Therapy Isn’t Working– Reasons Why and When It’s Time to Move On

Therapy is a very significant investment for anyone. It’s a money, time, and energy commitment that, at its core, asks us to challenge ourselves, oftentimes to the point of discomfort. With all that it requires, it can be extremely discouraging to feel that therapy isn’t working.

As a registered psychotherapist, I’ve heard many clients share their past experiences and explain why things didn’t seem to work.

“Therapy felt like just talking.”

“I tried the tools they gave me but they didn’t work.”

“It felt like the therapist didn’t really get me.”

“I could never really get comfortable.”

In this article, I walk through the following: 

• Is therapy working?
• Signs therapy isn’t working
• 3 reasons why therapy might be going nowhere
• Signs it’s time for a new therapist

By the end of the article, you’ll have a better understanding of whether therapy is working, how to make the most of sessions, and when it’s time to find a new therapist. 

Is Therapy Working?

Firstly, let’s break down whether therapy is working or not. 

Oftentimes, media depictions of therapy offer scenes where clients have “big lightbulb realizations,” after which their life completely changes for the better. While therapy can absolutely have “aha moments,” and from time to time, you may notice large shifts in yourself or in your life, more often than not, therapy is gradual, and frankly, unexciting. 

Therapy is like going to the gym; it’s work, and we often only notice our gains in hindsight and over time. It’s important to have this in mind as we consider whether therapy is working. 

It’s also important to note that therapy takes time. Even more brief therapy approaches, like CBT, usually last at least 8 sessions.

Take stock of the following:

• Have I seen shifts or changes in my life?
• Am I closer to my therapy goals than I was at the beginning of treatment? 
• Has my perception of myself, others, or the world changed since I started therapy?
• How long have I been attending therapy?

You can bring these questions into sessions with you, and your therapist may have insights on points of progress or change you’ve made that you may have overlooked.

Signs therapy isn’t working

If, upon reflection, you recognize that you have not seen shifts, therapy might, indeed, not be working. You might notice your therapist doesn’t seem to understand you, or that you keep circling the same block without any new direction. 

Additionally, although therapy can sometimes feel uncomfortable, or occasionally raw, if you consistently feel worse after and in between each session, without being able to attribute it to anything else, that’s a very big red flag.

Signs that something isn’t right in therapy include:

• You don’t feel closer to your therapy goals than you did at the beginning of treatment.
• You haven’t seen any changes in your life.
• Therapy feels like “just talking” without any actual intervention.
• You don’t feel understood by your therapist, or feel the tools they provide don’t “fit.”
• You leave every session feeling confused or worse.
• You’re avoiding therapy or dreading your appointments.
• The same issues come up every session without any new insights or strategies.
• You aren’t applying anything between sessions.
• Your concerns are minimized, or judged.

Not every one of these signs means you should stop therapy immediately. It can be useful to share your concerns with your therapist, if it feels safe to do so. A good therapist will welcome feedback and incorporate it into your sessions. 

3 Reasons Why Therapy Might Be Going Nowhere

In this section, we’ll explore three common reasons therapy may not be working as well as you’d hoped, and, importantly, what you can do to help get your progress back on track. Later in the article, I’ll discuss reasons that may have more to do with your therapist or treatment plan.

1. You aren’t opening up

It’s completely normal not to feel entirely comfortable opening up at the start of therapy. At the beginning, your therapist is essentially a stranger to you. It makes sense not to want to dive deep right away.

However, if you’re noticing that you’re not opening up even as sessions continue, it could be getting in the way of your progress. Three of the foundational pillars of therapy are confidentiality, non-judgment, and safety for a reason; they promote openness. 

Openness is a necessary condition for making change. Without knowing about your current story and understanding existing patterns, your therapist cannot help you create connections or introduce useful tools to facilitate change.

If you’ve experienced judgment or something that’s compromised your ability to be open up in session, it may be a sign that your therapist is not the right fit for you. Later in the article, we’ll discuss what to do if this is the case.

2. You aren’t transparent

The concerns we bring up in therapy are often sources of shame for us. It can be easy to opt for avoidance when things come up that we have trouble admitting to ourselves, much less others. Being honest about the behaviours, thoughts, or feelings you have is an incredibly vulnerable thing to do, and it’s natural to want to opt out.

Honesty, however, is crucial in therapy. As discussed earlier, therapy is an investment, and without transparency, the investment is largely empty.

The magic of therapy comes from the knowledge that the person in front of you is accepting and will not judge. Therapists are less concerned with dubbing things as right or wrong, and much more concerned with the meaning of our experiences. It can be absolutely liberating to share something you feel conflicted or guilty about and have another human being accept you and meet you with curiosity and positive regard. It is through this that we can actually begin to accept ourselves and curve behaviours that feel unaligned with our values or identity.

3. You’re not being consistent

Not showing up to sessions, coming in late or distracted, booking appointments far out, or not completing the tasks your therapist set out for you are all things that can impede therapy progress.

It’s not always easy or possible to come in consistently or be fully present in session, but it is conducive to the work. Some folks who attend online therapy have a tough time connecting or focusing. If you need tips to make online therapy sessions feel more connected, click here. If you’re having a very tough time showing up consistently, let your therapist know of your limitations. You can come up with systems or a plan to work through it. If it’s still a big struggle, therapy might just not be the right resource for you at the time, and it might be good to consider re-trying when you’re better able.

Signs It’s Time for a New Therapist

If you have been attending regular sessions and try to be open and vulnerable during therapy, the lack of progress might be a result of your therapist or treatment plan. In this section, we’ll discuss when it might be time to seek out a new therapist or treatment.

1. Your therapist is showing red flags

It’s unfortunate, but it’s true; not every therapist consistently provides high-quality, ethical care. No therapist is perfect, but there are certain behaviours that might signal that it’s time to reconsider whether your therapist is the right person to support you.

It may be worth seeking a new therapist if you notice any of the following red flags:

• They dismiss or minimize your concerns.
• They frequently talk about themselves instead of focusing on you.
• They make you feel judged, shamed, or blamed.
• They repeatedly forget important details about your situation.
• They don’t respect professional boundaries.
• They discourage you from asking questions or giving feedback.
• They lack experience with the issues you’re seeking help for but don’t acknowledge it or offer a referral.
• They pressure you to continue therapy, or see them more often.

Some of these list items might not necessarily indicate that it’s time to leave, especially in isolation, but they may warrant a conversation with your therapist. As aforementioned, a good therapist is responsive and takes feedback into consideration.

You can learn more about what makes a good therapist here.

2. You and your therapist aren’t a good fit

If you notice your therapist is open, ethical, and warm, but therapy still isn’t working, it might mean you’re just not the right fit.

You might not feel like it’s a good personal match. For example, your therapist might be pragmatic and direct, when you’re looking for a more exploratory, collaborative approach.

Or, perhaps your therapist is open but doesn’t have enough knowledge of your background, and you feel you’d benefit more from someone with that preliminary understanding. A therapist’s age, gender, sexuality, cultural background, or religion do not inherently make them more or less effective, nor do these characteristics automatically determine whether they’ll be a good fit for you. However, for some people, working with a therapist who shares (or has a deep understanding of) certain aspects of their identity or lived experience can help them feel more understood, comfortable, and able to build trust.

Sometimes, it’s the therapy approach or expertise that doesn’t quite fit. Folks living with C-PTSD often cite that CBT isn’t as helpful for them as other types of therapy, for example. Additionally, your therapist might be really knowledgeable about some issues, but not have a ton of experience with your set of concerns.

It’s completely acceptable to ask your therapist about their approach and experience, and make a shift if it feels like you’re “stuck” or not making progress.

3. The treatment itself is not the right fit

It is also possible that the treatment you’re receiving is simply not the right one for you. Some folks attend individual therapy when their issues would be better addressed in couples therapy. Certain concerns, like active psychosis or eating disorders are not best treated in private offices, but public organizations or hospitals. Some folks require medication prior or alongside talk therapy for the best results.

Discussing these concerns with your therapist can be really useful. A therapist can provide referrals and recommendations if a different treatment plan is better suited.

Finding the Right Toronto Therapist for You

Finding the right therapist can feel surprisingly overwhelming. Lots of people don’t know what they’re actually supposed to be looking for, and that’s okay. Therapy is a deeply personal experience, and it’s normal for it to take a little trial and error before finding someone whose approach, experience, and personality feel like the right fit. 

That’s why I offer a free 15-minute consultation. It’s a chance for us to talk about what you’re looking for, answer any questions you have, and figure out whether my approach is a good match for your needs. If it’s not, I will try not to leave you empty handed. I have a trusted network of mental health professionals I can refer you to, if appropriate, if we’re not the right fit.

I provide online therapy across Ontario and in-person therapy in Toronto for individuals and couples experiencing concerns like trauma, anxiety, relationship issues, stress, burnout, and life transitions. If you’re interested, you can contact me here.