Why try again? Discussing when previous therapy has failed

Thankfully lots more people are accessing talking therapies now than ever before. Yet only a proportion of these clients get the result they were looking for. This blog talks about why you should try again, and options to consider.
There are many reasons why previous therapy may not have been a good fit for you:

Type of therapy:
It could be that the type of therapy you accessed was not best suited for your symptoms.
For example CBT rather than counselling is recommended for anxiety, whereas Counselling rather than CBT is recommended for grief.
There are a large number of different types of therapy available in the private therapy world, although there’s some crossover on what we treat, there are some symptoms/problems better suited to particular types of therapy.

Delivery of therapy:
Therapy can be accessed lots of different ways. It can be in a group, in a couple, individually. It can be online, by telephone, in person. All of these can make a difference to us. For example, some people feel they need to see the therapist and be in the room with them to feel able to talk openly. For other people, they actually find the anonymity of telephone work where they can be at home in a safe place far more effective.

NHS versus Private therapy
I still do some work for them alongside private practice. The fact that we can have free access to therapy is wonderful, and a significant advancement over 10 years ago. However there are some distinct differences between the therapy I deliver in the NHS versus in private practice.

Waiting lists – this continues to be an issue in most areas. The problem with waiting lists is that for a proportion of people their symptoms will worsen. Private therapy offers the advantage of no waiting times.

Number of sessions – within NHS work, in order to keep the waiting lists down, we are restricted to the number of sessions we can offer. This varies with each service but for CBT is as low as 6, and at the most is 20. Yet the training CBT practitioners receive suggests that most anxiety disorders should have 12 sessions, and depression 20. Therefore just because you haven’t got better with the limited sessions offered in the NHS does not mean the treatment has failed, it often just means you weren’t able to be offered the ‘dose’ that is actually effective.

Therapist qualifications
The qualification level of therapists can vary dramatically. Unfortunately there is no regulation on who can call themselves a therapist or counsellor in private practice. Practitioners will advertise themselves after just brief study in college or having completed a course online for example. The recommendation would always be to access therapy from an accredited practitioner. Each therapy type will have its own accredited body, like BABCP for CBT practitioners, or BACP for counsellors. These body’s have their own websites allowing you to verify your practitioner.

Because there is no way of stopping false advertising, many clients will have received what they believe is CBT for example, when actually the person is not qualified or training to deliver it. This happens a lot, and clients will often just see that someone does CBT, and go for the cheapest option not realising they are not seeing a Cognitive Behavioural Therapist.

Therapist skill
It is not just the qualification level that can alter, but also the workers skill level. We are all trained to treat a wide variety of symptoms, but each therapist will have symptoms/problems they are more experienced with, or have better skills for. Try to find a therapist that specialises in the symptoms you experience. Also even though therapists might deliver the same type of therapy, we all have our own way of delivering it. So just because a therapist hasn’t worked for you, doesn’t mean that therapy isn’t for you.


As you can see, there are lots of factors to consider. I really believe that therapy can help. That’s why I specialise in working with clients that have tried and failed in therapy before. I am happy to look at why therapy didn’t work for you, what you want from therapy, and how I can work with you to make sure this time you achieve your goals. If I am not the right person for you, I will be honest about this and make recommendations of what I think would be better. I offer a free 15 minute phone consultation so we can decide if we are a good fit.

To find out about how I can help you, please get in touch. Private therapy available in Cheshire, by telephone and video call. 

Hannah Paskin
Awareness in Mind (AiM)
“Helping you to achieve your AiMs for a more positive and stress-free future”