Why therapy stalls, and what each reason points to
Getting yourself into therapy takes time, money and some nerve. When the sessions keep coming and not much seems to be changing, that can be discouraging. Progress in therapy isn’t a straight line, and slow patches are common. Therapy can also stall for quite different reasons, and each reason suggests something different to raise with your therapist. A stall points somewhere. It’s information about what to change.
Is this a stall, or is it just slow?
A large study of 7,161 adults having therapy for depression gives a picture of the usual shape of improvement (Forand and colleagues, 2026). Improvement usually starts showing up somewhere around the sixth to eighth session.
About two-thirds of the people in the study improved clearly at some point. A bit under half got to where their symptoms had largely gone. Of the people who improved, around 82% had done so by session twelve, and 96% by session twenty-four. Some people who hadn’t improved by session twenty-four did improve later.
Everyone in the study was having therapy for depression, by Telehealth A session by video or phone instead of in person. Medicare gives the same rebate for a session by video as in person. More in the jargon decoder , with a service that tracked their symptoms as they went. They filled in the same questionnaire session after session, and their therapists could see the results. Most therapy in Australia doesn’t run that way, so the timings are unlikely to match yours exactly.
In the study, slower improvement went with anxiety alongside the depression, with chronic pain, with several things going on at once rather than one clear problem, and with poor general health. Each of those adds to what someone is dealing with.
If things haven’t shifted yet, it’s worth talking with your therapist about how the sessions so far have gone. The two of you can then work out whether anything needs to change.
Start with your therapist
Not every therapist responds well the first time they hear therapy isn’t working. Even so, for every reason below except harm, the usual next step is to tell your therapist what isn’t working. Then the two of you can decide what changes: the pace, the focus or the Approach (modality) The kind of therapy someone uses, such as CBT or psychodynamic therapy. You'll also see it called a modality. More in the jargon decoder . All three can often change without changing therapist. Some therapists will also suggest someone who works differently.
Telling your therapist something isn’t working has words you can use to start that conversation.
Eight reasons therapy stalls
It stayed on the surface
You talked through the week, felt a bit better for it, and nothing underneath moved. The same things kept coming up, and sessions kept going to whatever had happened most recently.
What to raise with your therapist: spending more time on the patterns that keep repeating, and where they started. Your therapist may be able to shift the focus that way. Schema therapy, Psychodynamic therapy A therapy that looks at the parts of your life you can't quite see from the inside. Its core idea is that a lot of what shapes how you feel and act sits outside your awareness, and was laid down early. More in the jargon decoder and internal family systems therapy are built around looking at those patterns.
It was too much in my head
Sessions were mostly about thinking things through. You could explain what was going on, sometimes very clearly, and it still felt the same.
What to raise with your therapist: spending more of the session on what you feel as it happens, including what you notice in your body. Some therapists can bring that in alongside what you’ve been doing. Somatic therapy Talking therapies that pay close attention to the body. "Somatic" just means bodily. They work less with what you think about something and more with what your body does when it comes up. More in the jargon decoder is one approach built around working with the body.
I couldn’t keep up with the between-session work
Your therapy relied on things to do during the week: worksheets, writing down thoughts as they came up, or practising something between sessions. When those don’t get done, a therapy built around them has less to work with.
What to raise with your therapist: what got in the way of the tasks. Your therapist may be able to make them smaller, or lean on them less. If tasks between sessions are likely to stay hard to fit in, Person-centred therapy A therapy where you set the agenda. Your therapist follows where you go and stays with it, on the idea that being properly heard, by someone who isn't judging you, is itself the treatment. More in the jargon decoder and psychodynamic therapy set nothing for the week ahead.
I didn’t click with my therapist
You didn’t quite trust your therapist, or you found you couldn’t be straight with them about how things really were.
What to raise with your therapist: that it hasn’t felt easy to be open with them. Problems in the relationship can improve once they’re talked about. How well you and your therapist work together affects how therapy goes, whichever approach they use. Why who you see matters more than what they do has the research on that.
It was more confronting than I could manage
Sessions went at something painful before you felt steady enough for it.
What to raise with your therapist: slowing down. You can ask to build some steadiness first and come to painful things more gradually. If going at something painful has left you shaken and the feeling isn’t easing, Lifeline is on 13 11 14, and Kids Helpline is on 1800 55 1800 for anyone aged 5 to 25.
I ran out of sessions or money
Paying the full fee week after week can stop being possible. Sessions that come in a set number, through a workplace program, headspace A national youth mental health service for anyone aged 12 to 25, with centres around Australia and support online and by phone. It's free or close to it, you don't need a referral or a parent, and you can book it yourself. More in the jargon decoder or a Mental Health Treatment Plan A document your GP writes with you. It makes you eligible for a Medicare rebate on up to ten individual sessions a calendar year: six, then a review with your GP, then the remaining four. The plan itself isn't therapy. More in the jargon decoder , can also run out partway through your therapy.
What to raise with your therapist: that the sessions or the money are running out. Your therapist may run a group, which usually costs less, or know of other cheaper ways to keep going. Free and low-cost options sets out what’s available.
It helped, then stopped helping
Early on, therapy made a real difference. Then things levelled off and stayed there.
What to raise with your therapist: what you’d still like to change. Talking that through might lead to a new focus, a different approach, or a decision to finish on purpose rather than drifting out. When is therapy finished? is about deciding when to end.
Something about it felt wrong or harmful
Harm is different from a poor fit. If your therapist has done something harmful, you don’t owe them a conversation about it, and you can stop seeing them.
Where to go from here: when therapy goes wrong covers how to tell harm from a poor fit, what you can do next and who you can raise it with.
If things are difficult right now, Lifeline is on 13 11 14, the Suicide Call Back Service is on 1300 659 467, and Kids Helpline is on 1800 55 1800 for anyone aged 5 to 25. In an emergency, call 000. Crisis and emergency support has the full list.
Where next
If talking to your therapist leaves you wanting to see someone else, finding a therapist covers where to look. If you have a Mental Health Treatment Plan, ask your GP (general practitioner) For most people, where getting help starts. A GP can write a Mental Health Treatment Plan, prescribe medication and refer you on, and some are trained to deliver a small number of structured therapy sessions themselves. More in the jargon decoder or the new practice how it works when you change therapist.