7 signs of ineffective therapy

I wrote this blog after I received a call from someone seeking therapy for the first time. They had been putting off contacting a therapist because of embarrassment, but events in her life took a turn for the worse. The time had come for her to get support, she said.

We arranged a time for an initial phone-based consultation and I gave her as much time as she needed to feel confident to go ahead. At the end of the call she expressed her gratitude to me. When I asked her why she felt the need to do so, she replied that the only other therapist she contacted was ‘blunt and to the point. They just told me what it would cost and that I would need to see her face-to-face as she was unwilling to give me some time on the phone.’

I don’t understand my profession sometimes.

1. Ineffective therapy is tenuous

There can be many reasons why a therapist and client don’t connect in a meaningful way. Here are some signs that can indicate a therapeutic relationship isn’t strong enough:

  •  A client has to ask a ot of questions because they don’t understand their therapist
  •  A therapist’s answers to a client’s questions results in the client asking their questions again
  • A client notices feeling irritated because their therapist isn’t ‘getting them’
  • A client needs to invent subjects to talk about
  • A client doesn’t think about their therapy in between sessions
  • A client is not looking forward to seeing their therapist
  • A client or their therapist is trying harder and harder to find a way forward
  • A therapist does not give a convincing explanation for a client’s issue or outline a convincing way forward
  • A client is there because someone else thinks counselling is a good idea, not because they do
  • A client feels worse at the end of a therapy session, not better

2. Ineffective therapy: past, present & future

I took a call from a client who told me that having had two years of psychotherapy, she was looking for something more future orientated. Her impression was that psychotherapy is concerned with the past whereas other forms of therapy attend to the future. No! Only ineffective therapy focuses just on the past. Effective therapy can address the past, present and future.

3. Ineffective therapy: other approaches not included

There is no right or wrong way in therapy, just the way that works for individual clients. However, knowing what therapy has the potential to include can help clients make informed decisions about a) what therapy to choose and b) how to shape it as it progresses. Ineffective therapy is inflexible and unable to adapt to changing client needs.

4. Ineffective therapy isn’t honest

A concerned relative contacted me about counselling for her brother who had longstanding, complex mental health issues. I said I would agree to work with her brother only if he committed to potentially working over a significant period of time. To my surprise she said ’Thank you for being honest.’ She went on to say that other therapists had simply said they would work with her brother without stipulating any conditions. She decided they weren’t being straight with her.

5. Ineffective therapy generates scepticism

I will never forget a friend describing his experience of Cognitive Behavioural Therapy (CBT) he had for depression. ‘After 18 sessions I knew a lot more about my depression, but I was still depressed. I ended the therapy because she [the therapist] kept saying it would work in time, but it never did despite my feedback that it wasn’t helping. If she’d acknowledged this that would have been something, but she didn’t.’

6. Ineffective therapy is missing something critical

Seeking therapy is a comment on the inability of our existing relationships to give us what we need. The point of the therapeutic relationship is that it must provide what other relationships cannot or will not. Ineffective therapy does not contain the missing ingredient.

7. Ineffective therapy does not make a difference

What that difference is will be depend on the individual client, of course. It could be that someone wants to see concrete changes in their life as a result of therapy. For others, it might be something more subtle – if no less important – such as feeling genuinely listened to. Regardless of the difference sought, ineffective therapy does not make any type of difference.

Effective therapy and how to find it

Effective therapy should put you in charge. It should make you feel positive and hopeful, cared for and supported, and in possession of ideas, knowledge, strategies and techniques to make the difference you are after. So be on the lookout for signs that your therapy isn’t working for you – because it needs to!

At Conversations With Impact, we know we are effective for most of our clients. However, we don’t help everyone. If we can’t provide you with therapy that is effective we won’t work with you. Instead, we’ll do our best to help you find someone who can meet your needs.

For more information about effective therapy, please get in touch.