What to Do When Therapy Didn’t Work.
If I had a nickel for every time a client told me during our first session, “I’ve had therapy before, but it didn’t really help…” let’s just say I would have a lot of nickels.
Have you ever felt more fragile after therapy than when you started?
I love helping clients through challenges like these!
There seems to be an infinite supply of therapists, all promising the same thing, “I can help you! I am sure I can help you!”
However, too many therapists get caught up in the overwhelming field of mental health (trying to find time for insurance panels, credentialing; continued education, HIPPA laws, and a plethora of other behind-the-scenes items that shouldn’t concern the client). Administrative issues often hinder client progress by sapping therapists of precious time and energy which could have been focused on therapy.
This is a travesty, and has nothing to do with the client’s willingness to receive help.
Here are reasons clients said therapy didn’t work before:
The therapist asked the same questions over and over again, and the client felt they weren’t moving any closer to their treatment goals.
The therapist kept asking about the client’s trauma, assuming there was some elusive “root issue” the client wasn’t aware of.
The therapist assumed that trauma was the only thing the client wanted/needed to talk about.
The client was a young child or adolescent when they started therapy, and was told by an adult to go, but now they don’t remember much of it.
The therapist was not knowledgeable about the client’s specific challenges (PTSD, Sexual Trauma, LGBTQA+, Dissociation, etc).
The therapist was knowledgeable, but not very experienced, and made the client uncomfortable talking about deeper issues.
The client didn’t trust the therapist, because of personality differences (i.e. the therapist might have been boisterous/bossy/loud/demanding, etc).
The therapist ended therapy suddenly without notice, possibly due to quitting their job.
The therapist no longer accepted the client’s insurance.
The therapist was unable to complete the work started with the client due to various life changes (i.e. homeschooling children, or becoming the primary caregiver for elderly family members).
I’ve met with too many clients who were forced to switch therapists up to 10 times before working with me. They felt stagnant in their growth and were wondering if therapy (with any therapist) could actually work for them.
Helpful Thoughts
Over the years I have discovered three thoughts to be most helpful for clients who are considering therapy, especially after being disappointed in the past. I always talk about these items during our first session so you have the tools necessary to know therapy (with me) will be a good fit:
Confidentiality
It is of utmost importance to me that clients feel safe in therapy (emotionally and otherwise). Part of feeling safe is knowing about your rights to confidentiality. Your personal information will NEVER be shared with anyone outside of therapy, EXCEPT under three circumstances- if you or someone else is in imminent danger, a child/elderly person/disabled person has been neglected/abused, or a court order is requesting your therapist or therapy records to appear in court. Outside of those rare occasions, everything shared in therapy will stay in therapy.
Therapeutic Orientation
Every therapist has their own personality, background, ideas about how problems occur, and ideas about how to solve them. Here are my thoughts on the matter:
Therapy is not going to make all of your life problems disappear.
Why not?
Because you are human, and problems are a part of the human experience. If you don’t have any life problems, you’re not human. You’re a robot. However, if you are feeling stuck in any particular life problem, therapy can be very helpful.
Ideally, once you are done with therapy, you would have gained things that help you continue moving forward through life’s problems, without feeling stuck again in the future. If after leaving therapy you begin to feel stuck again or encounter a new life problem that has you feeling stuck, that could be a good time to go back to therapy. Not all therapists view therapy in this way, which is why I share this as my therapeutic orientation in the first session.
Client Expertise
I do not know what it is like to walk in your shoes and I will never pretend to know. Only you know what it is like to walk through the world as (your name here). Therefore, you are the expert in your own life and I am an expert in facilitating change. Together, we collaborate in therapy to work towards your goals based on what you deem is most important.
As you might imagine, this is helpful to establish at the beginning of therapy, so a lot of time isn’t wasted just “getting to know you” without making meaningful progress towards your goals.
BONUS
Here is a bonus thought I would like to add:
THERAPY CAN END WELL!
With the right support, even the most fragile heart can feel strong again!
The ideal way to end a therapeutic relationship is for the client to reach all therapeutic goals as detailed on their treatment plan.
THIS ACTUALLY HAPPENS!
And when it does, both the client and the therapist start to feel like each session is more of a “check in” than an actual session.
At this point the therapist might ask, “Does it feel like a good time to decrease the frequency, to pause, or to end therapy based on the progress you’ve made? Do you feel like you can continue moving forward through life’s problems as they come, using what you’ve learned, without getting stuck again?”
If you’re working with me, your treatment plan will map out specific goals, objectives and interventions so we both feel really great looking back on what we’ve accomplished together.
Like I mentioned before, sometimes therapy ends during less-ideal circumstances. We don’t always have control over life’s unexpected twists and turns, but ending therapy is a normal part of the therapeutic process. Proper steps should be taken when possible to promote care, consideration, and continued progress AFTER ending therapy.
I would be happy to answer any questions you have about how therapy might be helpful for you, even if you felt therapy was not helpful in the past.
If you’re thinking about giving therapy a(nother) try, I would encourage you to schedule a free 20-minute consultation with me by clicking here. I look forward to hearing from you!