Reasons Why People Say Therapy Doesn’t Work That Aren’t Therapy’s Fault 

With the increased awareness of the importance of mental health, therapy has never been more out in the open and discussed. The reduced stigma is great, but we still have a long way to go to make the mental health system more equitable and accessible. Since therapy has often been viewed as something shameful, it makes sense that the concept of therapy is commonly misunderstood. One of the best tools we have in combatting shame is to bring it out in the open and name it. Let’s look at some common myths, misunderstandings and barriers that can contribute to the feeling that therapy doesn’t work, but in actuality  they don’t  have anything to do with the therapeutic process at all.  

1. Plenty of therapists suck at their job 

I wish it wasn’t true, but unfortunately a lot of therapists suck at their job. They might be burned out, stuck in their ways or use their position as the therapist to exert power over vulnerable people. You’d think the system would do a great job at vetting people joining the profession, but like anything else perfect isn’t real.  If someone gets the degree, passes the exams and gets their clinical hours done they will get a license to provide therapy. A lot of harm can be done by therapists through sheer incompetence. The field also attracts people who have been through emotional and mental health challenges, which can be a great asset, but if these challenges have not been properly addressed clients are impacted. This type of harm is rarely the type to reach the threshold of reporting someone to their respective board. People are allowed to be bad at their jobs. When dealing with vulnerable people, this means that a client may feel like they are doing therapy wrong which reinforces many of the negative beliefs that brought someone to therapy to begin with.  

2. It’s hard enough to find a therapist at all, finding one that is a good fit is challenging.  

Even though it has gotten better, it is still hard to combat the stigma associated with therapy. Suffering from feelings of depression or anxiety can make it that much more difficult to go through the process of locating a therapist that is taking new clients, navigating insurance, and figuring out scheduling. Sometimes a therapist is very good at their job, but they might not the right fit for you. This can make it seem like therapy doesn’t work. The foundation of the therapeutic process is the therapeutic relationship. There can be things beyond our control that impact the feeling of the relationship being a good fit. For example, if you don’t trust your brother and your therapist reminds you of him, it is going to be hard to feel open to the therapeutic process. It is important to bring up any concerns about the therapeutic relationship to your therapist so that they can help you process and navigate this situation. Quality therapists know they cannot be the right fit for everyone. It can be awkward to bring this up, so it is common that people simply stop going and say that therapy doesn’t work.  

3. Therapy is an investment of time and money. 

Whether we like it or not, we exist in the world of for-profit healthcare. Changes in insurance or work schedules can disrupt the therapy process. Often the times we need therapy to help navigate life stressors and changes those same life stressors get in the way of being able to attend. Therapists may leave for other job opportunities, or they may need extended time off to attend to their own health. When these outside factors force the termination of the therapeutic relationship and we aren’t ready for it, this can trigger feelings of disappointment or abandonment.  

Another way that the investment of time can feel like therapy doesn’t work is that the healing process is not straightforward. When we are suffering, of course we want to feel better as soon as possible. It can take time to build a strong therapeutic relationship. It is more common to think of our experience with routine physical health where we report symptoms to a doctor and there is a direct solution. Everyone is different, but it is not uncommon for things to emerge as therapy progresses. This can feel like therapy doesn’t work or even is making things worse. 

4. Therapy doesn’t fix systemic issues.  

When people think of therapy, they typically think of being treated for symptoms of depression or anxiety. The symptoms are seen as the problem to be fixed. Quite often, these symptoms are a normal reaction to stressors that people experience. If the systemic issues are ignored, it can seem like therapy doesn’t work. Things like discrimination, abuse, toxic environments, and financial hardship are all types of chronic stressors that can be hard to cope with. Therapy can help you to feel seen, heard and it can teach you coping skills, but it can’t change the system itself. It can be easy to scapegoat the process of therapy for not working when therapy is also a mere cog in the wheel of the mental health care system.  

5. Therapy doesn’t fix other people. 

Another common misunderstanding that can seem like therapy doesn’t work is how often people come to therapy hoping to make other people change. It’s common to have feelings of frustration or sadness related to important people in our lives that we care about. Sometimes people come to therapy expecting to learn what to say to make other people change. Sometimes people are coerced into therapy because other people in their life think they need to make changes. Therapy attendance can be mandated by the court system for various reasons. The meaningful change that can happen from therapy can only happen if the person is capable of doing so. They are not capable if they people expect things beyond their mental capacity. For example, someone with ADHD is always going to have ADHD regardless of treatment. Parents may get frustrated with ADHD related behaviors and there are ways that therapy can help, but it will not result in their child behaving as though they do not have ADHD. Another example is the importance of motivation to change. In drug and alcohol treatment, it is not enough to mandate that someone attend therapy. They may attend consistently, but people are only going to get out of therapy what they put in. Sometimes forced attendance sparks motivation but is it far from a guarantee. Change cannot be forced. No matter how skilled they are, no therapist is a magician.  

Having an increased understanding of the limitations of therapy can help reduce frustration. It can also help us further reduce the stigmas, myths and misunderstandings associated with therapy and the benefit for our mental health. If you are in therapy and feel frustrated with the process, please bring this up to your therapist. They can help you determine if things need to change course or if there is a misplaced frustration in the healing process.

  Rayelle Davis is a Nationally Board Certified Counselor licensed in Maryland and West Virginia. She is an expert content reviewer for highered.com and a faculty trainer for the American Society of Addiction Medicine. Her research on the diseases of despair and Appalachia fuels her mission to build community centered around accurate and decolonized mental health education.