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Signs a client is “stuck” in therapy—and how to help

If your client isn’t progressing, even after a long period of time, you may need to change your strategies.

One of the most rewarding things about working as a therapist is seeing your clients progress toward their goals. They come to you with a concern, you provide tools and resources to help, and ideally, their symptoms improve. You may even decide together to stop working together in therapy. 

In other cases, a client may not be seeing the progress they’re looking for, even after a long period of time. A “stuck” client can be discouraging, and you may not be totally sure how (or if) you can help. Ahead, learn more about how to tell when a client is “stuck” in therapy, and what you can do to support them.

What does it mean when a client is “stuck?”

Simply put, “stuck” means a client is no longer making progress in therapy. “A stuck client keeps coming to every session the same without moving the needle toward their goals and continuing the same patterns without improving at all,” says therapist and practice owner Abby Gagerman. Maybe the client isn’t internalizing or applying strategies they learned in therapy, or the strategies they’re using aren’t working. 

Signs a client is stuck in therapy 

You may be working with a stuck client if: 

  • You feel frustrated or exasperated in session 
  • Your client leaves appointments upset or agitated
  • Your client regularly cancels appointments 
  • Your client doesn’t engage in conversations or complete assigned homework

This lack of progress can be discouraging—you care about your client, and you want them to get better. You may even blame yourself for the lack of growth. Instead of fixating on what you did wrong, take this as an opportunity to better support your client.

Ways to help stuck clients

Identifying that your client may be stuck is the first step toward helping them grow. From there, you can take a few different steps to ensure their symptoms improve. 

Reframe what stuck means.

If a client is no longer progressing, Gagerman says it may mean the strategies you’ve employed in therapy aren’t working for them (and that it may be time to adjust the treatment plan). Try to be open to new ways of supporting your client, even if they aren’t what you originally envisioned. 

Have an honest conversation. 

Be up front with the stuck client about what you’re observing. Depending on what’s going on, you could say, “I’ve noticed you’re not doing the homework I assign” or “I've noticed we’ve had similar conversations for the past several sessions. Have you noticed that, too?” Your client may open up about something in therapy that’s not working for them, whether a particular treatment modality or communication style. 

Update your treatment plan.

Getting aligned about what’s going on can support your therapeutic relationship and help you come up with a plan that supports your client’s well-being. Take some time to consider and document your client’s current symptoms, including their lack of improvement with a particular approach. You may decide to introduce a new therapeutic modality or tweak the frequency of your sessions. 

Know when to refer out.

If you’ve already attempted changes in therapy and your client is still not improving, it may be time to part ways. It can be hard to accept when a therapeutic relationship isn’t working out, but “we have to own it when we aren’t the right fit,” says Gagerman. If you can’t help the client, refer them to a colleague who treats their presenting symptoms. 

Headway makes it easier and more profitable for therapists and psychiatrists to accept insurance.

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Running a practice