Over the course of my career counseling thousands of clients with everything from mild anxiety to severe personality disorders with criminal behavior, I have come to realize that therapy doesn’t work for everyone. It does, of course, work for anyone who is invested, willing to put in the time, patience, and energy to make it work. Regardless of the disorder or level of intensity, anyone can get better, if they choose.
Unfortunately, it is not just the clients who have a lack of faith in the therapeutic process, sometimes it is the therapist themselves. Sadly, I have come across many licensed professionals who believe that a person cannot improve simply because the client is diagnosed with a certain type of disorder. I strongly disagree with this point of view. Regardless of the diagnosis, there is always room for awareness, understanding, better coping mechanisms, and management of their disorder.
While it is true that some diagnoses don’t disappear, even with therapy, it can still be managed. This is best seen with personality disorders. A person who has a personality disorder will have it for the rest of their life. But as time passes, the intensity of the disorder can increase or decrease. The therapeutic process can help a person to learn how to manage the disorder and set parameters for accountability going forward. This is the same process that has been successfully utilized when dealing with addiction.
A client who is committed to improvement and a therapist who is equally dedicated is a beautiful combination. But it requires both the client and the therapist to work at making the process work. Here are 13 reasons why therapy is not effective. Some of the reasons are the client’s responsibility, others the therapist’s, and some are both.
- The client wants to remain the victim. A person who wants to remain the victim does so because it is more comfortable, they are getting some benefit from it, or they are afraid to move forward. A therapist who identifies this resistance can overcome it by slowing down therapy and addressing the underlying fears.
- The client refuses to self-reflect. Sometimes, clients come into therapy to vent about their partner, family member, or friend. They are looking for validation for their feelings, thoughts, or actions from the therapist and not help themselves. Empathy from the therapist intertwined with redirection in a back and forth process can result in the client learning how to self-reflect.
- The client is too tired, exhausted, or overwhelmed. The deep work of therapy is not best done when a client is drained. Rather, a triage approach needs to be taken with the client so that what is most pressing is dealt with first and then the underlying issues can be addressed.
- The client has a fear of rejection or not being believed. Clients with severe levels of trauma are often too afraid to share all of their stories. Rather, they dole it in bits and pieces. Empathy and patience from the therapist are needed to draw out the trauma so it can be properly healed.
- The therapist has clinical limitations. Not all therapists are skilled in all areas of treatment. Nor are they familiar with all types of therapy or research. Before seeing a therapist, it is best to research them to make sure that their skills match the needs of the client.
- The therapist is not professional. Unfortunately, not all people who call themselves a therapist or counselor are licensed to do therapy. Coaching is not therapy. Counselors associated with a church or not-for-profit organization are not necessarily trained or licensed. A client should know the training and education of the therapist before engaging in the process.
- The therapist hasn’t done their own work. Sadly, this happens all too often. A therapist who has unresolved trauma can do more harm than good to a client. If a client notices a startle reaction in the therapist or drifting off, they should confront the therapist. A good therapist will admit their limitations and will be appreciative of the observation.
- The therapist is the wrong fit for a client. The age, gender, personality, expense, or office environment of the therapist might not be the right fit for the client. Some therapists will offer a 15-minute free consultation to ensure that this is not a problem for the client.
- One or both are unwilling to try. Much of therapy is a give and take. Treatment is not a one-size-fits-all, despite what some insurance policies might imply. Both the therapist and the client need to be flexible and honest with what is and is not working.
- One or both have unrealistic expectations. In the first session, a therapist should set a reasonable expectation for the therapeutic process. As therapy continues, the expectations might change. Both parties will need to adjust in order to keep the therapy effective.
- One or both have a lack of clear direction. One of the reasons for properly diagnosing a client is to have a clear uniform direction for therapy. If the diagnosis is incorrect, the therapy is not likely to be effective.
- One or both have a previous bad therapy experience. Sometimes therapy doesn’t work for the client or the therapist. A bad pervious experience can taint future attempts at therapy. Both parties need to acknowledge past failures and commit to trying again.
- One or both have a misunderstanding of therapy. In my office, we define the purpose of therapy as getting free from the past so there can be growth in the present and inspiration for the future. Free, grow, inspire is our tag line. A misunderstanding of what therapy is can be harmful to both parties.
These 13 reasons as to why therapy is not effective are just a small sample as to some of the causes. However, when the reasons are overcome, therapy is a powerful way to positively impact the future.