Therapy can be an incredibly helpful tool for managing mental health conditions and personal growth. However, not all therapy is created equal. Sometimes, despite your best efforts and an otherwise competent therapist, therapy ends up feeling ineffective or stagnant. How can you tell if your therapy has stalled or if it’s time to try a new approach? Here are some signs that your current therapeutic approach may not be working.
You don’t feel heard or understood
One of the core components of effective therapy is the therapeutic relationship between you and your therapist. You should feel safe, heard, and understood. If you find yourself constantly feeling dismissed, judged, or misunderstood, this is a red flag. Your therapist should make you feel cared for and provide a nonjudgmental space for you to open up. If the therapist-client relationship feels off in some way, continuing may not be worth your time or emotional investment.
You experience no improvement in symptoms
Of course, therapy takes time to work. But generally, within 10-15 sessions, you should notice some improvement in your mood, thought patterns, behaviors, or relationships. If you feel like your symptoms are as bad as ever, despite actively engaging in treatment, consider whether your current therapeutic approach is right for your needs.
You keep having the same breakthroughs
Breakthrough moments can be incredibly powerful in therapy. However, you should experience new insights over time, not the same ones repeatedly. If you find yourself frequently having the same breakthroughs related to your past, your relationships, etc., but not making any forward movement, the therapy may have become stagnant.
You dread going to appointments
It’s normal to feel a little apprehensive before therapy. It can be difficult confronting emotional issues. But you should generally feel uplifted and empowered after sessions. If you find yourself dreading appointments because they make you feel worse in some way, pay attention. You may need a new therapeutic approach.
Your life isn’t improving
Again, progress takes time. But one major goal of therapy is to improve your ability to function in life – at work, in relationships, in your general well-being. If therapy has no positive impact on your life outside of sessions, it likely isn’t addressing your real-world needs.
You and your therapist don’t agree on goals
Your therapist should work collaboratively with you to establish treatment goals and periodically reevaluate them. If you feel like you aren’t on the same page in terms of what you want to accomplish, continuing treatment may feel pointless. Aligning on shared goals is key.
Your gut says something is off
Listen to your intuition. If you have an underlying sense that the therapy isn’t working, pay attention to that feeling. You know yourself best. If your gut says it’s time for a change, explore other options even if you can’t pinpoint what’s wrong.
When is it time to switch therapists or modalities?
If you recognize some of the above signs, here are some next steps to consider:
- Have an open conversation with your therapist. Voice your concerns and see if anything can be adjusted or improved.
- If you want to stay with the same therapist, ask about trying a new treatment approach like CBT instead of psychodynamic therapy.
- Look into therapists who specialize in your specific concerns like trauma, eating disorders, mood disorders, etc.
- If cost is an issue, check if your employer offers an Employee Assistance Program for discounted therapy.
- Research alternative modalities like hypnotherapy, EMDR, or somatic therapy.
- Take a break from therapy if you feel burned out. You can always return later.
Above all, trust your instincts. You know better than anyone else what works for you mentally and emotionally. If your current therapy stops feeling productive or helpful, moving on may be the healthiest choice.
Signs therapy is working well
For contrast, here are indicators that your therapy is on the right track:
| Signs Therapy is Working |
|---|
| You feel understood and cared for |
| You’re gaining insight into behaviors, thoughts, feelings |
| You feel empowered and equipped with new coping skills |
| Symptoms are improving over time |
| Your life outside of therapy is getting better |
| You achieve the goals you outlined together |
| You feel motivated and hopeful after sessions |
When to stick it out
That said, the process isn’t always easy. Challenging moments can signify real therapeutic progress. Consider sticking it out through temporary difficulty if:
- You feel supported, even if feelings are raw
- Hard conversations lead to breakthroughs
- Symptoms get worse before improving
- Your therapist challenges you compassionately
- Discomfort leads to deeper self-understanding
Examples of ineffective therapy
To make it more concrete, here are some examples of therapy gone awry:
Feeling dismissed
Joan was struggling with anger issues. Her therapist consistently minimized her feelings and tried to divert sessions to lighter topics. Joan did not feel heard or understood and kept returning to the same feelings of anger.
Lack of progress
Despite months of psychoanalysis, Lucy continued having severe anxiety around social situations. Her constant anxiety felt unchanged, even though she gained insight into her childhood.
Stagnation
In every session, Michael epiphanized that his need to control everything stemmed from childhood powerlessness. However, he experienced no reduction in controlling behaviors over time.
Life not improving
Though Rosa found therapy insightful, she continued to isolate herself and rarely left home. Her therapist failed to help Rosa make connections between sessions and real life.
No shared goals
James entered therapy to manage his addiction. However, his therapist focused on exploring James’ relationship patterns instead. They never aligned on James’ initial treatment goals.
When is it time to leave your therapist?
Therapy is deeply personal work. You should feel safe, respected, and cared for by your counselor. Consider parting ways with your therapist if:
- The relationship never feels warm or trusting
- Your therapist crosses ethical boundaries
- Sessions leave you consistently feeling worse
- You dread seeing your therapist
- Treatment feels judgmental or punitive
- Your therapist invalidates your feelings or concerns
An incompatible therapist-client relationship can often prevent progress, no matter how competent the therapist. You may be better served working with someone new.
Questions to reflect on
If you are unsure whether or not to continue with therapy, reflect on questions like:
- Are my symptoms/situation improving at all?
- Do I feel comfortable opening up emotionally in sessions?
- Does this therapist “get” me?
- Am I gaining any new coping skills or insights?
- What are my therapist’s strengths? Weaknesses?
- Does therapy empower me or make me feel inadequate?
- Does my therapist take my goals/concerns seriously?
- Does this therapeutic approach align with my needs?
Ways to maximize any therapy
While finding the right therapist is key, you can also optimize the benefits of any therapy by:
- Attending every session consistently
- Arriving prepared to each appointment
- Applying your insights to daily life
- Doing homework assignments
- Voicing your needs and concerns
- Seeking support outside of sessions
- Committing to the process
When to stick it out
Finally, here are some signs it may be worth sticking with your current therapist:
- You have a strong rapport
- The therapist is competently trained
- You feel engaged in sessions
- Your life is improving in small ways
- Treatment aligns with your goals
- You trust your therapist’s methods
Every therapeutic relationship goes through ups and downs. Give feedback to your therapist and adjust the approach if needed. With commitment from both sides, therapy can often get unstuck.
Conclusion
Therapy is highly personal. What works for someone else may not be right for you. Pay attention to your own needs and trust your instincts. If you give informed consent and remain fully engaged, yet still see no progress, explore other therapists or modalities. An incompatible fit between you and your therapist is often the issue, not some inherent shortcoming within you. With the right treatment approach and working alliance, therapy can be profoundly healing and empowering.