3 Reasons Why Therapy Doesn't Work For You And How To Fix It

When I first meet with a client for therapy, one of the things I want to know is if they have been in therapy before and how it went for them. The most common response is, "therapy didn't work for me". The research seems to support this claim with studies estimating an average of 40% to 60% of those that seek therapy never return after a second session. That is a staggering number of people who are not getting what they are looking for. I have been counseling individuals and couples for almost 20 years and while there are many reasons therapy may not work for someone, I am going to walk you through the 3 biggest reasons why I believe this happens and how not to let it happen to you.

So, therapy didn't work for you? I would say in my experience that is generally the case. I often tell clients that I don't have a magic wand that will fix their life and that I would use it on myself if I had one! Instead, therapy is work and the only one who can do that work is you. Having said that, who you do this work with plays a crucial role in your success. Studies have shown over and over that the number one predictor for successful therapy outcomes is the therapeutic relationship. It is no surprise then that I believe this is the biggest reason why clients are not successful in therapy. However, it might not be for the reason you think. I will come back to this, but for now, I would like to start with 2 other important reasons.

If you have gone to therapy before, then you know that you don't always feel like a million bucks when the session is over. In fact, you may even feel like you just went 10 rounds in the boxing ring. Therapy can be emotionally painful and uncomfortable at best. While we all have the expectation that these feelings are temporary many people are either not prepared for or cannot tolerate these feelings. The natural response to something painful or uncomfortable is to avoid it, which results in many people not returning for a second session. Logically, this makes sense, after all, who wants to pay someone only to feel lousy! However, this is your first opportunity for change and going into therapy with the expectation that you may feel uncomfortable along with other strong emotions will help you be prepared to tolerate them and learn from them. The good news is, your therapist is your partner in coping with these feelings, so be open about what you are feeling from the start. I have new clients fill out a history prior to our first session and it includes a space for them to tell me whatever else they want me to know before we meet. Many of my clients are using this space to let me know that they are nervous or anxious about therapy or that there are certain topics they are worried about discussing. If you are starting therapy or seeing a new therapist, make sure to share your concerns about dealing with uncomfortable feelings and work together to come up with plan that allows you to feel safe and supported. And don't forget, like most things, they get a little worse before they get better.

Congratulations! You have made it to the end of your therapy session and the therapist starts to tell you what you have for homework. Homework?! In the session you explore and process your thoughts, feelings, experiences, and memories but outside the therapy session is where you put into practice what you are learning. Which leads me to the second reason I see therapy not working for some people. They are simply not ready or able to do the work. This often happens when someone starts therapy because they acknowledge there is a problem but are not yet ready to make a change. How do you fix this? Maybe you don't. For some being aware of that this is in-fact the first part of charge is enough. For others, continuing therapy can help them begin to feel confident and gain the tools to make changes. Either way, the key is being aware that therapy will work for you when you are ready to do the work in and outside the session.

So, let's talk about the most important factor, the therapeutic alliance or therapeutic relationship. This relationship is said to be more important than what type of therapy or therapy techniques that are used in your session. I am often told by new clients that their previous therapist was "nice" but they just weren't getting what they needed. It is much more than "liking" your therapist, then what should you be looking for? How can you guarantee you will have a strong therapeutic relationship; well, the short answer is you can't 100% know. However, knowing what a therapeutic means and what it looks like will help you find someone you are likely to be a good match with. There are 2 aspects to consider.

1. The first is a collaboration of purpose, treatment goals and tasks. Your first therapy session should include a portion that discusses how you will know attending therapy has been helpful? What will you do, feel, or think differently about when you are done in therapy? How will that impact your life? In other words, what do you want to get out of therapy and how will you know you are there? Too often therapy goals are vague, or the therapist and client are not working toward the same goal. In a strong therapeutic relationship, you and your therapist are clear about what you are working towards, what you are going to do to achieve this goal, and how you will know when you get there.

2. The second is building a connection between you and the therapist. When you speak do you feel heard, understood, and supported? Do they give you their undivided attention? Do they ask questions to better understand? Are they able to give you feedback that reflects what you feel, think, need? All these things are indicators that a connection is being built. There are some clients I meet and there is immediately a connection. But for many the connection build one sessions a time. If you have given it time and still aren't feeling a therapeutic connection, then before you quit, discuss this with your therapist. Let them know you aren't feeling connected and be open to ways that it can be built.

Having both a collaboration of purpose and connection between you and your therapist are ideal, but both are not necessary to have successful outcomes. If you have one or the other, you can still make therapy work for you!

The bottom line is that seeking out therapy is something you are doing for you and the more you understand about how it works, the more successful you will be. There are many reasons why I don't think therapy may work, but the three most important that I have found are, first, you must tolerate uncomfortable feelings, second, you must put in the work, and lastly, you must understand what makes up a therapeutic relationship and how to help create it. I hope this helps, thank you for letting me walk you through it!