When Therapy Doesn’t Work: What To Do

A therapy session, two chairs facing one another.

Therapy can be transformative, but it’s also a method of treatment that requires adjustment, reassessment, and effort.

Sometimes, it just doesn’t feel like therapy is working, and a client leaves a session frustrated and unsure what to do next.

When therapy doesn’t work, it doesn’t mean therapy will never work.

Instead, it can indicate something about the current course of treatment needs to change. In this guide, we’ll take a look at some potential steps to take when therapy doesn’t feel effective.

What To Do When Therapy Doesn’t Work

There’s no clear solution for when therapy doesn’t work. 

Abandoning therapy entirely can feel like reaching the end of the road, and can end up setting progress even further back. Instead of ending the relationship, here are some steps to consider first.

Open A Dialogue With The Therapist

When therapy isn’t working, it’s important not to see this as a “failure” on anyone’s part.

Therapy not working doesn’t always mean the client or the therapist is at fault.

Before making any sudden changes, it’s important to open a dialogue between client and therapist.

Talk about the changes you were hoping to see from therapy, and where you think you stand in relation to these goals.

These conversations can help you find what it is about therapy that just isn’t working. It can’t guarantee a fix, but it can help you move closer to a solution.

Consider The Timeline

A handful of therapy sessions won’t be enough to see real and permanent positive change. Even encouraging results in the first few sessions won’t necessarily add up to a successful long term treatment.

Before deciding whether therapy has failed, take a moment to reflect on the timeline:

  • How many sessions have there been?
  • How did you expect to feel at this point in the journey?
  • Have there been recent changes to your therapy sessions?

If you’re still early in the journey, then try to give it more time before leaving altogether.

Reassess Expectations

Therapy isn’t an immediate fix. In many cases, it isn’t even a “fix”. The results of therapy can vary massively, so what is considered a success might not meet your expectations.

If you’ve been putting off therapy for a while, you might have started the sessions with high expectations.

When therapy doesn’t provide obvious solutions, and you don’t start feeling like a whole new person, it can seem like it just isn’t working. 

For therapists, it’s important to be open with a client about what they want from therapy, and what they can expect.

Set achievable short term goals, to act as an indication of continuing progress.

Change The Type Of Therapy

It might be that the type of therapy isn’t working, and a new approach can show better results. For example, a person with an addiction might find one on one therapy too intense, and struggle to open up.

Group therapy, on the other hand, could offer the supportive atmosphere they need to become vulnerable.

Changing the type of therapy isn’t a sign that therapy has failed, just that you’re looking for the right fit.

As a therapist learns more about the client, it will be easier to find a therapy that will be effective.

Therapy is, essentially, a medicine. It won’t always be the right type or the right dosage straight away. Instead, it’s necessary to make adjustments until you find something you’re happy with.

But having to change the prescription doesn’t mean that medication will never work.

A woman sitting across from her therapist, eyes downcast.

Change Life Outside Therapy

Therapy is only one part of the equation. If you’re looking for lifestyle changes, then the work has to continue outside the session.

Often, therapy provides people with the confidence to pursue these changes.

The two elements need to work together: therapy builds the strength to make the change, but you can only see the results of therapy when you actually implement the treatments.

Therapist and client need to work together to identify problem habits, and enact positive change.

If one person isn’t doing the work, then therapy won’t show results.

Spend More Time On Homework

Leaving school feels like the time to say goodbye to homework forever, but it does play an important role in therapy.

Homework is an opportunity to reflect on a session, and adapt methods and treatments to real life. Again, this is a two-part system.

A therapist needs to be setting homework, and a client needs to be completing it.

Discuss Medication

Therapy doesn’t have to work on its own, and sometimes a combination of therapy and medication is the best way to see results. Speak to a doctor about possible medication options.

Try A New Therapist

The client-therapist relationship is essential to the success of the treatment.

Boundary issues, contrasting personalities, or just failing to find someone that “clicks” can all lead to the relationship failing. This happens, and it’s frustrating.

However, it doesn’t mean that therapy isn’t the right choice. It just means you need to find a new therapist.

If this isn’t possible, consider ways to change the relationship.

An open conversation between therapist and client can help fix personality clashes.

It Is Working, You Just Don’t Like It

Therapy can be hard work, and it forces us to examine parts of ourselves we don’t necessarily like.

Leaving a therapy session feeling angry, confused, or upset might not be pleasant, but it’s often a necessary part of the process.

Therapy isn’t always going to be, for a lack of a better word, therapeutic. There are days when it’s going to feel horrible.

Instead of a cathartic exploration of an issue, the session had been nothing but hard work. These kinds of experiences are crucial to effective therapy, even if they are unpleasant.

The hard work now will result in the therapeutic treatment you’re looking for.

It Isn’t Working, And You Choose To Stop

Therapy isn’t for everyone, although it’s a difficult thing to come to terms with. Some people don’t respond to traditional therapy treatments. 

Alternatively, you might not be ready for therapy yet, and you need more time to confront an issue.

Before stopping treatment, speak to your therapist. Together, you can discuss alternative options, and how to proceed. 

Final Thoughts

When therapy doesn’t work, it’s a sign that something needs to change. 

These changes might be small. A client might need to dedicate more time to making life changes, or a therapist might need to reassess their treatment plan. 

Sometimes, it shows a bigger issue is at play. It might be time to change the type of therapy, or look for a new therapist.

Whatever needs to be done, the best starting place is always an open and honest conversation between client and therapist.

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