What Your Clients Really Think About Therapy

What Your Clients Really Think About Therapy

Most high-functioning people don’t come to therapy because their lives are falling apart.

They come because they want something better.

They want clarity.
They want to feel happier and more effective.
They want to stop repeating patterns that no longer serve them.
They want to figure out how to do things differently — in their relationships, careers, and inner lives.

And they walk into therapy believing they’ve finally found the place where that will happen.

But for many of these clients, what they discover instead is deeply disappointing.

Not because therapy hurts them.
Not because they’re resistant.
And not because they’re avoiding “real work.”

They leave because therapy feels like an ineffective use of time — thoughtful, perhaps, but not actually helping them change how they live.

That’s what I want to talk about today, colleague to colleague — because this pattern isn’t just about client dissatisfaction. It’s an ethical issue our profession needs to look at honestly.

I’m Dr. Lisa Marie Bobby, a psychologist, licensed marriage and family therapist, board-certified coach, and the founder of Growing Self. I’ve spent years training, supervising, and working alongside therapists who care deeply about their clients — and who are quietly noticing the same thing:

Capable, motivated people are losing faith in therapy.

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What People Hope Therapy Will Be

Most high-functioning clients don’t walk into therapy thinking, “I need to heal my trauma.”

They walk in thinking:

“I want to be happier.”
“I want to stop getting in my own way.”
“I want to handle my relationships better.”
“I want tools, perspective, and guidance.”

They believe therapy will help them understand themselves and show them how to operate differently in the world. From the outside, therapy looks like a sophisticated learning process — a place where insight leads to strategy, growth, and forward movement.

That expectation makes sense.

Therapy is positioned culturally as the highest form of personal development. It’s expensive, time-intensive, and delivered by highly trained professionals. Many clients reasonably assume it will help them become more effective, more emotionally intelligent, and ultimately more satisfied with their lives.

In short, they believe therapy will help them feel happier — not euphoric, not perfect, but more grounded, confident, and capable.

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When the Reality of Therapy Doesn’t Match the Promise

For many high-functioning clients, the reality of therapy feels very different.

Instead of learning how to do things differently, they find themselves revisiting the same conversations. The focus drifts backward when they’re trying to move forward. Sessions feel validating, even supportive — but not especially useful.

They start thinking:

“I already understand this.”
“We’re talking, but nothing is changing.”
“I don’t need to keep unpacking my past.”
“Why am I still here?”

This isn’t a shame-based experience for them. It’s clarifying.

They don’t conclude that they are broken. They conclude that therapy is not the right tool for what they want now.

That’s when many of these clients quietly disengage — canceling sessions, spacing appointments farther apart, or disappearing altogether. I’ve written about this pattern in depth in why therapy clients ghost, because it’s often less about avoidance and more about unmet expectations.

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Why High-Functioning Clients Get Stuck — and Then Leave

Therapists are exceptionally well trained to diagnose, treat mental illness, and reduce symptoms. That training is essential and lifesaving for clients who need clinical care.

But many of us were not trained to:

• Teach decision-making skills
• Facilitate behavioral experimentation
• Help clients design new habits and strategies
• Work toward clear, measurable outcomes
• Translate insight into real-world action

When high-functioning clients come to therapy seeking growth and change, and we offer primarily insight-oriented work, they don’t experience depth — they experience stagnation. This is one of the most common reasons clients get stuck in therapy.

At that point, many therapists begin questioning whether therapy is actually working for clients, while clients quietly decide that it isn’t.

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Insight Isn’t the Problem — It’s the Ceiling

Insight matters.
Empathy matters.
Validation matters.

But for high-functioning clients, insight is often the starting line, not the destination.

Research consistently shows that insight alone does not reliably produce behavior change. Sustainable change requires structure, skills practice, feedback, and opportunities to apply new ways of thinking and behaving in real life.

When therapy doesn’t include those elements, capable clients don’t feel supported — they feel stalled. And when that happens, the issue usually isn’t “resistance.”

It’s a modality mismatch.

Exactly this conundrum was explored by the National Board for Certified Counselors in this article, Coaching and Expanding the Reach of Your Counselor’s Practice.

They did a deep dive into how therapists need to pivot in order to have the competencies and orientation that many clients want and expect.

The headline here is this: While clients use the term therapy as an all-purpose word for all types of personal growth and development, psychotherapy means something different to therapists. The right word to describe what these clients want from us is not therapy at all: it’s coaching.