What to Do When Therapy Doesn’t Seem to Be Working
At CARE Counseling, Inc., we know that reaching out for therapy takes courage. But what happens when you find yourself asking, “What to do when therapy doesn’t work?”
First, take a deep breath—you’re not alone.
Sometimes therapy doesn’t feel effective right away, and other times, it might not feel like the right fit at all. Here are some thoughtful steps to take if you’re questioning whether therapy is working for you:
Getting to the Root of It and Exploring Different Approaches
If therapy doesn’t seem to be helping, it might be because it’s working on the wrong level of the brain.
At CARE Counseling, we often reference the “brain as stairs” model—a way to understand how different parts of the brain are responsible for different functions, from basic survival to higher reasoning.
The bottom stairs (brainstem and limbic system) handle safety, regulation, and emotional memory.
The middle stairs (midbrain) deal with attachment, emotions, and sensory experiences.
The top stairs (cortex) support thinking, talking, insight, and logic.
If your body doesn’t feel safe—or if your nervous system is stuck in survival mode—talking about your problems from the “top of the stairs” won’t be enough. You may need therapy that meets you at the bottom.
That’s where bottom-up interventions come in. These are especially helpful for trauma, anxiety, dissociation, or chronic emotional dysregulation.
Here are some examples of bottom-stair approaches:
Somatic therapy – Helps you notice and work with body sensations.
Brainspotting & EMDR – Use eye position or bilateral stimulation to access deep, stored trauma.
Polyvagal-informed therapy – Focuses on nervous system regulation and safety.
Internal Family Systems (IFS) – Creates connection with “parts” of the self that hold pain or survival strategies.
Sensorimotor Psychotherapy – Blends movement, posture, and awareness to resolve trauma stored in the body.
Coherence Therapy - Identifying and resolving emotional roots.
When therapy targets the lower stairs first—focusing on safety, regulation, and embodied healing—clients often find that the higher-level insights start to click more naturally. It becomes easier to talk about emotions, make decisions, and build connections when the foundation is secure.
2. Reflect on Your Goals
Ask yourself:
What did I hope to get out of therapy?
Have I shared these goals with my therapist?
Have they changed over time?
Therapy is a collaborative process, and sometimes it helps to revisit or clarify what you want from your sessions. Your therapist can then tailor the approach to better align with your goals.
3. Talk About It—in Session
It might feel awkward, but talking about therapy in therapy can be transformative. Share your concerns openly:
“I’m not sure if this is working for me. Can we talk about that?”
A good therapist will welcome this feedback and work with you to adjust course.
4. Insider the Fit
The therapeutic relationship is one of the most important predictors of success. If you don’t feel heard, understood, or emotionally safe, it may be time to explore another therapist.
Questions to consider:
Do I feel a sense of trust or connection?
Can I be honest in sessions?
Do I feel respected and seen?
It’s okay to “shop around” until you find someone who feels right for you.
5. Notice Subtle Shifts
Progress in therapy isn’t always dramatic. Sometimes, change looks like:
Feeling more aware of your emotions
Pausing before reacting
Sleeping a little better
Setting a small boundary
Even small shifts are signs of growth.
6. Give It Time—But Not Forever
Some healing takes time, especially if you’ve experienced complex or long-standing challenges. But therapy shouldn't feel like you’re stuck or going in circles indefinitely.
If after several sessions you still feel disconnected or unheard, it may be time to try a different approach—or a different therapist.
7. You Deserve the Right Support
Therapy should help. And you deserve care that feels aligned, empowering, and effective.
At CARE Counseling, Inc., we’re committed to walking alongside you, adapting our approach to fit your needs—not the other way around. If something isn’t working, we’ll talk about it, adjust, or help you transition to a better fit.
Because your healing matters. And we care.
Ready to talk about what you need from therapy? If you’ve felt like therapy isn’t working, it might not be you.
Reach out today to schedule a consultation with a CARE therapist who’s committed to helping you find your path forward. It might just be time to shift how and where we begin.
At CARE Counseling, we honor the whole brain—and we’re trained to meet you at every level and offer a range of therapeutic styles because we know each client is unique.
