one way to treat a problem, or who pressures you to continue an activity that is making you uncomfortable or upset. In those circumstances, ending the therapy can be a good exercise in boundary-setting, particularly if you can articulate to the therapist why you are choosing to end the relationship.


Other Considerations

The reasons for your dissatisfaction may also be masking other issues that have been stirred-up by the therapy, that you are not ready to deal with, such as long-forgotten, intense feelings of anger, grief, shame, or guilt. If the thought of addressing those issues feels too intimidating, you should let your therapist know. Your therapist can help support you in exploring these feelings at your own pace, but if you feel strongly that you’re not ready to do so after discussing the issue with your therapist, then you can discuss terminating therapy.

While change may be the ultimate goal for clients seeking therapy, the idea of change becoming a reality can spark an intense reaction in clients that they may not have anticipated and may not understand. Change ushers in uncertainty. It may be accompanied by success, failure, truth, or a complex range of feelings that cannot be easily identified but are nonetheless frightening. Clients often are unaware that fear of the unknown is underlying their dissatisfaction with therapy. This again underscores why it is important to let your therapist know that you are not happy with the course of your treatment. They can help you to identify the source of your dissatisfaction and support you in overcoming your resistance to therapy.


If you’re looking for a therapist, contact the Waverly Center for Psychotherapy, LLC to discuss scheduling an appointment.

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