Quick Overview: If therapy does not seem to be helping after an amount of time that feels reasonable to you, the National Institute of Mental Health says to discuss that concern with your therapist. You may also explore other mental-health professionals or approaches. A conversation can focus on your goals, the approach being used, how progress is assessed, and what might happen if improvement does not begin. The information in this article cannot determine fit or outcomes for any individual.
Discuss the Concern With Your Therapist
The National Institute of Mental Health describes psychotherapy as a variety of treatments intended to help people identify and change troubling emotions, thoughts, and behaviors. It states that psychotherapy goals can include relief from symptoms, maintaining or enhancing daily functioning, and improving quality of life.
The same organization says that if you have been in therapy for what feels like a reasonable amount of time and are not getting better, talk with your therapist. It also says you might want to explore other mental-health professionals or approaches. This guidance does not determine what will fit a particular person or what result will follow from a conversation.
A direct question can keep the discussion focused on information available to you and your therapist. For example:
- “Can we discuss whether I am getting better?”
- “What are the goals of therapy at this point?”
- “How will progress be assessed?”
- “What happens if I do not start to improve?”
- “What other approaches or professionals might I explore?”
These questions reflect topics that the National Institute of Mental Health identifies for a preliminary conversation with a therapist, including the approach used, the rationale and evidence base for that approach, therapy goals, the recommended time frame or number of sessions, progress assessment, and what happens if improvement does not begin.
Questions About Goals and the Current Approach
The National Institute of Mental Health says that therapists may use one primary approach or incorporate elements from multiple approaches, depending on their training, the disorder being treated, and the needs of the person receiving treatment. It also says that therapists have different professional backgrounds and specialties, and that the approach used depends on training, experience, and the disorder being treated.
If you are considering whether to revisit the therapy approach, you can ask for information rather than assume what a change would mean. Questions may include:
- “What approach are we using?”
- “What is the rationale for this approach and its evidence base?”
- “How does this approach connect with the goals of therapy?”
- “Are there other approaches I could ask about?”
The National Institute of Mental Health notes that many psychotherapies are variations of established approaches. It also states that research involving large numbers of patients has provided evidence for many therapies, while preserving that treatment choices are based on individual needs and medical situation under the guidance of a mental-health professional.
Reflection Questions for a Therapy Conversation
The following table is a set of questions to consider before or during a discussion about progress. It does not determine whether to continue therapy, change approaches, or contact another professional.
| Reflection question | Question to bring forward |
|---|---|
| What goals did I understand therapy to address? | What are the goals of therapy now? |
| What do I understand about the current approach? | What approach are we using, and what is its rationale? |
| How is progress being considered? | How will progress be assessed? |
| What would I like to know if improvement does not begin? | What happens if I do not start to improve? |
| Am I considering another professional or approach? | What information can help me explore other options? |
Exploring Other Professionals or Approaches
The Substance Abuse and Mental Health Services Administration states that finding a suitable professional or program can take work and that a perfect match may not happen right away. It suggests looking for treatment or support that accepts insurance or offers free or low-cost services, is taking new patients, has appointments or meetings that fit a schedule, and includes qualities that are important to the person seeking care.
That organization also says that it can be helpful to talk to more than one person for recommendations because many types of support are available. These points describe possibilities for a search; they do not establish which professional, program, or approach is suitable for you.
The National Institute of Mental Health says that a preliminary conversation can help a person understand how treatment will proceed and whether they feel comfortable with a therapist. It identifies rapport and trust as essential and lists questions about specialty, approach, rationale, evidence base, goals, progress assessment, and improvement. It also says these conversations may happen in person, by phone, or virtually. This does not describe the format of any specific practice or service.
Questions to Bring to a Consultation
A consultation call at Rooted Integrative Therapy is described as a first step with an opportunity to ask questions and consider fit. You may wish to ask:
- What information can you share about individual therapy?
- How do you discuss therapy goals?
- How can I ask about progress or lack of improvement?
- What approach do you use, and what is the rationale for it?
- What can I ask if I am considering another approach or professional?
Practice Note: Rooted Integrative Therapy lists individual therapy, couples therapy, group therapy, and therapy intensives. Alina Hovsoyan, LCSW, offers in-person therapy near Orem and Provo, with virtual therapy across Utah. The practice’s FAQ describes scheduling a consultation call as a first step for asking questions and considering fit.
FAQs
What should I do if therapy is not helping?
The National Institute of Mental Health says that if therapy has continued for an amount of time that feels reasonable and you are not getting better, discuss it with your therapist. It says you may also explore other mental-health professionals or approaches.
Can I ask how progress is assessed?
Yes. The National Institute of Mental Health includes “How will progress be assessed?” among questions to ask a prospective therapist. It also includes asking what happens if you or the therapist feel improvement is not beginning.
Does exploring another approach mean it will work better?
No source provided here can determine whether another approach will work better for an individual. The National Institute of Mental Health says treatment choices are based on individual needs and medical situation under guidance from a mental-health professional.
Does a consultation determine whether a therapist is a perfect match?
No. The Substance Abuse and Mental Health Services Administration says a perfect match may not happen right away. Rooted Integrative Therapy describes a consultation call as an opportunity to ask questions and consider fit.
How can I contact Rooted Integrative Therapy?
The practice’s Connect page invites inquiries and appointment requests through its contact details or form. You can use the Connect page to request a consultation.
Sources and Further Reading
Sources used for this article:
- National Institute of Mental Health: Psychotherapies
- Substance Abuse and Mental Health Services Administration: Health Care Or Support
A Grounded Next Step
If you are deciding what to do if therapy is not helping, consider writing down a question about goals, progress assessment, the current approach, or other professionals or approaches. The National Institute of Mental Health identifies each of these as topics for discussion. If you would like to contact Rooted Integrative Therapy, its Connect page invites inquiries and appointment requests.
Please do not include urgent or highly sensitive clinical information in a general inquiry.
This article is for general education only. It is not a diagnosis, treatment plan, or substitute for individualized mental-health care. A qualified mental-health professional can help you consider what fits your circumstances.