Often times, people come to therapy struggling with a particular issue, be it anxiety, depression or relational problems. Starting treatment can bring a wonderful dose of optimism, helping clients feel that they’ve finally found the answer they were looking for. After a forever of suffering alone, they have someone to listen to them, take them seriously and allow them to truly heal. In a best-case scenario, the relevant problems are clarified, goals are set, and a plan of action is developed to work toward those goals. Despite the wide array of psychotherapeutic treatments available for various issues, the overall path is more or less the same.

But not all scenarios are best case. At times it might be a struggle to identify why a client is seeking therapy to begin with. Clients might have trouble pinpointing exactly what is going wrong or feeling off in life. Maybe they know they feel depressed, but still can’t establish any clear goals to work toward in the alleviation of their depression. Maybe a plan is established, yet fails. These scenarios or a combination thereof, are quite frequent in therapy and at least initially, don’t mean that something is necessarily wrong. Humans are complicated creatures and figuring ourselves or each other out isn’t an easy process. That being said, a competent therapist should be experienced with and adept at helping clients through these obstacles.

Nevertheless, sometimes it doesn’t work. Therapist and client try an array of strategies and don’t get anywhere. Clients in these situations tend to feel frustrated, because they’ve spent G-d knows how much time and money on getting help and find themselves stuck in square one. They don’t know how to proceed or whether it’s worth continuing, just because of how much they’ve already invested.

The most important thing for such clients to consider is as follows: If you honestly feel that you aren’t getting help, you probably aren’t. Therapy is not math. Client plus therapist does not necessarily equal all better. There are too many confounding variables; poor therapist, poor motivation or insight on part of client, wrong choice of therapeutic modality, just to name a few.

These kinds of situations tend to fall into one of two categories: those that are avoidable and those that aren’t. When looking for a therapist, it’s always a good idea to ask for a phone consultation. This allows client and therapist to get a feel for one another and determine whether the therapist’s work and treatment modality matches up to the client’s symptoms and experiences. Individuals with a severe trauma history, for example, require a provider that utilizes a posttraumatic intervention. Even when all of this checks out, first appointments should be held on the premise that either party can discontinue treatment based on the actual, therapeutic experience.

In many cases, however, even when all of the above is said and done, there comes a time when therapy stops working. Maybe some goals have been accomplished and others haven’t. Some symptoms might be resolved, while others remain. Sometimes a particular therapeutic relationship has run its course and the path to further healing requires a transition to a different therapist, or perhaps another pursuit altogether. Whatever the case, clients and therapists need to recognize and call out these issues when they arise and work in tandem to determine the best course of action for the client. Forcing helpless therapy is a waste of time for client and therapist and recognizing it is in everybody’s best interests.


By Elliott Blitenthal