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When Psychotherapy Fails to Work

March 2019 / Psych ZenHealth

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What is Psychotherapy?

 

Psychotherapy, also known as talk therapy, is a range of approaches that can help people with various mental illnesses, emotional challenges from depression to low self- esteem, trauma, PTSD, personality disorders and family disputes. This therapy is achieved through verbal communication and relationship factors between a client and a trained mental health provider. It usually occurs once or twice a week for 30-50 minutes per session. Sessions may be one-to-one, in pairs, in groups or family sessions

 

WHY PSYCHOTHERAPY DOESN’T WORK FOR SOME PEOPLE

 

Psychotherapy works for most of the mental disorders. It is a proven effective treatment for mild to moderate psychiatric symptoms. However, for some people, it just doesn’t work for them. It can even have a negative outcome such as worsening of the symptoms or becoming too dependent on the therapist. There are various reasons why psychotherapy fails to work. Therapy needs to be specific to each person’s struggle. There is no ‘one-size-fits-all’ approach to therapy.

 

Factors that may block the effectiveness of the therapy:

 

1. Unhealthy underlying factors such as unhealthy thoughts, beliefs, actions, situations, and circumstances can deviate the client’s perception of the therapy. Rigid thinking, anger, unrealistic expectations, and perfectionism are examples of unhealthy behavior that can affect the way they perceive the therapy. For example, a person who has issues with impatience and unrealistic expectations might believe therapy is not helping them because he thinks he should make faster progress than he is. So he quits therapy prematurely believing it doesn’t work, or a person who is a rigid thinker might be resistant to making any changes. Therefore, the therapist needs to tailor his approach to the client’s needs and goals.

2. No Goal have been set, or the goals are unrealistic. It’s important for the client and the therapist to set realistic goals and outcome. Clients need to be involved in setting the goals of therapy and educated about what the process will entail. This is helpful to ensure that they are making progress and keep track of the recovery.

 

3. The client believes she knows better than the therapist. If you believe you know more than the therapists you worked with, it’s better to find a more knowledgeable therapist than it is to continue to struggle on your own. There should be a good therapeutic trusting relationship between a client and the therapist.

 

4. Resistance is a common cause why psychotherapy does not work for some people. They are either unwilling or unmotivated to do the work to get better, or they prefer to stay unwell to avoid dealing with the deeper issue. Another example is that some people find it too risky to let their guard down so they would rather remain safe than vulnerable.

 

The therapists should be able to address their client’s treatment preferences and expectations – such reflection could have led to the realization that a more “directive, task and action-oriented” form of therapy may have been more appropriate for these clients. On the other hand, some people prefer an approach with more emphasis on reflection and understanding.

When therapy is not working for you, you should talk to your provider so he can make some changes in his treatment approach. You should ask about the timeframe of the therapy, the treatment approach that the therapist use, and what you can do to improve your progress such as life style changes– improving your diet, regular exercise, regular sleeping pattern and mindful breathing or meditation. A good therapist can also recommend changes you can make that might improve your prognosis.

Every client is different, and every mental health condition requires slightly different treatment approaches. It is proven that lifestyle changes can often help combat mental illnesses.

The most important predictor to determine the effectiveness of the therapy is the relationship between the client and the therapist. The relationship should be a good fit. A therapist who accepts your values, understands your struggles, who can empathize with you, and who makes you feel accepted and heard is a must to the therapy. If you don’t have a good fit with your therapist, perhaps it’s time to try a new one.