People stay with therapists who aren’t helping them for the same reasons they stay in other things: the sunk cost, the awkwardness, a sense of obligation to someone who has been kind, and a suspicion that wanting to leave is itself the problem being avoided.
Sometimes that suspicion is right. Frequently it isn’t, and it’s worth knowing how to tell.
Hard versus not working
Signs it’s working and simply difficult: you’re talking about things you avoid. You leave sessions unsettled and think about them during the week. Something is changing outside the room, even slightly. You can predict what they will say, and it’s useful. The difficulty is in the material.
Signs it isn’t working: six months of pleasant conversation with nothing changing. You update them on the week and leave. There’s no formulation you could explain to someone else. You have raised a concern and it went nowhere. You feel judged, or managed, or subtly dismissed. You asked for a structured treatment and aren’t receiving one. Or you find yourself performing progress to avoid disappointing them.
That last one is worth sitting with. Managing your therapist’s feelings about your progress is a common and quietly corrosive dynamic.
Raise it before you leave
This is the step almost everyone skips, and it’s the one that most often improves things.
Something like: “I want to talk about how this is going. I don’t feel like things are changing, and I am not sure we have a shared plan.”
A good therapist will welcome this. It’s genuinely useful clinical information, and the conversation itself is frequently the most productive session you’ve had. Many courses of therapy turn a corner at exactly that point.
A therapist who becomes defensive, or who interprets your concern as resistance without also considering that you might be right, has answered the question for you.
How to actually leave
Directly and briefly. “I have decided to stop. I appreciate the work we have done and I want to try a different approach.” That’s a complete and sufficient statement. You don’t owe a detailed critique.
A final session is worth having if you can face it — endings handled well are clinically useful, and for anyone whose difficulties involve abandonment or conflict avoidance, this is a rare chance to do one properly. But ghosting is common, and no clinician will be surprised by it.
Ask for a referral on the way out
The most under-used move in this whole process. A therapist who knows you and knows they aren’t the right fit is far better placed to suggest someone than any directory, and most will do it gladly.
When it’s more serious
If a therapist has crossed a professional boundary — a personal or sexual relationship, sharing your information without consent, practising while impaired — that isn’t a fit issue. California licensing boards take complaints, and the Board of Behavioral Sciences and Board of Psychology both have a public process for it.