What Should You Do If Therapy Makes You Feel Worse at First?

Starting therapy can bring up difficult emotions. Sometimes it can even make you feel worse prior to feeling better. The key is knowing how to respond in a way that supports your progress, rather than leaving you stuck or discouraged.

At HelloSelf, we encourage clients to treat therapy as a collaborative process, one where your experience matters just as much as the method.

Step 1: Name What You’re Feeling

If therapy is making you feel worse, the first step is to acknowledge it.

Ask yourself:

• What exactly feels worse? (Anxiety, mood, overwhelm?)
• When does it happen? (During sessions, after, or between?)
• Does it feel linked to specific topics or exercises?

Clarity helps you communicate effectively and make informed decisions.

Diane Kohl, consultant counselling psychologist at HelloSelf says, ‘Your therapist is the expert with regards to therapeutic approaches, but you are the expert when it comes to your experiences and whether something works for you or not.’

Step 2: Talk to Your Therapist

It might feel uncomfortable, but raising any concerns you have is a crucial part of therapy.

You could say:

• “I’ve noticed my anxiety has been higher since we started”
• “I’m finding some of the exercises overwhelming”
• “Can we slow this down or approach it differently?”

A good therapist will welcome this conversation and adjust their approach accordingly.

Diane Kohl says, ‘Therapists are used to getting constructive feedback regarding their approaches and will adapt them according to your views.’

Step 3: Adjust the Pace or Approach

Therapy isn’t fixed. It should adapt to you.

Possible adjustments include:

• Slowing down exposure work
• Spending more time building coping strategies
• Shifting focus temporarily to stabilisation
• Exploring a different therapeutic style

Feeling challenged is normal. Feeling consistently overwhelmed is not something you have to push through.

Logging your progress in the HelloSelf app can help you decide whether the current set-up is working. Check in regularly with our therapist-designed Companion tool to track how you’re feeling, set goals and celebrate any forward steps you make, however small. 

Step 4: Understand Productive vs. Unhelpful Discomfort

This is one of the most important distinctions.

Productive discomfort:

• Feels purposeful, even if difficult
• Happens in manageable doses
• Leads to insight or gradual change

Unhelpful experiences:

• Feel chaotic, intense, or unsupported
• Leave you dreading sessions without any sense of progress
• Don’t improve even with adjustments

If it’s the latter, something needs to change.

Step 5: Consider Therapist Fit

Sometimes the issue isn’t therapy itself, it’s the fit.

You might benefit from a different therapist if:

• You don’t feel understood or heard
• Your communication with them feels strained
• You’re not comfortable being honest

The relationship you have with your therapist is one of the strongest predictors of therapy success.

Step 6: Explore Alternative Approaches

If one approach isn’t working, others might suit you better.

For example:

• Emotion-focused therapies for deeper processing
• Trauma-informed approaches if past experiences are central
• Integrative therapy tailored to your needs

The goal is not to “push through” something that doesn’t fit but to find what does.

When Should You Reconsider Therapy?

It may be time to pause or rethink your approach if:

• Your symptoms are worsening significantly
• You feel unsafe or unsupported
• Your concerns aren’t being addressed

Therapy should challenge you but it should also feel safe and collaborative.

The Bottom Line

Feeling worse at the start of therapy isn’t uncommon but you don’t have to navigate it alone or silently.

The most effective therapy is flexible, responsive, and centred around you.

If something doesn’t feel right, that’s not a failure on your part. You should listen to your intuition because using that feedback is part of how therapy becomes truly effective.

Any questions, get in touch at hello@helloself.com