Most of us have heard that “therapy works” – and for many people, it really does. Countless studies show that psychological treatment can reduce symptoms, improve quality of life, and help people build healthier relationships with themselves and others. But the reality is more complex: not everyone feels better, or progress can take much longer than expected. This doesn’t mean that therapy has failed or that someone is beyond help. It usually means there are factors getting in the way, and with the right adjustments, improvement is still possible.
One important factor is the therapy itself. The therapeutic relationship – the connection between client and therapist – is one of the strongest predictors of success. If you don’t feel safe, understood, or like you “click” with your therapist, it’s harder to open up and make progress. The type of therapy matters too. Cognitive Behaviour Therapy (CBT), for example, is very effective for some people, but others might need trauma-focused approaches, emotion-focused therapy, or longer-term psychodynamic work. Even pacing plays a role; therapy can stall if it feels rushed or if it drags without enough momentum.
Client-related factors also matter. Sometimes people want things to feel different but aren’t quite ready (or able) to make changes in their behaviours, routines, or environments. Others may expect therapy to be a quick fix and feel disheartened when it takes longer than anticipated. Avoidance is another big one – it’s natural to want to pull back from painful emotions or memories, but this can slow down healing. Co-occurring issues such as substance use, untreated medical conditions, or memory and concentration difficulties can also interfere with therapy’s effectiveness.
Then there’s the reality of life circumstances. If someone is living with ongoing stress – a toxic workplace, an unsafe relationship, financial struggles, or unstable housing – therapy can help them cope, but it can’t erase those external problems. Lack of supportive relationships outside therapy can make progress feel slower, and practical barriers like cost, limited sessions, or cultural mismatch can add extra hurdles. And sometimes, the nature of the condition itself matters. Complex trauma, personality vulnerabilities, or chronic mental health conditions often require more time, persistence, and sometimes additional support like medication.
It’s important to remember that when therapy feels stuck, it doesn’t mean the person or the process is a failure. More often, it’s a sign that something needs to shift – whether that’s trying a different therapeutic approach, addressing practical barriers, adding supports outside therapy, or combining therapy with other treatments. Healing is rarely a straight line, and for many people it’s about finding the right balance of support at the right time.
If therapy isn’t moving in the way you’d hoped, it’s absolutely okay to bring this up with your therapist. Talking about it together can open up new ways to move forward or find strategies to help you cope in the meantime.
In my clinical experience, those who end therapy too early can sometimes be at greater risk of suicide. This is why it’s so important to raise these thoughts or feelings with your therapist if they come up – even if it feels uncomfortable to do so.
#MentalHealthAwareness #TherapyJourney #HealingIsNotLinear #YouAreNotAlone #TherapyWorks #EmotionalWellbeing #ItsOkayToAskForHelp
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