What do you do if therapy is not helping?


By David Joel Miller.

Counseling not working?

So you have been going to therapy for a while now and things are just not getting better what should you do now? Here are a few suggestions.

Talk to the counselor about your progress.

Sometimes you may think nothing is changing, you may be too close to your problems and in so much pain that you don’t see the progress you have made. Reviewing what has happened so far in counseling can help you gain perspective. Some problems are more difficult to solve than others. Consider where you started from in evaluating your progress. Sometimes, for some people, the light just comes on but other people find lifelong problems take time to work through.

Clarify your objectives.

You also want to discuss your objectives with your provider.  If you provider is working on one issue but you really feel that you need to solve something else you need to tell them. If your goals are unclear then it is not surprising you are not seeing progress. When therapy started you may have been in so much pain all you wanted was for the hurt to stop. Often in the early stages of change, we are very unclear about what we want to have change. As the process progresses you may decide on a goal or you may want to change your goal. Is it possible your goal changed without you noticing?

Consider what you are doing in the hours outside of therapy.

There are 168 hours a week; you only spend one or two of those in therapy.  If you come to the counselor’s office, talk about change but the rest of the week you live your life the same old way, you are not likely to make much progress. Are you working on improving your lifestyle? Have you cut down on drugs and alcohol? Should you cut them out altogether? Do you get enough sleep? Do you eat well and exercise? An hour a week talking about your stress will not do much if you continue to live a stressful life. Has your counselor suggested homework? Have you done it? If they did not suggest homework consider asking them why not? If you didn’t do the action steps ask yourself why not.

 Reevaluate your motivation to change.

Are you interested in changing? Did you come to therapy hoping that the counselor could help you change someone else? Specifically, what do you want to change? Or do you really want anything to change? If you don’t what change, then what do you want from being in counseling?

Are there other helpful things you could add to therapy?

Consider adding self-help groups, reading self-help books and working on developing or improving your support system. Support groups of others who are struggling with the same issue are extremely powerful. Learn from those who are farther along in their journey. Self-help books are full of ideas that might be just what you need. Ask your counselor to recommend some books or groups that might aid in achieving your goals. Take the good and uplifting from where ever you can get it. Do you have a religious or spiritual belief? Are you practicing that belief?

Consider adding medication.

Many people come to counseling resistant to medication. Medications are not a magic cure-all but for some conditions, they are helpful, for some they are essential. Possibly the help you get from a medication may be just the thing you need to get that initial progress into motion.

Reexamine the relationship between yourself and the therapist.

The major predictor of success in a counseling relationship is your belief in the counselor’s ability to help you. If you have any doubts about that consider why you have doubts about this relationship. Do you lack trust? Do you not feel heard?  Consider talking with your provider about your doubts. Then if you still feel that this relationship is not helping consider seeing someone else. There are times when even the best therapist might decide that they are not helping a client. The ethical thing for a provider to do if they are unable to be helpful is to refer that client to someone else that has more expertise or is a better fit for that client.

Here is hoping that you are finding the things you need to help you along your journey to the life you truly want and deserve.

For more on this subject see:

5 Rules for Picking the Right Therapist

How to Spot a Bad Therapist

Reasons Counselors and Therapists lose licenses 

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog, there is also a Facebook authors page, in its infancy, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. Thanks to all who read this blog.

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4 thoughts on “What do you do if therapy is not helping?

  1. Pingback: Reasons Counselors and Therapists Lose Licenses | counselorssoapbox

  2. Pingback: 5 Rules for picking the right therapist | counselorssoapbox

  3. Pingback: How to spot a bad therapist | counselorssoapbox

  4. Pingback: How much should you tell a therapist? | counselorssoapbox

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