When Therapy Isn't Working: Part Two

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The last blog in this series addressed things to know before starting therapy to help prevent it from not working. This one will address reasons why it may not work once it has already started.

Below are some reasons why therapy may not be working:

1. Giving suggestions unrelated to your reasons for seeking therapy. If your therapist is advising you on things that are not related to mental health, it may be time to reconsider your provider. We operate under something called a "scope" of practice. This means that as long as it is within our training, experience, and permitted under our licensing board, we can support you in it. For example, if a licensed therapist is giving you suggestions about your fitness routine, that is out of their scope of practice. Unless of course they are also experienced in fitness and it is in relation to your mental health. It may be more appropriate for them to recommend you talk to a doctor about your health and its relation to fitness, or even a physical therapist.

2. Not creating goals. If you have been in therapy and there is no direction, that may be why you aren't feeling like you are getting to the place you want to be at. Goals help give both the client and the therapist and idea of what to work towards. This should be something you are discussing often. It may not look exactly like, "your goals are...". It may look more like, "how would you know that therapy is helping?"

3. Not making progress. If you have been seeing a therapist for several months and you don't feel like anything has changed/shifted, it may not be a good fit. Typically, there is some kind of movement around 3 months, but that isn't the case for everyone. For some people, after 3 months they may feel like they are doing so much better, and for others it may just look like a little relief.

4. Falling asleep or answering phone calls during session. Your therapist is ideally available for you for the full time you have scheduled. They should never be falling asleep in session or answering phone calls. If your therapist does not feel like s/he can show up for you that day, it would be appropriate for them to cancel or reschedule with you. The only time they should be answering phone calls is if it is concerning your safety. Things come up, but if they are not communicating to you, then you are not getting what you need, and that is unfair to you.

5. Theoretical orientation. Every therapist has a set of general counseling skills that they learn in the beginning of their work, however, each person has a different view (background/framework) of why problems exist and how to work through them. Some therapists work strictly from one, while others may work from many. You can look more into each theory, as specific ones might appeal more to you. You may feel like the approach that is being used may not work for you.

6. Unclear boundaries. If you are unsure about what to expect from your therapist, such as what their policies are regarding reaching them outside of office hours or what their fees may look like, this may be a reason therapy isn't working. You may be unsure because it was never stated, but it may also be unclear because it was stated and you find that they are contradicting themselves through their actions. This may send you the wrong message, and if you aren't able to find clarity by bringing it up and discussing it, this can make it difficult moving forward because you aren't sure what to expect.

Overall, if you aren't feeling like you are getting what you need, and you don't feel like you can discuss this with your therapist to find a solution, it may be time to look into other options for a therapist. Therapy is your time to work on you. It is okay to ask for what you are needing.