If therapy doesn’t feel like it’s working for you, it could be due to a variety of factors — from provider fit to a misdiagnosis or your personal preferences.
While progress in therapy can be slow, it’s important to speak up if you’re feeling like you’re not getting the benefits you want.
Having an accurate diagnosis will ensure you get effective care. If you feel like therapy isn’t working, it might be because you’re not receiving the right treatment for your needs.
Therapy can be a life-changing and, at times, lifesaving experience [1]. It can help you overcome the effects of trauma, increase your self-awareness, strengthen your self-esteem, and improve your relationships.
At the same time, healing is highly personal, and everyone has a unique path to recovery. Sometimes, despite your best efforts, it might feel like therapy isn’t working. If you’ve ever felt this way, know that your feelings are valid and you’re not alone.
But before you decide to call it quits with therapy, consider the vast variety of treatment techniques. Each therapist has their own style. It might be about doing some exploration to find the right fit for your needs, goals, and preferences. Understanding why therapy doesn’t feel like it’s working can help you make a change and find the best care for your needs.
Let’s break down some of the top roadblocks to success in therapy.
Provider fit
There’s an abundance of research [2] that shows the importance of a strong relationship between client and therapist. Regardless of the specific type of therapy a provider practices, a foundation of trust is critical. If you don’t feel safe opening up to your therapist, it will be harder to make meaningful progress.
Some people have reported being harmed in therapy [3] due to their therapists’ unprofessional behavior. But that’s typically the exception to the rule. More often, this disconnect with a provider stems from a mismatch of personality types or communication styles. If you’re feeling disconnected from your therapist, know that it’s likely not anyone's fault, and it’s OK to look for a different provider.
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Emotional exhaustion
You might go into therapy thinking you’ll always feel lighter after a session. But the truth is that therapy is often heavy emotional work. When you unpack past traumas or delve into deep personal issues, it can bring up strong emotions.
While confronting those challenges is often necessary for healing, it isn’t always an easy process. Sometimes in therapy, you might feel worse before you feel better. Feeling heavy or drained after a therapy session doesn’t automatically mean that therapy isn’t working. But if that’s happening, don’t hesitate to bring it up to your provider. You can work together to create a self-care plan to help you navigate tough emotions between sessions.
Misdiagnosis
Different mental health conditions require different forms of care. For example, a person with a personality disorder won’t have the same treatment needs as a person with mild depression. That’s why it’s essential to get an accurate diagnosis.
Some conditions have symptoms that closely mirror one another. For example, attention deficit-hyperactivity disorder (ADHD) and generalized anxiety disorder (GAD) can both involve restlessness, sleep trouble, and problems with concentration. Getting an accurate diagnosis can help ensure that you address the root cause of your challenges. Otherwise, your symptoms could worsen, and it might not feel like therapy is working.
Feeling unproductive
Maybe you enter your therapy sessions feeling unsure what to talk about. Or maybe you leave sessions feeling like nothing important happened. If so, know that this is a common experience — especially during the first few sessions.
Keep in mind that not every session will be full of “ah-ha” moments or breakthroughs, so it might be hard to identify the impact of these sessions. But often, while it might not seem like anything major is happening, just building the mental muscle of taking regular time for yourself can have a positive impact.
However, if this keeps happening, don’t hesitate to bring it up. You can work with your provider to find ways to help you feel more productive in therapy.
Treatment-resistant conditions
According to the American Psychological Association (APA), therapy helps about 75% of people [4] who try it. Some people have mental health conditions that are considered treatment-resistant. This means that the typical supports — usually therapy and medication — don’t help them.
For example, people with psychotic disorders may have difficulty with therapy if they’re detached from reality due to hallucinations or delusions. Severe major depressive disorder (MDD) may also be treatment-resistant. This doesn’t mean that talk therapy can’t have any positive impact on people with these conditions. But they may require additional forms of support.
It’s also important to understand that relapse does not mean therapy isn’t working [5]. Many mental health conditions, including depression and substance use disorder, can involve periods where symptoms return. Therapy often focuses on helping people recognize warning signs, strengthen coping strategies, and get back on track when setbacks happen.
Personal preference
Although going to therapy is, thankfully, becoming more universally accepted, that doesn’t mean it’s right for everyone. Most people with severe mental health challenges need professional help to maintain stability. But if you find yourself feeling that therapy isn’t helping you, it’s OK to explore other options.
People find peace along many paths, and it’s possible to strengthen your mental health in other ways. For example, maybe you’re drawn to creative expression, spending time in nature, or somatic experiences. What matters most is finding the supports and experiences that support your growth and well-being. Sometimes that includes therapy, and sometimes it doesn’t.
One sign I look for is whether the client is becoming more aware of patterns that were previously automatic. That awareness can feel uncomfortable at first, but it often means meaningful change is starting. Feeling challenged or unsettled can be a sign that the work is reaching deeper levels.
Brandy Chalmers, LPC
Clinical reviewer
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Therapy is helpful for many people. But there may be some situations in which it feels like it’s not working, even if you’re giving it your best effort. It can take some time to find a provider who’s the right fit, building trust, and figure out what approach works best. Remember that mental health isn’t a one-size-fits-all endeavor, and it’s important to find ways to support your mental well-being in ways that meet your needs, goals, and preferences.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- Effectiveness of Psychotherapy on Suicidal Risk: A Systematic Review of Observational Studies https://pmc.ncbi.nlm.nih.gov/articles/PMC6389707/
- Psychotherapy and Therapeutic Relationship https://www.ncbi.nlm.nih.gov/books/NBK608012/
- Negative experiences in psychotherapy from clients’ perspective: A qualitative meta-analysis https://www.tandfonline.com/doi/full/10.1080/10503307.2023.2226813#abstract
- What is Psychotherapy? https://www.psychiatry.org/patients-families/psychotherapy
- Drugs, Brains, and Behavior: The Science of Addiction Treatment and Recovery https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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Rula’s editorial team is on a mission to make science-backed mental health insights accessible and practical for every person seeking to better understand or improve mental wellness.
Members of Rula’s clinical leadership team and other expert providers contribute to all published content, offering guidance on themes and insights based on their firsthand experience in the field. Every piece of content is thoroughly reviewed by a clinician before publishing.
