The #1 Reason Why Therapy Isn't Working

Christie Pearl, LMHC, LPC on Jan 27, 2023 in Treatment Orientation

Have you ever gone to therapy and didn’t return after the first or second session? If so, you’re not alone.

Studies show anywhere from one-third to one-half of therapy clients don’t come back after the first session — and another one-third only attend therapy a couple of times.

Now let’s think about this for a minute. We hear so much in the mental health industry about how hard it is to get an appointment and how in-demand therapy is. There are so many people in desperate need of mental health services who, for a variety of reasons, are unable to access them. And with all the trauma of the past few years (that is, sadly, still unfolding every day) and the heavy loads people are carrying, if you’re one of the lucky ones who — hallelujah! — can finally get an appointment, but you actually DON’T COME BACK after the first session, then what in the world happened?

Did you get what you needed in one session? Possibly.

Did you decide you didn’t have time to dedicate to coming to therapy every week? Maybe.

Did you get overwhelmed and realize you didn’t really want to deal with your stuff? Conceivably.

But here’s the thing.

According to studies, the top reason clients gave for not coming back: dissatisfaction with the therapist!

Clearly something isn’t working here. And I believe we therapists need to pay attention. We have an opportunity to elevate the discussion about mental health and how we engage with each other in the therapeutic process.

In my opinion, we therapists have a long way to go to step out of outdated models of practice that no longer fit our lives today. What worked 30 years ago just doesn’t serve us anymore.

One thing we therapists can get a lot better at is seeing ourselves as specialists in a few certain areas as opposed to generalists, and then we can market ourselves better so that prospective clients more clearly know whether or not we can help them.

It’s very difficult for the average person to decipher whether or not a particular therapist is knowledgeable in the issues they are facing — especially when many therapists are mostly talking about themselves and their credentials, using expert jargon and listing everything but the kitchen sink on their websites or therapist directory profiles.

Let’s face it: None of us is an expert in depression AND anxiety AND trauma AND life transitions AND couples AND children AND women’s issues, etc.

No wonder potential clients are confused and then dissatisfied once they are sitting with us.

The therapy industry has historically operated as if each therapist is a superstore instead of a specialty shop.

Take me, for instance. If you want a therapist to help you navigate grief, I’m not the best choice for you. If you want a therapist to help you resolve family conflict or heal from infidelity issues in your relationship, don’t even think about coming to see me!

But if you are an adult child of an alcoholic/dysfunctional family and you want a therapist to help you resolve leftover emotional baggage from your childhood that is interfering with your ability to succeed in your adult life — I’m your girl!

What I strive for, and what I teach when I consult with other therapists, is to clearly communicate who I really am, what I really do, how I really do it, and what is going to be different in your life as a result of working with me.

When we do this, our potential clients can more easily find a therapist who is a better match for them, who can see them and hear them in just the way that they are looking for.

Christie Pearl is a Licensed Professional Counselor in Glen Allen, VA.

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