You've been going to therapy but nothing's changing. Is it you? The therapist? The approach? Here's how to figure out what's wrong and what to do.
Signs Therapy Isn't Working
- No improvement after 8-12 sessions
- Same conversations week after week
- Dreading sessions (beyond normal discomfort)
- Feeling worse overall (not just temporarily)
- Therapist seems checked out or distracted
- You're not using anything from therapy in real life
Why Therapy Might Not Be Working
Wrong Approach
Not all therapy is the same. If you have OCD and you're doing insight-oriented talk therapy, it won't help—you need ERP. If you have trauma and you're doing general CBT, you might need EMDR or prolonged exposure.
Poor Fit with Therapist
The relationship matters more than the technique. If you don't feel understood, safe, or connected, the therapy won't work regardless of approach.
Not Doing the Work
Therapy requires active participation. If you're not doing homework, practicing skills, or being honest in sessions, progress will stall.
Need Medication
Sometimes symptoms are too severe for therapy to work alone. Medication can create enough relief to engage in therapy effectively.
Wrong Diagnosis
If the underlying problem is misidentified (e.g., treating anxiety when it's ADHD), the treatment won't match.
What to Do
Talk to Your Therapist
Before anything else, bring it up. 'I'm not sure therapy is helping. Can we talk about what's working and what isn't?' A good therapist will welcome this conversation.
Get Specific About What's Not Working
- Are symptoms not improving?
- Is the approach not resonating?
- Do you not feel comfortable with the therapist?
- Are you not applying what you learn?
Consider Changes
- Different approach (ask about CBT, EMDR, DBT, etc.)
- Different therapist (it's okay, they won't take it personally)
- Adding medication (talk to a psychiatrist)
- More intensive treatment (IOP, PHP) if needed
The Bottom Line
Therapy should help. If it's not, something needs to change—the approach, the therapist, or what you're doing in and out of sessions. Don't stay stuck for months hoping it'll click. Name the problem and make adjustments.