what to do when speech therapy isn't working

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Speech Language Therapy- Three Common Factors For Lack Of Progress

With any therapy the final goal is carry-over and independence. When it comes to articulation errors , the complaint I hear most often from parents coming from other speech therapists is that they did the work they were supposed to be doing at home yet their child did not make progress.

There are several factors that play into this scenario of frustration and failure.

The First Factor The first being lack motivation on the child’s part. It is difficult to blame the child for this because as speech therapists we must learn to motivate even the most difficult child.

The Second Factor The second factor is parents not having the time and/or patience to do the work sent home. Again, this is not always the parents fault as sometimes they read their child’s reaction to frustration and failure and avoid the activity leading to these feelings. Typically this is caused by the speech therapist giving the wrong homework.

The Third Factor The third and most likely factor leading to lack of progress is the speech therapist and her inability to read and treat the situation properly. If there is no structural, medical or physiological reason for a child to not speak clearly, they can and should learn to speak perfectly clear.

In private practice children often come to me who have been receiving speech-language therapy elsewhere for many years but still have the same lingering speech errors. I always ask parents to bring in their homework book to try to figure out the problem.

A Mistake Speech Language Therapists Frequently Make What I find most often is that the child had been working on the wrong thing. I also typically find that the homework they were given is almost always several steps ahead of where it should have been.

For example a child with a lateral lisp is given sentences containing the “s” sound to practice at home. I have even seen a child asked to make up stories with “s” vocabulary words. Not surprisingly, when probed, the child is unable to make the “s” sound in isolation.

If your child has an articulation disorder , or even an articulation delay, trying to teach him how to use a sound in a sentence before he can use it consistently in isolation is like trying to teach him to run before he can stand. It will just never work.  When it comes to articulation errors a child will never carryover or gain independence given this scenario.

Not Unique To Speech Language Therapists Unfortunately trying to move too fast is a mistake that is not unique to speech therapists. For example, my daughter Maya has some developmental articulation errors that we have been working on. She can’t say her “k” or her “g” sounds and whenever we get around family or friends someone will always ask her to correct her speech with unrealistic expectations. I find that very frustrating. All it does is lead to frustration and make her less willing to try.

The same can be said of bad speech therapy. When a therapist has unrealistic expectations and places unreasonable demands on the child it frustrates him and makes him less willing to try.

As a Speech Language Pathologist it is my role to bring all parts of the equation together. I must know where to start and how to motivate each and every child. I must give appropriate homework which is achievable and leaves parents and their children feeling successful. I have to judge the pace accordingly and not move too quickly. When all these pieces are put in place then and only then, independence can be achieved.

Note: Should you have concerns about your child’s progress you may call 914.488.5282 to request a confidential consultation with Isa Marrs.

Reader Interactions

October 31, 2010 at 8:48 pm

Isa, Thank you so much for your website. I found myself exploring for a long time! You have such a way with words and ease of explaining your work. I am an SLP who has been working with children for nearly 40 years. I have a private practice in Palm Beach Gardens, FL. I was referred to your site by April Choulat, educational/RDI consultant. Donna PS I’d like to subscribe to your newsletter, however I am uncertain as to how to do that.

January 1, 2012 at 10:28 pm

Hi Isa, My 5 yr old son has been in speech therapy for almost 3 years. He progressed some but has really not progressed much. He is in school now and we thought that would help but he has actually gotten worse since then. We have had his hearing tested by 3 different ENTs and he has passed all the test. He has had negative pressure at some points. I truely feel something with his hearing is wrong but can’t prove it and with 3 ENTs saying it isn’t I don’t know where to turn now. He is not really motivated but yet remaims extremely frusterated when you can’t understand him. I don’t know where else to turn… I read over your website and I’m looking for help, suggestions, anything to grasp. I have talked to a lot of people over the past 3 years and one day I know I will talk to the right person that will steer me in the right direction. Any advice you have would be appreciated. April

January 2, 2012 at 6:38 pm

Hi April, I am sorry to hear about the struggles you are going through with your son’s speech. Is your son receiving speech therapy in school? If so have you been able to talk to the Speech Language Pathologist who is working with him? In order for there to be progress there would need to be quality therapy at school and carry over by you at home. Do you have a Hospital or University by you that might provide quality therapy? Maybe a private therapist in your area could help? He could have CAS; he could also have an Auditory Processing disorder which can’t be properly assessed by an Audiologist until he is about 7. I would look into all your options and stay involved.

April 10, 2012 at 11:47 am

As a practicing speech pathologist since 1967 and recently retired, I am wondering whether or not we are working on symptoms rather than the causes related to lack of articulation carry-over. I am questioning auditory memory or processing problems in some cases. I believe too much time and emphasis may be placed on developmental articulation skills, as studies have shown that once a student reaches 75% accuracy with self-correcting behaviors in place, spontaneous improvement automatically occurs and can be measured with talk probes administered a few times each grading period rather than weekly therapy. Also, I am discouraged by the lack of emphasis I have observed regarding literacy related problems. Reading failure may be due to poor decoding skills that are phonologically based, slow decoding due to auditory memory problems, or poor comprehension due to language disorders. Speech pathologists are detrimental in improving these skills and should be utilized more in helping those who are at risk for reading failure. Just speaking from experience, and thanks for allowing me to vent.

April 10, 2012 at 12:05 pm

It is also important to determine if an articulation disorder requires a phonological approach to treatment rather than a developmental one which is utilized more often. Use of gestures and basic sign language skills may be helpful with comprehension issues.

May 22, 2012 at 11:56 am

Hi Sandi, Thank you for the comments.

October 23, 2013 at 9:12 am

I wish I had known all about these when my son was growing up. He is now in college and continues to struggle with his expressive math & or language. My husband & I are both therapist and have observed him to lack skills in communicating himself. When he was 18 months, he had almost 2 years of speech therapy sessions and 1 year of Occupational therapy sessions. These were all given because of his extreme delay in speech. His form of communication with us was through gestures & sounds, to present time, he still has had hard time finding his words we think, he loves the stage because his speech is rehearsed. He does not have to think of what to say. When we converse at home, he usually stay quiet and seems like does not know how or what to say. Most often times he would just be mad and go back to his room and be quiet.

December 2, 2013 at 4:35 pm

Maribel, It is never too late to get help. Many schools will have Speech Language Pathologists available especially if they have a Speech program. If your son is open to the help there are many strategies he can be taught that will assist him greatly.

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The Benefits of Speech Therapy

What to expect, frequently asked questions.

A speech-language pathologist (SLP) can help you with speech, language, and swallowing. They provide speech therapy to children and adults who may have speech or language disorders.

People with certain medical conditions may also benefit from speech therapy. Medical conditions that may cause speech or swallowing impairment include traumatic brain injury , stroke (brain damage due to a blood vessel blockage or bleed), and dementia (decline in memory and thinking functions).

This article looks at the various uses for speech therapy, what to expect during a session, and the techniques involved in this type of therapy. 

Verywell / Theresa Chiechi

Speech therapy can help with a variety of conditions.

Speech Disorders

Speech therapy may help with speech disorders like:

• Stuttering : Stuttering may involve repeating parts of words, prolonging words, or struggling to get out certain words. You may be more likely to have a stutter if you have a family history of stuttering.
• Apraxia : This motor speech disorder makes it difficult to move the tongue and lips to make sounds required for speech. In some cases, people with apraxia cannot speak at all. Causes for this disorder include brain tumors, dementia, stroke, and any other condition that causes brain injury.
• Voice : Voice disorders can be temporary or permanent and make it hard to speak. Chronic voice disorders include chronic cough, vocal fold paralysis, vocal polyps (growths on the vocal cords), and spasmodic dysphonia (vocal cord spasms).
• Dysarthria : People with this speech disorder have muscle weakness that makes it difficult to talk. They may slur or mumble their words. Dysarthria can happen due to brain injury or chronic degenerative conditions like Parkinson’s disease or Huntington’s disease .

Language Disorders

A language disorder ( aphasia ) is a condition that makes it difficult for a person to read, write, speak, or understand speech or other modes of communication. 

Someone with this type of disorder may struggle to:

• Use incorrect words for things
• Say complete sentences 
• Understand what other people say
• Understand jokes
• Read or spell 

Brain tumors, traumatic brain injuries, and degenerative disorders that affect cognitive function can all cause aphasia.

Feeding and Swallowing Disorders

Feeding and swallowing disorders can occur in both children and adults. A feeding disorder involves trouble with eating, sucking, drinking from a cup, or chewing. The specific term for swallowing disorders is dysphagia . Children or adults with dysphagia have trouble swallowing food or drink. 

Problems swallowing or feeding may or may not be related to a medical condition. Conditions that may cause a swallowing or feeding disorder include:

• Cleft palate or cleft lip
• Asthma and other breathing issues
• Heart disease
• Premature birth
• Nervous system disorders
• Reflux 
• Muscle weakness 
• Sensory issues
• Autism  
• Behavior problems
• Certain medications

Speech therapy begins with an evaluation to assess your difficulties and whether any structural issues contribute to your speech, language, feeding, or swallowing problems. An evaluation may involve a standardized test to help determine what you most need help with. Informal conversations may also help figure out your needs. 

A speech-language pathologist will then work with you to help improve your ability to speak, converse, or swallow. This may involve:

• Educating you on how to do certain things like articulating or pronouncing sounds
• Teaching you language skills
• Providing you with educational materials
• Giving you exercises to help strengthen your muscles 
• Giving you exercises that help you breathe better
• Participation in group therapy sessions 

You should also expect to practice the skills and exercises you learn in speech therapy sessions at home. Your speech-language pathologist may provide you with workbooks, worksheets, or virtual apps for at-home practice.

Speech Therapy for Adults

Depending on the reason you’re seeking out speech therapy, a speech-language pathologist may:

• Help you learn to move your muscles correctly to make sounds if you have apraxia or dysarthria
• Teach you how to use your breath to speak louder if you have dysarthria
• Help you learn to manage stuttering by teaching you to lower stress levels in certain situations
• Help you strengthen your mouth muscles to make it easier to swallow and eat if you have a feeding or swallowing disorder due to a brain injury or disease

Speech Therapy for Children

A speech-language pathologist’s approach will depend on the child. When working with a child who has a feeding or swallowing disorder, they might focus on:

• Strengthening the muscles of the mouth
• Helping the child with chewing
• Encouraging the child to try new food and drink
• Changing food texture to make it easier to swallow food 
• Helping with sensory issues related to food

Other skills a speech-language pathologist may work on with a child include:

• Language complexity : For example, they might teach words like "and" and "or" to connect ideas within sentences.
• Conversation skills : This may include role-playing to help the child with socialization and improve their read of social cues. 
• Vocabulary : They may use games or storytelling to help build the child’s vocabulary. 
• Phonological awareness : This recognition of the sounds that make up words is an important skill for reading. The SLP may work on helping the child identify sounds and rhymes in words to build this skill.

Healthcare professionals will also test your child’s hearing to see if hearing loss may be contributing to language and speech issues.

If you or your child is getting speech therapy from a qualified speech-language pathologist, you might wonder how likely it is that you’ll see improvement in speech, language, or feeding. 

Results will depend on the individual. It’s also essential to follow the exercises, tips, and strategies provided by the speech-language professional. Regular visits and keeping up with practice activities and exercises make it more likely to see an improvement in yourself or your child. 

A speech-language pathologist works with children or adults who have speech, language, or feeding and swallowing disorders. Typically the first session will involve an evaluation to determine the areas that are causing you the most problems. 

From there, they may teach you exercises and strategies to improve your speech, language, or ability to swallow and eat. 

A Word From Verywell

Think you or your child would benefit from speech therapy? Get in touch with your primary healthcare provider and ask for a recommendation. You can also use the American Speech-Language-Hearing Association’s (ASHA)  Find a Certified SLP Tool . 

Not all children develop at the same rate, but if your child has issues understanding language, doesn’t use gestures, or doesn’t seem to be learning new words, you might consider having them evaluated by a speech therapist. 

While this may depend on the individual and the cause of speech-related problems, research suggests that speech and language therapy can significantly improve speech and language issues.

One example of a typical speech therapy technique is articulation therapy. This technique teaches the person to make specific sounds, sometimes by showing them how to move their mouth or tongue.

A language delay is when a child has difficulty in speaking and understanding speech that is unusual for their age.

American Speech-Language-Hearing Association. Stuttering .

American Speech-Language-Hearing Association. Apraxia of speech in adults .

American Speech-Language-Hearing Association. Voice disorders .

American Speech-Language-Hearing Association. Dysarthria .

American Speech-Language-Hearing Association. Aphasia .

American Speech-Language-Hearing Association. Feeding and swallowing disorders in children .

Brainline. Speech therapy .

Understood for All. What is speech therapy .

Centers for Disease Control and Prevention. Languages and speech disorders in children .

Broomfield J, Dodd B. Is speech and language therapy effective for children with primary speech and language impairment? Report of a randomized control trial . Int J Lang Commun Disord . 2011;46(6):628-640. doi:10.1111/j.1460-6984.2011.00039.x

Nemours Children's Health. Speech-language therapy .

By Steph Coelho Steph Coelho is a freelance health and wellness writer and editor with nearly a decade of experience working on content related to health, wellness, mental health, chronic illness, fitness, sexual wellness, and health-related tech.She's written extensively about chronic conditions, telehealth, aging, CBD, and mental health. Her work has appeared in Insider, Healthline, WebMD, Greatist, Medical News Today, and more.

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Delayed Speech or Language Development

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As with other skills and milestones, the age at which kids learn language and start talking can vary. Knowing a bit about speech and language development can help parents figure out if there's cause for concern.

How Do Speech and Language Differ?

• Speech is the verbal expression of language and includes articulation (the way we form sounds and words).
• Language is giving and getting information. It's understanding and being understood through communication — verbal, nonverbal, and written.

What Are Speech or Language Delays?

Speech and language problems differ, but often overlap. For example:

• A child with a language delay might say words well but only be able to put two words together.
• A child with a speech delay might use words and phrases to express ideas but be hard to understand.

What Are the Signs of a Speech or Language Delay?

A baby who doesn't respond to sound or vocalize should be checked by a doctor right away. But often, it's hard for parents to know if their child is taking a bit longer to reach a speech or language milestone, or if there's a problem.

Here are some things to watch for. Call your doctor if your child:

• by 12 months : isn't using gestures, such as pointing or waving bye-bye
• by 18 months : prefers gestures over vocalizations to communicate
• by 18 months: has trouble imitating sounds
• has trouble understanding simple verbal requests
• by 2 years : can only imitate speech or actions and doesn't produce words or phrases spontaneously
• by 2 years: says only some sounds or words repeatedly and can't use oral language to communicate more than their immediate needs
• by 2 years: can't follow simple directions
• by 2 years: has an unusual tone of voice (such as raspy or nasal sounding)

Also call the doctor if your child’s speech is harder to understand than expected for their age:

• Parents and regular caregivers should understand about 50% of a child's speech at 2 years and 75% of it at 3 years.
• By 4 years old , a child should be mostly understood, even by people who don't know the child.

What Causes Speech or Language Delays?

A speech delay might be due to:

• an oral impairment, like problems with the tongue or palate (the roof of the mouth)
• a short frenulum (the fold beneath the tongue), which can limit tongue movement

Many kids with speech delays have oral–motor problems. These happen when there's a problem in the areas of the brain responsible for speech. This makes it hard to coordinate the lips, tongue, and jaw to make speech sounds. These kids also might have other oral-motor problems, such as feeding problems.

Hearing problems also can affect speech. So an audiologist should test a child's hearing whenever there's a speech concern. Kids who have trouble hearing may have trouble saying, understanding, imitating, and using language.

Ear infections , especially chronic infections, can affect hearing. But as long as there is normal hearing in one ear, speech and language will develop normally.

How Are Speech or Language Delays Diagnosed?

If your child might have a problem, it's important to see a speech-language pathologist (SLP) right away. You can find a speech-language pathologist on your own, or ask your health care provider to refer you to one.

The SLP (or speech therapist) will check your child's speech and language skills. The pathologist will do standardized tests and look for milestones in speech and language development.

The SLP also will check:

• what your child understands (called receptive language)
• what your child can say (called expressive language)
• sound development and clarity of speech
• your child's oral–motor status (how the mouth, tongue, palate, etc., work together for speech as well as eating and swallowing)

Based on the test results, the speech-language pathologist might recommend speech therapy for your child.

How Does Speech Therapy Help?

The speech therapist will work with your child to improve speech and language skills, and show you what to do at home to help your child.

How Can Parents Help?

Parents are an important part of helping kids who have a speech or language problem.

Here are a few ways to encourage speech development at home:

• Focus on communication. Talk with your baby, sing, and encourage imitation of sounds and gestures.
• Read to your child. Start reading when your child is a baby. Look for age-appropriate soft or board books or picture books that encourage kids to look while you name the pictures.
• Use everyday situations. To build on your child's speech and language, talk your way through the day. Name foods at the grocery store, explain what you're doing as you cook a meal or clean a room, and point out objects around the house. Keep things simple, but avoid "baby talk."

Recognizing and treating speech and language delays early on is the best approach. Call your doctor if you have any concerns about your child’s speech or language development.

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What to know about speech therapy

Speech therapy provides treatment and support for people experiencing speech disorders and communication problems. The approach is useful for treating several issues in both children and adults.

Speech is the expression of thoughts using articulate sounds. A speech disorder is an issue that prevents a person from communicating using spoken words. People may also refer to them as communication disorders.

Keep reading to learn more about speech therapy, including the conditions it may benefit, and how it works.

What is speech therapy?

Speech disorders can develop in multiple ways. They can occur due to:

• nerve injuries to the brain
• muscular paralysis
• structural abnormalities
• developmental disabilities

A 2015 study showed that around 8% of children aged between 3–17 years experienced a communication disorder during the last 12 months.

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), around 7.5 million people in the United States have trouble using their voices.

Speech therapy is an effective treatment for speech and communication disorders.

With speech therapy, a speech-language pathologist (SLP) provides treatment and support for people with speech disorders. They are health professionals trained to evaluate and treat those with speech, language, or swallowing disorders.

People often refer to SLPs as speech therapists.

How does it work?

An SLP will begin by assessing the individual. They can then identify different types of speech disorders and how they can treat them.

Speech therapy for children

A child may participate in speech therapy in a classroom as part of a small group or in a one-on-one setting. This depends on which speech disorder they are experiencing.

The SLP will use therapeutic exercises and activities to help them overcome their specific issues.

These include:

• Language activities: Involves playing and talking with the child while using pictures, books, and objects to stimulate language development. The SLP may also demonstrate correct pronunciation and use repetition exercises to help increase the child’s language skills.
• Articulation activities: These will involve the SLP working closely with a child to help them with their pronunciation. The SLP will demonstrate how to make specific sounds, often during play activities.
• Feeding and swallowing therapy: An SLP can work closely with a child with chewing or swallowing issues. The SLP can also use oral exercises to help strengthen the muscles in the mouth or work with different food textures to improve the child’s oral awareness.
• Exercises: The SLP may use a number of tongue, lip, and jaw exercises, alongside facial massage to help strengthen the muscles around the mouth. This can help them with future speech and communication.

An SLP will also provide the child with strategies and homework. These exercises allow them to work through certain activities with a parent or caregiver, so they can continue to practice at home.

Speech therapy for adults

An SLP can use several different techniques as part of adult speech therapy. These include:

• Social communication: The SLP may use problem-solving, memory activities, and conversation exercises to improve communication.
• Breathing exercises: An SLP may use breathing exercises to assist with resonance issues.
• Mouth exercises: These are a suitable way to strengthen oral muscles, which can help improve communication.
• Swallowing exercises: Medical issues, such as Parkinson’s disease, oral cancer, or a stroke, may cause swallowing difficulties. An SLP can use swallowing exercises to help a person manage these issues.

An SLP can use speech therapy to treat several conditions, which include the following:

Stuttering is a speech disorder that specialists characterize by the repetition of sounds, syllables, or words. A person with a stutter often repeats or prolongs words, syllables, or phrases.

A person with a stutter knows what they want to say but has trouble speaking clearly or in a manner that flows naturally.

People often also refer to a stutter as a stammer.

Learn more about stuttering here.

Aphasia is a disorder that causes a person to have difficulty with language or speech. Damage to the parts of the brain that are responsible for language may trigger aphasia. Strokes are a leading cause of the condition in adults.

A person with aphasia may lose their ability to express and understand language, and may also have difficulty reading or writing.

According to the NIDCD, around 1 million people in the U.S. are living with aphasia, while almost 180,000 acquire the condition each year.

Learn more about aphasia here.

Articulation disorders

Specialists classify articulation disorder as a disorder without associations to another speech or linguistic disability.

Articulation disorders refer to people experiencing issues with the production of sound involving the coordinated movements of the lips, tongue, teeth, palate, and respiratory system.

Those with these disorders may have difficulty making certain sounds, for example, saying “wabbit” instead of “rabbit.”

A person with phonological disorders can make these sounds correctly, but they may use them in the wrong position of a word.

People with articulation disorders often mispronounce words. Many individuals also have issues with other areas of language development.

Specific language impairment

A specific language impairment (SLI) is a disorder that causes issues with language skills development in children. It is a condition that is not due to a known neurological, sensory, or intellectual disability.

SLIs can affect the way a child speaks, listens, reads, and writes. Specialists sometimes refer to them as developmental language disorder, language delay, or developmental dysphasia.

SLI is one of the most common developmental disorders, affecting around 7–8% of kindergarten children .

The condition can impact a person as they enter adulthood. Speech therapy can improve an individual’s specific issues and help with their social and work life.

Resonance disorders

A blockage or obstruction to the regular airflow through a person’s mouth as they talk can trigger a resonance disorder. These disorders alter the vibrations responsible for speaking, leading to speech becoming unclear.

Healthcare providers often associate this speaking disorder with cleft palates and other neurological disorders.

Is it effective?

Several studies show speech therapy is an effective method for helping children and adults develop their communication skills.

One study of over 700 children with speech or language difficulties shows that speech therapy had a significant positive effect.

The results show that an average of 6 hours of speech therapy over 6 months significantly improved communication performance. Speech therapy was also much more effective than no treatment over the same period.

Another study looked at the effects of speech therapy on adults who had experienced a stroke and developed aphasia. The data suggest that speech therapy is effective in treating these communication issues.

The research also points to its efficacy in the early phase after a stroke, typically the first 6 months, and shows that intensive treatments have a greater effect.

Another study also suggests that speech therapy can be effective in treating people with aphasia. This study shows that 16 sessions of speech therapy across eight successive weeks helped improve communication skills.

Alternatives

There are some alternatives to speech therapy, which a person may use alongside speech therapy. These include:

Music therapy

Music therapy involves a number of specific music-led activities. These activities use music to strengthen language, communication, and social skills. A study shows it can help facilitate speech development in children.

Learn more about music therapy here.

Neurofeedback treatment

This treatment uses sensors attached to a person’s scalp, which record brainwave activity. Doctors then use a screen to display this activity. The person can then learn to control their brain functions as they communicate.

It is an effective treatment for speech problems in people who have experienced a stroke. However, it may have limited long-term benefits, with the research stating it cannot conclusively prove its efficacy.

Parent-implemented language interventions

This approach involves a parent or caregiver using routines and activities to help children develop their language skills. One study looked at parent-implemented language interventions with young children between 18–60 months of age.

The results showed that parents who implemented communication and language interventions had a significant, positive impact on the language skills of children with and without intellectual disabilities.

While speech and communication disorders are common in the U.S., speech therapy is proven to be an effective treatment for these disorders.

Speech therapy is effective for both children and adults, and SLPs can use various techniques to help a person improve their communication skills.

Last medically reviewed on January 6, 2021

• Neurology / Neuroscience
• Rehabilitation / Physical Therapy

How we reviewed this article:

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• Broomfield, J., et al. (2011). Is speech and language therapy effective for children with primary speech and language impairment? Report of a randomized control trial [Abstract]. https://pubmed.ncbi.nlm.nih.gov/22026565/
• Facts about cleft lip and cleft palate. (2020). https://www.cdc.gov/ncbddd/birthdefects/cleftlip.html
• Feeding and swallowing disorders in children. (n.d.). https://www.asha.org/public/speech/swallowing/feeding-and-swallowing-disorders-in-children/
• Groß, W., et al. (2010). Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921108/
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• Koyuncu, E., et al. (2016). Speech and language therapy for aphasia following subacute stroke. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116837/
• Mattioli, F. (2019) The clinical management and rehabilitation of post stroke aphasia in Italy: Evidences from the literature and clinical experience [Abstract]. https://pubmed.ncbi.nlm.nih.gov/30900098/
• Specific language impairment. (2019). https://www.nidcd.nih.gov/health/specific-language-impairment
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• Speech-language pathologist. (n.d.). https://www.nidcd.nih.gov/glossary/speech-language-pathologist
• Speech problems – articulation and phonological disorders. (2018). https://www.rch.org.au/kidsinfo/fact_sheets/Articulation_and_phonological_disorders/
• Statistics on voice, speech, and language. (2016.). https://www.nidcd.nih.gov/health/statistics/statistics-voice-speech-and-language#:~:text=Source%3A%20Compiled%20from%20fact%20sheets,have%20trouble%20using%20their%20voices
• Stelck, E. H., et al. (2011). Current practices for evaluation of resonance disorders in North America [Abstract]. https://pubmed.ncbi.nlm.nih.gov/21491359/
• Stuttering. (2017). https://www.nidcd.nih.gov/health/stuttering#treated

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Addressing Difficult Behavior During Speech Therapy

Speech therapists are instrumental in helping many young clients deal with the challenges speech presents. Speech does not come easily to everybody, which can lead to some frustrating circumstances. Speech therapists who work with children should address difficult behaviors before they progress.

Many speech pathology CEUs cover behavioral issues, especially considering that disruptions can lower the productivity of a therapy session. When you meet with a client only once or twice each week, each session matters. You must address challenges quickly.

Why Do Behavioral Issues Arise? 

Children may offer resistance when you are trying to help them through the difficulties of speech. Children who feel a sense of failure in the learning process are often not as motivated to attend therapy or even to be in a scenario where they focus on learning. They may feel that they will fail over and over.

Behavioral issues in children are common, but this is especially true in a clinical setting.

When issues arise in speech therapy, you have options. This guide will show you some ways you can handle behavioral issues that arise during your sessions.

Set Realistic Expectations

Clear expectations for behavior involve establishing a visual demonstration. Your clients need to know how they can reach your expectations, which includes you providing feedback on desirable and undesirable behaviors.

The biggest goal involved with setting expectations is to be consistent. When you allow sessions to go off course sometimes, clients may become confused when you stick to your established guidelines.

Open Lines of Communication

Any new client can be a challenge when you do not yet understand his or her personality and goals. Talk to the parents and guardians of each new client you take. Understand how this child typically relates to other adults and their peers. Develop an understanding of expectations for the child’s attention span and ask how the child reacts to frustration.

When you understand the child’s reactions, you can better serve him or her as a client. You also know the expectations you establish are realistic.

Learn to De-Escalate Problems

One skill you may learn in your speech pathology CEUs is how to prevent escalation of problems. Outbursts, especially in group therapy sessions, can throw off an entire session. Outbursts can damage the relationship between a therapist and a client.

De-escalation involves being sensitive to the issues that a client faces without giving in to a tantrum or outburst. Distractions can be a great way to prevent problems from growing, and by not giving in to a client’s feelings of powerlessness, you show respect.

Education can help you develop relationships with your clients so you can better understand their goals and frustrations.

Develop Positive Reinforcement

Motivation for children typically relies on positive reinforcement for a job well-done. When you use rewards for good behavior, you help build behavioral momentum. When you do this, you typically start easy or small and build up to more challenging tasks.

Take Speech Pathology CEUs

Speech-language pathology courses offer the opportunity to learn more about your career path. In your courses, you will learn how to best serve your clients, including children who may experience behavioral issues. Look at our courses to see how your practice could benefit.

Author:  PDH Therapy

Related posts.

Therapy Doesn’t Always Work. Here’s What To Do Next.

You might have been going to therapy for a while — and you may be leaving sessions feeling confused, angry, or stuck. If this sounds familiar, your therapy may no longer be working, and it can be difficult to know what to do next. While it's easy to freak out at this feeling, experts tell Bustle it may just mean it's time to reassess your therapeutic relationship. Looking critically at the help you need versus the help you're getting can help you determine a path forward, whether it's changing therapy types, moving to a new therapist, or something else.

Feeling resistant to your therapy sessions doesn't automatically mean that therapy isn't working for you; I went to a psychologist for five long years, and I can tell you from experience that if you feel uncomfortable and sad about going to therapy and relieved afterward, it may just mean that you're doing difficult but necessary work and you kind of hate it . However, if you really feel that your therapy isn't working for you, there are some proactive steps you can take. The first step, experts say, is to try and figure out what's going wrong.

You could discover that you're in the wrong kind of therapy. "Therapy is like medicine," clinical psychologist Dr. Josh Klapow, Ph.D. , tells Bustle. "There are different types of therapy for different conditions . And just like medicine, a therapy that is not properly matched with an individual's needs, condition, and sensitivities may be ineffective."

Like medication, he says, therapy can take a while to work. You shouldn't automatically bail after one week, unless your therapist is violating your boundaries or giving you other signals that you're not being heard . Therapists should ideally be given at least two or three sessions before you decide it's not working for you. However, therapy can also lose its effectiveness over time, or stop being needed.

If this is the case, you may need a different kind of therapy. "The term 'therapist' is a very broad term that covers everything from licensed clinical social workers, to family counselors, to licensed professional counselors, to counselors, to clinical psychologists, to psychiatrists," Klapow says. These people are not all trained in the same way and they can't provide the same kinds of treatment. If you're with a therapist who isn't qualified to provide the kind of care you want, or if your needs are now outside their remit, you may find yourself struggling.

Another common reason therapy stops feeling effective is the client-therapist relationship. "This therapist might not be the right fit for you," licensed professional counselor Heidi McBain, LMFT , tells Bustle. "This often happens in the beginning stages of therapy as you and your therapist are getting to know each other." You may also have reached a stumbling-block or a wall where you feel that you and your therapist just aren't making any progress. Klapow says these blocks often pass, but that if they don't, you need to figure out the next steps.

Whatever your reasons — whether it's the therapist, the therapy, or a feeling you can't explain — it's important to not just bow out without a conversation. "Do not just end therapy or email your therapist that you’re finished, especially if you’ve been working together long-term," McBain tells Bustle. For one, it's rude, but more importantly, it prevents you from figuring out what's going wrong so that you can both work together to fix it. Stopping suddenly will also deny you closure and a chance to talk about your therapy wins, McBain says.

A good therapist, Klapow says, will welcome your feelings and have an action plan . "They should be able to recommend a different course of therapy, a break, or help you communicate why you feel the impact of therapy is not as great as it was," he says. A therapist who gets defensive or upset at this conversation, he says, is showing that they're not qualified to deal with your issues, and you're probably right to not want to work with them anymore.

Sometimes you can fix therapy issues with changes in how you receive therapy. "Sometimes clients actually need to change the day, time, or frequency of their therapy visits, and once this has occurred, the therapy process continues," McBain tells Bustle. Other times, however, you'll need to move on.

Changing therapists or therapy methods can be emotionally difficult, and ideally your old therapist should help you through the process. If you can't talk to your old therapist about what precisely went wrong, McBain recommends journaling about it or talking to a family member or friend. Learn from the process and think about what you really want and need from a therapist, and then look for one with those skills. "Talking to [a] potential therapist on the phone before an initial session may help you to know if you have a connection and a level of trust with them right from the start," McBain says.

When therapy stops working, it can signal small issues that need to be fixed or bigger problems that require more fundamental changes. Either way, it's important not to keep it to yourself. The more honest you are, the more help you can get, so be brave and have that tricky conversation.

Dr. Josh Klapow, Ph.D. , clinical psychologist

Heidi McBain. LMFT , licensed professional counselor

This article was originally published on Jan. 17, 2020

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7 Phonological Awareness Strategies in Speech Therapy

This is a guest blog post by Monica, a school-based spech-language pathologist, all about Phonological Awareness Activities in school-aged speech therapy !

What is Phonological Awareness?

Phonological awareness is “the ability to identify, process, and manipulate phonological units that compose spoken words of different complexity and size” (Milankov, Golubović, Krstić, & Golubović, 2021). 

I n other words, phonological awareness is the ability to break down and manipulate spoken words into different parts.

Phonological awareness includes the awareness of words, sentences, syllables, onsets (first sound in a word), rimes (sounds that follow the first sound in a word), and individual sounds in syllables and words (Harbers, 2003). 

Some examples of phonological awareness are:

Rhyming: identifying words that rhyme

Counting syllables: identifying how many syllables are in a word 

Alliteration: identifying words that begin with the same sound

Phonological Awareness and Phonemic Awareness: What’s the difference?

Before working on phonological awareness and phonemic awareness in your speech therapy sessions, it is important to note the difference between phonological awareness and phonemic awareness.

Picture phonological awareness as an umbrella, with phonemic awareness falling underneath of it. Phonological awareness is the ability to break down and manipulate spoken words and sentences into different parts using larger chunks (think rhyming and counting syllables), whereas phonemic awareness is the ability to manipulate smaller pieces, such as individual phonemes in spoken syllables and words (Harbers, 2003). 

Some examples of phonemic awareness are: 

Segmenting phonemes: “map” = /m/ + /a/ + /p/”

Substituting phonemes : “say map, what is the word if we switch /m/ with /t/?”

Isolating phonemes: “What is the first sound in map?”

Why is Phonological Awareness important?

Making the jump from research to practice can sometimes feel overwhelming. Working on phonological awareness with students who are already at risk of developing dyslexia is one that translates pretty painlessly. This post will quickly cover why we should target phonological awareness in our sessions and then discuss speech therapy ideas. The activities will focus on preschool to 1st grade, but you could easily adapt them for any age group.

If you follow Dr. Farquarson on Instagram , you know that including phonological awareness activities during speech sound sessions is a must!

The article, Exploring the Overlap Between Dyslexia and Speech Sound Production Deficits , by Cabbage et al. (2018) is a must-read on the connection between dyslexia and speech sound disorders. The article states that, “Approximately 18% of preschool-age children with isolated speech sound disorder (absent of a co-occurring language impairment) have reading difficulty in mid-elementary school” (Cabbage et al., 2018) (Lewis, Freebairn, & Taylor, 2000). “In a separate line of work, an estimated 25% of school-age children with a family history of dyslexia have a history of speech sound disorder in early childhood (Pennington & Lefly, 2001). Thus, speech sound disorder and dyslexia are highly comorbid.”

Long story short, students with speech sound disorders are at a higher risk for developing dyslexia later in life , so including phonological awareness activities is an easy way to introduce reading skills early on (Tambyraja, Farquharson & Justice 2020).

If you want to know more about phonological awareness, check out the podcast episode on Where to Start With Phonological Awareness .

What is the Phonological Awareness Hierarchy?

Now that we have a better idea of what phonological awareness is, let’s take a look at the phonological awareness skills based on complexity. According to Moats & Tolman (n.d.), the following is a list of phonological awareness skills, ranging from the most basic phonological awareness skills to the most advanced phonological awareness skills:

Word awareness: tracking words in sentences

Rhyme and alliteration during word play: enjoying and reciting rhymes and alliterations (not producing)

Syllable awareness: counting, tapping, blending, or segmenting words into syllables

Onset and rime manipulation: producing rhyming words

Phoneme awareness: identifying and matching the sound in words (e.g. “which picture begins with /p/?”, segmenting and producing sounds (e.g. what sound does map start with?”), blending sounds (e.g. /m/ /a/ /p/ = map), segmenting phonemes in words (e.g. map = /m/ /a/ /p/”, and manipulating phonemes by removing, adding or substituting sounds (e.g. “say stop without the /s/”). 

Teaching Phonological Awareness Skills using the General Education Curriculum

I typically incorporate phonological awareness into my sessions based on the Preschool Learning Foundations (PLF) and Common Core Standards (CCS).

Here’s a quick snapshot of the PLF and CCS if you need them as a reference:

Preschool Learning Foundations:

Common Core Standards for Phonological Awareness ( Kindergarten and 1st Grade)

How to Write Speech Therapy Goals for Phonological Awareness Skills & Phonological Awareness Goal Bank

Like any speech language goals we write, we want to make sure our phonological awareness goals are SMART , meaning our goals are Specific, Measurable, Attainable, Realistic, and Timely.

A great place to start to get ideas for phonological awareness goals is the SLP Now Goal Bank . There are several examples of phonological awareness goals to get inspiration from. Remember, it is important to make goals individualized yo your students!

5 Examples of Speech Therapy Goal Targets For Phonological Awareness Skills:

Listen to a word and identify the first/middle/last phoneme.

Listen to individual sounds and blend them to form a word.

Produce the individual sounds in a stimulus word (e.g. /k/ + /a/ + /t/ for”cat”).

Delete phonemes in a word to form a new word.

Phonological Awareness Skill Building Activities

Now on to the phonological awareness activities! I’m going to cover my favorite ones and how to use them during speech sessions. I weave phonological awareness into my speech therapy activities. They aren’t separate tasks that take a lot of planning or prep. It’s part of the teaching process and works well with auditory discrimination.

Manipulating Individual Syllables

I use small dry-erase boards the most for this activity since it would be a lot of prep work to print and cut out words by syllables for all of my students. They also get practice writing out the words when we use dry erase boards, which teachers love anyways! I try to get a list of sight words from teachers and pick out words that have my student’s sounds.

Write out a target word on the students’ dry erase boards at the top to leave room for them to copy it on the bottom. Draw lines between the syllables and erase syllables, so students practice manipulating words.

Here’s what it might look like if you had a student working on multisyllabic words:

SLP: I’m going to write strawberry on the top. Let’s clap that out and see how many syllables it has. Straw/ber/ry. Did you hear 3? Let’s do it again. Straw/ber/ry. Let’s draw lines between the syllables, and then I’ll have you copy it down at the bottom. We heard 3 syllables, right? So every time you say the word, it should have 3 syllables. Let’s try!

*A prompt to build self-awareness could be, “did that have 3 syllables?”. Students would be able to say yes or no and then try their words again.

SLP: If I take out the first syllable “straw,” what’s left? Ber-ry. If I take out “berry,” what’s left? Straw. If a student can’t get this, I’ll use the dry erase board and cover the syllables to match what I’m saying. Let’s make sure we get all of the syllables when we say our words.

Rhyming Words

Using minimal pairs is an easy way to work on rhyming! I usually use a small set of words (no more than 5) and ask my students if the ending sounds the same. I mix in random words that sound really silly to make it fun when we’re contrasting sounds that don’t rhyme.

Here’s what it might sound like in a session if you were working on fronting:

SLP: Let’s look at these pictures. This person is tall (gesture for tall), and this person is making a call (gesture making a call). Let’s say those words. Tall. Call. Did you hear how both of the words have “all” at the end? Let’s just say “all”. Now let’s add our /t/ sound. Tall. Let’s say “all” again. Let’s add our “c” sound. Sometimes our “c” sound is just like our /k/ sound. Call. Did you hear how they both have the same sound at the end? That means they rhyme. What if I say call/oink. Did those two rhyme? No! That has a different sound at the end.

Other Phonological Awareness Ideas

Go through the minimal pairs and ask students to jump or do some movement or gesture every time the pairs rhyme, then sit down if they don’t.

Have the words separated into onset and rime. Have your students say what you hold up so that they have a visual of the rime being the same. Write the “c” and /t/ on their own and then have /all/ on its own and then put them all together to make words and also say /all/ by itself to build awareness. This is also a great way to work on blending.

Add some fun to repetitions by varying the speed of combining and deleting the onset and rime as they repeat them. Verbal instructions for this one could be, “Let’s put this one together fast” or “Let’s put this one together super slow”.

You could also put the pictures down and have students pick up matching rhyming pairs. You could modify this to add movement by sticking your pairs on the wall with some sticky tack and standing for parts of your session. You could make a scavenger hunt for the rhyming word after you’ve gone over all of the pairs. The ideas are endless!

Isolating Sounds

I use isolating sounds the most out of all of the phonological awareness tasks. It also really helps my deaf and hard of hearing (D/HH) students. If you have any students with initial or final consonant deletion, you’re probably already including it in your sessions. I love that it’s auditory discrimination and phonological awareness all rolled into one.

I mainly use gestures as we talk about our sounds and go through repetitions.

If a student is working on /s/ blends, I will ask them if the /s/ sound is in the front of the back. I put my hand on my heart for the “front” sound and point to my back for the “back” sound.

SLP : Our word is “spot”. Did you hear the /s/ sound in the front (hand to your heart) or in the back (point to your back)? Spot. I heard that in the front (hand to your heart). I want you to try the next word. Spill. Did you hear the /s/ sound in the front or the back? Yes! The front. What’s our back sound? Spill. It’s an /l/ sound! I will say the sound for new words and ask, “What sound did you hear in the front?” and “What sound did you hear in the back?”.

When a Student Responds Incorrectly

I ask, “Where is the /s/ sound? Front or back?”

Then I say, “You’re right! It’s in the front, try your word again.”

After enough times, if I ask “front or back,” they can correct their sound by themselves.

It works really well with initial /s/ blends and leads to less prompting pretty fast. I love that it builds self-awareness and self-correction quickly too.

Deleting and Manipulating Sounds

Here’s another activity that’s perfect for working on blends. Let’s say a student was working on /l/ blends. I use a dry erase board, or we make it a listening/auditory discrimination activity.

SLP: We’re going to work on the word “flip”. What’s the first sound we hear in “flip”? That’s right, an /f/ sound. What happens if I take the /f/ sound off? It becomes “lip”! Let’s try with some more words.

It also works well with final and initial consonant deletion.

SLP: Let’s work on the word “cat”. I’m going to write it out. If I cover up the “c” what do we have? At! Let’s try to say all the sounds by themselves “C-A-T”. If we put those all together, what does it make?

I often mix and match phonological awareness activities and put a couple of them together depending on what process we’re working on. I also adjust based on how much support my students need. Tambyraja, Farquharson & Justice (2020) highlight the unique skill and importance SLPs have in developing early reading skills with our students during speech therapy sessions. I love that I’m helping my students work on their reading skills, and it doesn’t take a lot of effort on my part.

I also love this resource from Reading Rockets . They partnered with the National Education Association and Colorín Colorado to make a guide for parents. It’s great for educators too. They have lots of activities for phonological awareness. It’s a great place to look if you want more ideas.

Cabbage, K. L., Farquharson, K., Iuzzini, -Seigel Jenya, Zuk, J., & Hogan, T. P. (2018) . Exploring the Overlap Between Dyslexia and Speech Sound Production Deficits. Language, Speech, and Hearing Services in Schools , 49 (4), 774–786.

Harbers, Heidi. (2003). Phonological Awareness and Treatment Outcomes. Perspectives on Language Learning and Education 10, 21-26. 

Lewis, B. A., Freebairn, L. A., & Taylor, H. G. (2000) . Academic outcomes in children with histories of speech sound disorders. Journal of Communication Disorders , 33 (1), 11–30.

Pennington, B. F., & Lefly, D. L. (2001) . Early Reading Development in Children at Family Risk for Dyslexia. Child Development , 72 (3), 816–833.  

Milankov, V., Golubović, S., Krstić, T., & Golubović, Š. (2021). Phonological Awareness as the Foundation of Reading Acquisition in Students Reading in Transparent Orthography. International journal of environmental research and public health , 18 (10), 5440.  

Moats, L, & Tolman, C (n.d.). The development of phonological skills. Reading Rockets. https://www.readingrockets.org/topics/developmental-milestones/articles/development-phonological-skills

Tambyraja, S. R., Farquharson, K., & Justice, L. (2020) . Reading Risk in Children With Speech Sound Disorder: Prevalence, Persistence, and Predictors. Journal of Speech, Language, and Hearing Research , 63 (11), 3714–3726.

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Hi there! I'm Marisha. I am a school-based SLP who is all about working smarter, not harder. I created the SLP Now Membership and love sharing tips and tricks to help you save time so you can focus on what matters most--your students AND yourself.

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Three Reasons Your Child Isn’t Progressing in Speech Therapy

1. beginning too advanced, 2. consistency, 3. carry-over, share on social media.

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What To Do If Children's Therapy Isn't Working

Tips on what to do if you feel that therapy or a stammering course isn't working for your child.

Are you having doubts about the therapy or course your child is having? Not quite sure where it's going? Does it not feel like the right fit for them? Here are some tips for what you can do. 

Questions to ask yourself

First up, take a step back and think about what's not working:

• What are your child's therapy goals? Does the speech & language therapist (SLT) share those goals? Goals can include all sorts of things. They can be learning to stammer in an easier way. Or managing thoughts and feelings around stammering, or increasing confidence. Or maybe it's speaking up more or learning to say what they want, when they want. Talk things through with your child and their therapist.
• What are you expecting from therapy? Are you or your child looking for a cure? It's important to have this discussion early on with your therapist. Many children do stop stammering. But young adults and teenagers won't stop stammering altogether. See What is Stammering? for more information. However, therapy will help them manage stammering and how they think and feel about it.
• Is your child not enjoying therapy? Does your child seem reluctant to go? If so, why? Depending on your child's age, ask for their opinion — are they finding it helpful?
• Is it the therapy approach? Does it make sense to you? Has the therapist explained what they're doing and why?
• Is it the relationship with the therapist? How your child gets along with the therapist will make all the difference. Sometimes they may not be the right fit. 
• Is this the right time to have therapy? Is your child able to give therapy 100% commitment? Do they have the time to put into practice what they've been learning? Almost all therapy programmes require practise at home between sessions. This is normally about 5 to 10 minutes every day. If there are other things going on for them right now, you might need to prioritise those. Go back to therapy at another time when they have less going on.
• Is therapy what you/your child needs right now? If your child is not particularly bothered by stammering, is this the right time for therapy? Would helping teachers, family members or friends understand about stammering be more useful? Why not show them our Guides For Non-stammerers. These will really help others to support your child.

What you can do

• Talk through your concerns openly with the therapist and discuss what can be changed.
• Talk to the manager of the service if needed — it might be possible to work with another therapist in the team.
• Take a look at the different options available to you. See Options for Children (& Teenagers) . Speech therapy is available on the NHS or privately, face-to-face or in some instances via video. Or there are stammering courses.
• Speak to us. Call 0808 802 0002 or start a webchat . We're here to listen and to give you information and support.
• Attend one of our online parent-led support groups or workshops . Email [email protected] for details.

Other options

Contact the Action for Stammering Children helpline . You can speak to a speech & language therapist who specialises in stammering. Call 020 3316 8100, weekdays 9am-5pm.

Join an online group like the STAMMA Facebook group . Lots of parents are members there, so you could ask them questions. Or there's the UK Network of Parents for Children who Stammer Facebook group .

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What to Do If Therapy Isn't Working

Julia Childs Heyl is a clinical social worker who focuses on mental health disparities, the healing of generational trauma, and depth psychotherapy.

Dr. Sabrina Romanoff, PsyD, is a licensed clinical psychologist and a professor at Yeshiva University’s clinical psychology doctoral program.

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Many make the decision to go to therapy when they are desperate for relief from deep pain. It isn’t an easy task, so if you have taken the leap to get support, take a moment to honor this accomplishment.

Therapy is a unique treatment. For many forms of clinical support we may seek, like getting medication for mood swings or hormone therapy , there is a clear timeline of when we can expect to see results. However, therapy can be a bit harder to gauge since it is based upon your personal situation, your mind’s response to talking about challenging things, the type of therapy you’re receiving, and the therapist you’re working with.

It isn’t uncommon to notice that therapy isn’t working the way you had expected. This article will cover how to tell if therapy isn’t working and steps you can take to ensure you get the most out of your treatment. 

How Do You Know If Therapy Isn’t Working?

We know when therapy is working well. We will notice ourselves making meaning out of our hardship , having breakthrough insights, and seeing how our life is beginning to shift. However, it can be harder to determine if therapy isn’t working .

A few clear signs of therapy not working are:

• feeling judged by your therapist
• omitting information from your provider for fear of their reaction
• consistently feeling worse in-between sessions and not receiving tools to move through the discomfort
• a complete lack of progress over the course of months

If You're Feeling Judged

If you’re feeling judged, sometimes that means you aren’t with the right therapist for you. The relationship between the client and therapist, also referred to as the therapeutic alliance , is a pillar of clinical progress. If that relationship isn’t strong, it can be hard to make progress.

It's not uncommon to work with several therapists before finding one who is the best fit for you. If you need to change your therapist , it's not a failure, and it doesn't mean therapy can't work for you. There are many options out there who may better suit your needs.

If You're Struggling Between Sessions

There may be times when you feel unwell in-between sessions. Sometimes therapy can feel worse before it gets better. This is because we are often discussing painful moments in our life that we haven’t shared with anyone before.

However, if you’ve voiced that you’re feeling destabilized between your sessions and your provider isn’t offering coping tools or even a check-in call when you’re in crisis, this is a sign that your current therapist may not be the right fit for you.

If You're Feeling a Lack of Progress

It is important to note that therapy is a long-term process—treatment can last well over six months for some folks. With this in mind, sometimes it can take a while to feel relief, and the timeline of beginning to see results can differ for everyone.

In short, sometimes therapy isn’t working and sometimes we need to adjust our expectations. Regardless of which is true for you, there are options to find the right support you need.

Reevaluating Goals and Expectations

First, when considering if therapy isn’t working for you, take a moment to reflect on your expectations. Sometimes we hope therapy is a quick fix, but it can take time. Other times, we may hope our therapist will “fix” our problems or offer advice.

However, the role of your therapist is to help you understand your mind better, give you tools to help you cope, and guide you towards learning how to solve the issues in your life. It is critical a therapist adheres to this role so that dependency isn’t created in the relationship.

Simply put, if a therapist is doling out advice and solving your problems for you, it hinders your ability to trust your intuition and grow your problem-solving skills. After evaluating your expectations, it is time to turn to your therapist for some answers.

Asking Your Therapist for Insight

Your therapist is a mental health expert who has experience supporting folks in their healing journey. Because of this, they have more insight into what your healing journey could look like. If you’re noticing therapy isn’t working, being honest with them can help you get answers.

Even if you find that perhaps your expectations for therapy aren’t realistic , sharing that with them can lead to fruitful insights. If you’re noticing that you feel judged by them, let them know. It may feel very scary to share that with them, but ultimately this is your treatment, and you always have the power to leave. Be candid about how you’re feeling in-between sessions and what you think may be lacking in your care. This allows your therapist to reevaluate their approach and course-correct as needed.

Assessing the Therapy Modality You’re Receiving

Sometimes talk therapy isn’t for everyone. Particularly for folks who have trauma histories, somatic therapy can be a much more effective modality. If this sounds like you, exploring a modality like somatic experiencing could be helpful . Others may wish for a more flexible and holistic approach to healing. A holistic therapist will support you through eclectic modalities and incorporating other forms of wellness, like acupuncture or yoga. 

If you’re feeling that the therapy modality you’re receiving isn’t the right fit, let your provider know. Again, they are well-versed in the mental health field and can help point you in the right direction.

Considering a New Provider

As mentioned, sometimes we just aren’t with the right therapist for us. If this is the case, it may be time to find a new provider . This can feel like a daunting process, but there are options for making it easier. If you hold a marginalized identity and would prefer a therapist who shares a similar identity, consider searching for a provider on Inclusive Therapists , Therapy for Black Girls , Therapy for Black Men , Latinx Therapy , or the National Queer and Trans Therapist of Color Network . If finances are a concern, Open Path Collective features a diverse collective of providers who offer therapy sessions for $30 to $60. You can also reach out to your health insurance to see what mental health offerings are covered by your plan.

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We've tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.

A Word From Verywell

Sometimes it can take a bit of trial and error to find the best provider. However, getting great care can change your life, so don’t be discouraged by the search. If you’re feeling overwhelmed by this journey, enlist some support along the way. Maybe you join a support group while you weigh out your therapy options. You can also have a friend or family member help you sort through different providers. If you’re noticing you’re in a crisis, reach out to a mental health hotline for immediate support. You are worthy of feeling good. Healing is possible.

Norcross JC, Lambert MJ. Psychotherapy relationships that work III . Psychotherapy. 20181018;55(4):303. doi: 10.1037/pst0000193

Gabbard GO, Long-Term Psychodynamic Therapy: A Basic Text . 3rd Ed. Arlington, VA. American Psychological Association Publishing; 2017

By Julia Childs Heyl, MSW Julia Childs Heyl, MSW, is a clinical social worker and writer. As a writer, she focuses on mental health disparities and uses critical race theory as her preferred theoretical framework. In her clinical work, she specializes in treating people of color experiencing anxiety, depression, and trauma through depth therapy and EMDR (eye movement desensitization and reprocessing) trauma therapy.

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When a Toddler Is Not Talking Yet… You Need a Plan!

As speech-language pathologists and parents, when a toddler is not talking yet, we rush in to try to help them learn to say new words and pronounce them clearly. When these first attempts don’t work, we become frustrated, sometimes very frustrated, with the lack of progress. This is the point where I usually meet parents – and even therapists – at a point of frustration. They’re out there looking for a way to do things better or faster and they find this website, my videos on youtube, or my podcast.

That’s the purpose of this post, to help you find a way to help your own late talker – or, if you’re a therapist like me, a whole caseload of toddlers with language delays!

Anytime you’re working on changing something, you need a plan!

When a child is not talking yet, you need not only a plan, but a good plan!

Early in my career, I recognized the need for a consistent way of designing my own treatment plans to make sure that I addressed every aspect of helping a child learn to communicate – especially those things that may not be as easy to identify as “he’s not saying any words.”

To keep myself on track, I developed a hierarchy or a plan for how to look at a child’s communication skills in a continuum knowing that everything a child learns is building a strong foundation for what comes next. I started sharing this hierarchy when I launched my website teachmetotalk in 2008 and began publishing my DVDs and therapy manuals. In 2010, I began teaching this hierarchy to therapists throughout the United States and did that for many years. Nowdays, I just do that on YouTube!

Today I want to briefly share that hierarchy with you and then show you how to apply this method or treatment plan when a toddler is not talking yet.

Remember – what you’re doing, the specific activity, is not that important. You can use this method for ANY toy and everyday activity. The important thing is learning the 4 big areas you should be looking at and in what order to make the most impact for working with a toddler with language delays.

The four areas are:

Social & Interactive Skills

Receptive Language

Expressive language, speech intelligibility.

Let me briefly explain each area and tell you why it’s important for language development.

Social and Interactive Skills

Every time we communicate, it involves at least 2 people. Actually, this 1 on 1 interaction is the reason language evolved in the first place. We don’t need to know how to talk to do many of the solitary things we do every day, but as soon as another person enters the picture, communication becomes necessary. The first piece of that is realizing another person is there and then learning to enjoy that interaction. Social engagement begins very early in a baby’s life – on day one! Over the first several weeks and months, a baby shows evidence that he likes being with other people and seeks out others for the purpose of interacting. Those skills continue to grow and develop over a child’s first year.

However, sometimes a baby who has been pretty social begins to withdraw. He or she begins to avoid interaction and tune other people out – especially people outside her own family. Or it may be more subtle – a child used to smile and giggle and be super engaged, but then it shifts a little. He becomes more interested in toys or screens than people. He or she doesn’t learn to consistently respond to her name or pay attention as people talk to her. She doesn’t look at things when you point to them. There’s scattered eye contact so that it may difficult to get them to look at you. They look like they’re always busy with something else or not listening as you talk to them.

Let’s contrast this with toddlers who have typically developing social skills. They do respond to their names. They watch you often as you talk to them. They seek out other people to help them and try to communicate with facial expressions and their own body movements, even before they can talk.

Social & interactive skills are the foundation for communicating.

When a child is not naturally social and interactive, he’s at a real disadvantage for learning to communicate because that foundational piece is missing. If a child you’re working with or your own child doesn’t frequently connect with you and a variety of other people, then this is the area where you should begin your plan. You’ll work to help a child learn to like (or at least tolerate) interacting with others. Without this piece, communication skills will not move forward. Social interaction and engagement should be your first goal.

I recommend AND USE the treatment approach in Teach Me to Play WITH You first with all kids and families who need help with social interaction ideas. I can teach you to do it too. Read more…

Children with significant social delays or differences that don’t resolve when they learn to interact will very likely go on to be diagnosed with autism. Understanding the underlying differences in how kids with autism learn language is critical. My treatment manual The Autism Workbook will help you pinpoint focus areas  you need to strengthen and help you design a treatment plan for a toddler or preschooler with characteristics of autism or an official diagnosis.

In case you’re wondering, throughout my career, I have also use these strategies with toddlers and preschoolers who have markers for autism but make so much progress (especially with social interaction) that they do not get the diagnoses. I get emails from parents who have bought my manuals and followed my work who tell me the same thing about their child. While I can never make a bold claim without seeing a specific child, please know that this is possible. When you implement the right strategies, things change.

The next big area for language development is receptive language or how a child understands the words he hears. Babies and toddlers must first learn to understand words before they use those words to talk and communicate.

The best and most practical way to judge a child’s receptive language skills are by looking at how well he follow directions during everyday routines such as “Go get your shoes,” “Bring me the cup,” or “Let’s go take a bath.” Toddlers with typically developing language skills are completing these kinds of routine requests by the time they are 15 to 18 months old.

For therapists, there should also be evidence of a child’s ability to follow commands during sessions. If mom says, “He understands everything,” but I can’t get him to do anything for me during therapy, there’s a problem! You’ll want to tease that out. Is a parent overestimating a child’s comprehension skills? Many times, parents attribute a child’s lack of compliance to behavioral or personality issues like “He’s stubborn” or “She’s lazy,” but most of the time, that’s not the case. Even the most strong-willed toddlers with normal receptive language skills follow many different requests during everyday routines at home, especially when there’s something in it for them!

Receptive language is heavily dependent upon a child’s cognition – or how he thinks, learns, plans, and remembers. Toddlers with cognitive delays will always have difficulty learning language. You’ll know to expect those challenges and adapt your teaching strategies to meet a child’s needs in this area. Your goal here will be teaching a child to understand new words and new concepts, not say those words just yet.

If a child does not understand language well enough to consistently follow directions, you’ve found your first (or next) goal! Teach a child to understand more words first and to follow simple commands. Here’s why and it’s pretty obvious when you think about it… and I’ve said it before, but I’ll repeat it so you can remember…

Toddlers must first understand words before they can use words to communicate.

It’s highly unproductive to spend time trying to teach a toddler to say new words when he doesn’t understand those words. Any child who is 18 months old and can’t follow simple directions during familiar daily routines will very likely be diagnosed with moderate receptive language delays. Children who are 2 and aren’t following simple directions in everyday routines are at risk for significant receptive language delays. You’ll have to address this area first before you teach them to say more words.

My best receptive language resources are Teach Me To Talk: The Therapy Manual for specific goals/milestones and activities from under 12 months to 48 months and Let’s Talk About Talking , a comprehensive speech therapy manual to help you determine why a child isn’t talking and what skills you need to strengthen to get a child there!

The 3rd area for language development is expressive language or how a child uses words – or even gestures or pictures – to communicate his own needs and his own ideas with others. Parents and therapists think about expressive language as the “talking” piece.

Before kids can talk, they need to be able to vocalize or use their little voices purposefully. Sometimes toddlers with speech disorders aren’t able to control their vocalizations. Everything is still very reflexive – like crying or even noises with sneezing or coughing. This has to become volitional – where a child understands that he can use his voice and imitate the sound you’ve made.

When babies first begin to babble and vocalize, the sounds are pretty random. Late talkers will continue to do that too. They may even jabber and use lots of jargon. The problem is that they haven’t learned to link meaning with those sounds yet. They don’t understand the direct imitation piece – meaning you say a word and then they say a word.

Verbal imitation is a big part of learning how to talk. It’s often a piece that’s missing too when a toddler is not talking yet.

But we can’t begin teaching a child to imitate with words – it comes at a much earlier developmental level. We first teach a child to imitate using actions with objects and with body movements. In typically developing toddlers, this process evolves over several months in the last half of the first year. It can take much longer in toddlers with developmental delays.

If a child you’re working with isn’t using very many words (but is socially engaged and does follow directions), then look at his or her verbal imitation skills. That could be your starting point. My best resource for teaching a child to imitate is Buidling Verbal Imitation in Toddlers . (This is out next podcast series too. I am so excited about teaching this material to parents and professionals on YouTube!)

You may also consider introducing strategies like sign language or picture systems or if this is likely to be a long-term issue, another kind of AAC device – a speech generating device or an app that speaks for the child when he selects the correct picture message until he’s developmentally ready to talk. Watch a podcast on getting started with AAC.

The last big area is speech intelligibility or how well you can understand a child as he talks. Of course being understood is a big part of communicating! Speech-language pathologists think about this area as articulation – or getting the right sounds in the right places. Remember too that ALL toddlers can be difficult to understand when you’re an unfamiliar listener. Even parents may struggle to understand everything a child tries to say. The norms are pretty generous in this area. Parents may understand only about half of what a 24 month old says and closer to 75% by 2 ½ and then 90% by age 3.

A child’s speech may be hard to understand for several reasons. Sometimes they’re just using jargon or jabbering which means there are only a few true words included. Those kids understand that they should talk – they just don’t have the vocabulary yet to say what they want to say. This could be an expressive problem, but it’s usually an indicator of a receptive language problem after the second birthday.

Kids may have specific sound errors which prevent them from being understood. It may go beyond just not being able to pronounce a certain sound yet. There are often error patterns – a child speaks only using vowels or he may be able to include a few consonant sounds at the beginning or some words and never the ending sounds. Or he may shorten words and omit entire syllables.

Or there may be no pattern in his errors at all. His speech sound errors are inconsistent – he may say a word fine one time and then never again or every time he tries to say a word, it sounds a little different. There are several diagnoses associated with poor speech intelligibility. But we wouldn’t address this as the main focus for a child with delayed language until the other areas are firmly established.

When a child is developmentally ready, I use the methods I explain in FUNctional Phonology which outlines how to deterimine if a child is ready to work on articulation (or getting all the right sounds in all the right places) and how to prioritize your goals. It’s a developmental approach with lots of word lists, tricks and activities for toddlers rather than older kids.

Each of these 4 areas is an important part of language development when a toddler is not talking yet.

When we don’t address a toddler’s area of weakness, it could be the reason why progress in learning to talk is much slower – even when a child is already in therapy.

I hope this post helped you understand as parents what may be going on when a toddler is not talking yet. For therapists… this is how I explain each area of language development to parents. For more help deciding which products would be best for each issue when a toddler is not talking yet, you can also read this post.

Thanks so much for reading this lengthy post to the end! You’re a person after this writer’s heart.

With gratefulness –

teachmetotalk.com

Psalm 100:4-5

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"Hello Miss Laura, First, I would like to thank you for all you do for us moms who are lacking support in the autism community, and thank you for providing tons of information and resources to help our bright children. I myself benefited so much from watching your videos and reading your daily emails. I cannot stress enough how much all this information helped my toddler. Of course, getting an autism diagnosis for your child is extremely scary (she was diagnosed at 2 years old) and I was depressed and did not know what autism was, how it affected children, and how to teach children struggling with this condition. However, your videos helped me to find light in my child and now I am your biggest fan! I rewatch your videos over and over again to make sure I didn't miss anything that can help my daughter. I even purchase two books- Autism workbook and Teach me to Play. My toddler was completely non-verbal, she didn't know how to imitate, no eye contact, no pointing.. you name it she didn't have any skills and I didn't know how to teach her! And that is until I discover ed You- my toddlers (Fairy: smiling_face_with_3_hearts:)!

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Thank you for systematically organizing and explaining essential steps for young children to learn and develop. You are having a great impact on our profession, the ECE profession and families!"

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"Dear Laura,

What an inspiration!

Thank you for helping me be a better Developmental Therapist. I often listen to your podcasts which help me help families.

Your enthusiasm, professionalism and the sheer volume of information is so great.

You are part of my team.

I just wanted you to know I appreciate you."

Thank you for your generosity in sharing so much knowledge in such a clear and enthusiastic way.

As a retired audiologist with a fabulous and language delayed grandson, I used your podcasts and outstanding publication, The Autism Workbook, to inspire and guide me over the past year.

It works!! He went from barely verbal, no gestures, didn't respond to his name etc etc to a verbal, social, curious, ready to imitate anything, fill in the blanks on familiar "set" speech, generate his own totally appropriate and mostly understandable sentences...not just short phrases anymore... full little paragraphs...about imaginary things, what he did during the day, what he wants. True communication!

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"I’m sure Laura gets these messages all the time, but I thought I’d share. I stumbled across Laura‘s "Autism or Speech Delay?" YouTube video when I really needed it. This video finally listed and explained some of the red flags my son was showing for autism. I share the link anytime a parent is questioning in my FB autism group. This mother I don’t even know said Laura's video changed her life. I know exactly how she feels because It changed families too. Thank you to everyone at Teach Me To Talk."

"Good Morning Laura, I received your book (The Autism Workbook) yesterday and it is absolutely amazing! As I evaluate young children (0-3) for developmental delays and write plans for them with their parents, there are a ton of ideas that are ready to use. Others that reinforce what I have been doing, and saying, all along. Thank you so, so much for writing this incredible book and pulling everything together in one place!"

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Girl…my son is 3 years old, and he NEVER asks for something using words. We were playing “Get Your Belly” (from Teach Me to Play WITH You), and after several times, he laughed and screamed "BEWIEEE!!!"  It was a hoot. And I can't believe he said it! I have played with him like this before, but this time I took your advice and acted CRAZY!! I will act like a total lunatic if it will get him to talk to me!  Now I can give him "the look" from across the room, and he will say it. That manual is so amazingly practical, and it is a GODSEND right now! Thank you SO MUCH!”

" I wanted to send you a quick email to say thank you. I started watching your videos/podcasts about 4 months ago. My son has gone from losing words he previously used, only having about 7 words at his 2 year check up in August (assessed at a blended 10 month language level) -- to now having so many words, increased social engagement, following commands, spontaneously requesting things, and naming letters & numbers (not in order) as well as colors. We had our monthly meeting with our SLP through the state infants & toddlers program and it felt like we were just bragging the whole time, but I knew in the back of my head it was because I have been using strategies you taught me. We still have so much work to do with our sweet boy, but I know in my heart he would not have succeeded without the education you provided. I will continue to read your emails & watch videos as we go along this journey and face challenges, but credit is due to you, Laura. Thank you so much, endlessly."

"I just want to tell how fortunate I feel to have found your website and you!! I became a special instructor in EI almost a year ago and I started with hardly any applicable training. I felt so lost and confused as how to help the kids I work with learn how to use words and play. Honestly, I didn't even understand the importance of play, although I always played with my kids. But, once I started to watch your podcasts and get some of your manuals I felt a weight had been lifted off my shoulders and that I could finally teach these kids and their families something of value from a real therapist and based on research!. Thank you so much for seeing the need to help other EI service providers and providing a forum to share your knowledge and years of valuable experience. I'm sure you get a lot of these emails every week if not every day, but I wanted to make I could add to those notes of gratitude!! THANK YOU again!!"

"Just wanted to say a HUGE thank you for these emails and your books, I have them all and they have seriously saved and improved my sessions with my kiddos. Huge thank you."

"I was very frustrated with how speech therapy was going for my child. I would take him and drop him off and not hear much of anything from his therapist and teachers other than, "He had a good (or a bad!) day." Your materials were invaluable for us because I learned how to work with him on his speech. I learned how to teach him to talk and play. I learned how to pay attention to his cues and work with him to teach him to communicate. Without it, I have no doubt he still wouldn’t talk."

"Hi! I just wanted to say (from an SLT perspective) how incredibly useful I am finding absolutely all of your articles, blogs and resources - I only discovered your site last month and have just received all your books which I feel I am learning more than on my entire university training course!! But also the way in which you give specific, realistic, fun, encouraging ideas for working with parents is really just fantastic, I only wish I have your site sooner! Thanks so much from the UK! Kind regards."

"I just wanted to reach out to say thank you for making things a little easier to manage for me this year. I made the transition from school SLP to private therapist about a year ago. While the change was welcome, it was a lot, and I was just getting my footing in the clinic when I began teletherapy full time. Your website has been a huge lifeline in helping me work with late talkers and coach their parents in an accessible but effective way, even remotely. I look forward to getting your emails each week. I am floored by the amount of valuable, free information that your website provides, and I’m looking forward to investing in your workbooks soon. A sincere thank you for all you do!"

"You are an inspiration! I am truly grateful for the way you put into words and writing how to do what we do as SLPs. At this time in my 13 years of practicing, I find your encouragement keeps me going. As a single mom, I find it a stretch to buy materials these days and I am so thankful for the freebies you so generously share that help me teach my families. I don’t have much time to put together lists or quick references for parents!! Much gratitude!!"

Laura thank you so much. Btw, you have transformed my therapy- I have become such a competent and strong therapist after watching probably like 350 of your videos and podcasts over the past few years. And I am a seasoned therapist with almost 25 years experience. (Yes prob 350 episodes ha!) But there was still a lot I learned from you. I have such a thorough understanding of birth to 3 development and how to properly incorporate appropriate therapeutic goals, techniques and strategies now, thanks to you. Kelly

Hi Laura, I want to thank you so much for the resources you provide, my daughter has delayed speech and though she qualifies for CDS. Honestly the most progress she has made in her speech/language development has been after I implemented your 5 top strategies for delayed talkers! She is now almost 2.5 and her vocabulary is well over 75 (I haven’t counted recently, could be over 100) words when at 2 she barely had four words. Honestly the last few months have been a transformation for her.

School Speech Therapy Isn’t Working…Now What?

School speech isn’t working.

Maybe your kiddo is in school-based speech therapy.  Maybe you’re frustrated because there are only a few months left of school and you haven’t seen a lot of improvement in her speech and language skills.  You’re thinking that it’s time to switch to private speech therapy. But before you make that decision, what’s the difference between the two? Is there anything you need to know about school based speech therapy before you make any changes?

Getting School-Based Speech Therapy

It’s up to your kiddo’s teacher to give a recommendation for speech therapy before a speech therapist is contacted.  But to get to that point there are several steps involved. First, your child must be three years old and above before they are even eligible for speech therapy.  Second, a teacher must determine that speech and language problems are affecting your child’s education. Typically your kiddo would have to be severely delayed before any thoughts of speech therapy are entertained.  The next hurdle is that the teacher must try everything to help your kiddo, all available supports and accommodations. If your kiddo’s speech and language issues still impedes her ability to learn, it is then and only then that her teacher recommend a school speech therapist.

School Group Therapy

School speech therapists (or SLPs) will often see kids in groups, as many as 3-5 at a time. This makes it hard for kids who need added behavioral support to get it.  This model is also a disadvantage for kiddos who have apraxia or other articulation disorders, who need intensive practice. Another aspect to consider is that parents rarely ever see the speech therapist, usually only once or twice a year at IEP meetings.

School Therapy Pros

School based therapy is not without its benefits.  One of the best things about school based therapy is that it’s free .  Although students get pulled out of class by SLPs they are still at school , their natural environment.  Finally, putting kids into groups allows those kids who struggle with social cues and norms to practice their social skills.

What makes private speech therapy different?

Getting Private Speech Therapy

Private speech therapy falls in the medical realm, so those who need speech therapy have to have a medical need.  It also has to be a medical need that affects daily living. However, private therapy has more wiggle room when it comes to accepting kiddos for speech therapy.  Kiddos don’t have to be severely delayed before they can start accepting private speech therapy. And yet, kiddos still have to perform below the normal range.

Pros To Private Speech Therapy

Typically in a private clinic (office, hospital, etc.), therapists only see one kiddo at a time.  This way kiddos can get more direct and individualized support. Parents (or caregivers) are welcome to be as involved as they’d like to be.  They can even sit in during the session. Therapists talk freely and often with parents, perhaps to ask how they think therapy is going. Parents have the opportunity to see what they can do at home to practice the skills being taught.  Another plus is that there are no age restrictions, so very early intervention is possible. Of course, group therapy is still possible in private care, especially when it comes to social skills or feeding therapy.

Private Therapy Cons

Another thing to consider about private therapy is that it isn’t free .  Caregivers need insurance or they can pay out of pocket. Also, private therapy pulls the child out of school, and it doesn’t take place during school hours.

It’s Your Choice

In the end, the choice is up to you whether you want to go with school-based speech therapy, private therapy…or both.  Any way you choose to go, some help is light years better than none. Early intervention is best. And from my own experience, school therapy paired with private therapy results in the most improvement in the shortest amount of time.  

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When Therapy Isn’t Working: What to Do and Alternatives to Consider

Home » Our Blog » When Therapy Isn’t Working: What to Do and Alternatives to Consider

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Therapy is a powerful tool for helping people with mental health issues, yet it doesn’t always work. There are times when therapy may not seem to be having any effect on your well-being or progress toward recovery from mental illness. If you’re feeling stuck and feel like traditional therapy isn’t working, there are alternatives that can help move you forward in the right direction. In this article, we’ll discuss reasons why therapy may not be working as well as what steps to take if it’s not providing relief and alternate options including a virtual IOP which could prove beneficial for many individuals struggling with a mental health issue.

Reasons Why Therapy May Not Work

Poor fit between therapist and client:.

One of the most common reasons why therapy may not be working is due to a poor client-therapist relationship. This can occur when the style and approach of the current therapist do not match what the client needs, or if there is a lack of trust or rapport between them. It is important for clients to feel comfortable in their therapeutic relationship in order for it to be successful. If this isn’t present, then it can hinder progress toward behavioral change and lead to an unsuccessful outcome. Matching with a new therapist is a lot like dating: there needs to be chemistry, trust, and connection on a deeper level for the best therapeutic fit. 

Unclear Goals or Expectations:

Another reason why therapy may not work is due to unclear goals or expectations from either party involved. Without having clear objectives set out at the beginning of treatment, it can be difficult for both parties to stay on track throughout the process. Additionally, if expectations are too high from either side then this could also lead to disappointment which could also impact progress negatively. Successful therapy hinges on one’s ability to get to the root of emotional pain and move through the healing process. Most therapists’ therapeutic approaches might conflict with a given client’s mental health goals and expectations .

Need a Higher Level of Care:

Some might feel like therapy isn’t working because their symptoms are too acute and need more support than a weekly appointment. Talk therapy alone is not designed to be effective for people who are experiencing issues such as severe depression or anxiety, intense phobias, or suicidal ideation. There are higher levels of mental health care that cater to these individuals. The highest level is mental health residential treatment , which steps down into outpatient mental health treatment (PHP & IOP) . The lowest level is weekly therapy with a counselor. If you feel like you are not making progress, ask your current therapist to provide a referral to a higher level of care, or search for online mental health treatment in your state.

Therapy can be a powerful tool in helping individuals learn coping skills, however, it may not always work as intended. As such, it is important to understand the potential reasons why therapy may not work so that one can make informed decisions about their care plan. Taking the time to reflect on progress made thus far and considering changes in goals or therapists are key steps when therapy does not seem to be working.

What to Do When Therapy Doesn’t Seem to be Working

When therapy isn’t working as expected, it can be difficult to know what steps to take. Re-evaluating your goals and expectations is a great place to start. It’s important to make sure that the therapist you are seeing is a good fit for you and that your goals are realistic and achievable. If they don’t seem to be, then it may be time to consider changing therapists or adjusting your expectations of the process.

Another option is taking some time away from therapy in order to reflect on the progress made so far. This can help provide perspective on where things have been successful, as well as identify areas where more work needs to be done. During this period of reflection, consider if there might be any alternative options available that could better suit your needs or lifestyle.

It’s important not to feel discouraged if traditional therapy doesn’t seem right for you at this moment in time – there are plenty of other alternatives out there. Taking advantage of these different forms of treatment can help create an individualized plan tailored specifically towards helping achieve positive outcomes within one’s own unique journey towards wellness and recovery.

Alternatives to Traditional Therapy

For those seeking alternatives to traditional therapy, there are several options available. Virtual IOP programs offer a convenient way for individuals to receive care without having to leave their homes. These programs provide evidence-based treatments such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). They also often include support groups, educational materials, and other resources that can help people achieve behavioral change.

Virtual IOP programs offer increased accessibility and affordability of care while still providing quality services from licensed mental health professionals with the added convenience of receiving therapy from their own homes. Online counseling services allow struggling individuals access immediate support from anywhere in the world without having to leave their homes or find transportation resources.

Self-help resources and support groups can be beneficial for those looking for additional ways to cope with a mental disorder outside of traditional therapies. Self-help books, websites, podcasts, and videos are all great sources of information on managing various conditions such as depression, anxiety, addiction, trauma etc., while providing guidance on how best to take care of oneself mentally and emotionally during difficult times. Support groups allow individuals struggling with similar issues the opportunity to connect with one another in a safe space where they can share experiences and gain insight into different coping strategies that have worked well for others in similar situations.

Benefits of Alternative Treatment Options

Alternative options can provide many benefits compared to traditional therapy settings. Increased accessibility and affordability of care are two major advantages that alternative treatments offer. With online outpatient programs, individuals have the opportunity to receive help from anywhere in the world without having to worry about travel costs or time constraints associated with in-person appointments.

Clear Behavioral Health’s online treatment is in-network with most major commercial insurers so access to professional health from different providers in the mental health field is just around the corner.

What to do when therapy isn’t working

Therapy not working is a reality for many individuals. It’s important to remember that there are other options available and that you don’t have to settle for traditional therapy if it isn’t helping. Alternatives such as finding a new therapist or a virtual IOP can provide the same level of care while offering more flexibility and convenience. With these alternatives, individuals can find the support they need in order to manage their mental health issues and live happier and healthier lives.

It is clear that there are many families in California struggling with mental health issues. We must take action to ensure everyone gets access to the proper care, support, and resources they need to heal. Clear Behavioral Health’s Virtual IOP provides a range of telehealth services including individual therapy, group therapy, case management, and life skills training – all designed to help those affected by mental illness progress through the therapeutic journey. Let’s work together as a community so no one has suffer alone; contact us today if you or someone you know needs assistance.

Clear Behavioral Health is In-Network

FAQs in Relation to Therapy Not Working

What do you do when therapy isn’t working.

Consider what could be done differently in order to get better results. It may be beneficial to try different approaches such as medication management, lifestyle changes, or alternative therapies like yoga or mindfulness meditation. Additionally, talking with a trusted friend or family member can help provide insight into how best to move forward with treatment. Ultimately, it is important to remember that everyone’s journey is unique and there are many paths available for finding relief from mental health issues and addiction struggles.

How do you know if therapy isn’t working?

Therapy is a process, and it can take time to see results. If you don’t feel like your therapy sessions are helping, it’s important to talk with your therapist about how you’re feeling. It could be that the approach needs to be adjusted or that another type of treatment may be more effective for you. You should also look out for signs such as increased feelings of depression or anxiety, difficulty sleeping, changes in appetite, and lack of motivation. If these symptoms persist after several weeks or months of therapy then it may be time to consider other options.

Is it true that therapy doesn’t work for everyone?

No, therapy does not work for everyone. Everyone’s experience with therapy is unique and individualized. While some may find it helpful, others may not see the same results or feel as if they are making progress. It is important to remember that different types of therapies can be beneficial in different ways and that there is no one-size-fits-all approach when it comes to mental health treatment. Additionally, having a supportive environment and access to resources such as medication management or other forms of support can help improve outcomes from therapy.

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Clinically Reviewed by: Lindsey Rae Ackerman, LMFT

Written by: Alex Salman, MPH on March 7, 2024

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Last Updated on March 7, 2024

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