Health
Digging Out of a Therapy Rut
Therapy has been a part of Katerina Kelly’s weekly routine since elementary school, when a teacher suggested counseling for the 8-year-old.
At the time, Katerina’s autism was affecting their ability to manage time, make decisions and socialize. And for many years, the therapist seemed helpful. But once college rolled around, things changed.
“I always left counseling feeling either worse than I started — or numb,” said Mx. Kelly, 29, who lives in Natick, Mass, and uses they/them pronouns.
The skills that Mx. Kelly’s therapist had taught her in childhood weren’t translating as well now that she was older. In other words, they had hit a rut — the therapy, and the therapist, were not producing the desired results.
A therapy rut can feel disheartening, but it doesn’t have to end your pursuit of better mental health. We asked psychologists how to identify whether you’ve reached a sticking point and what to do about it.
What exactly is a therapy rut?
If you’ve hit a rut, you may feel as if your therapy sessions have stalled or become unhelpful, said Jameca Woody Cooper, president of the Missouri Psychological Association.
You may be emotionally disconnected from your therapist or less trusting of their plan. Perhaps you’re uncomfortable and tense during therapy, or you’ve started to dread or miss appointments, Dr. Woody Cooper added.
A rut can translate into “increased irritability while you’re in session, or a feeling of being misunderstood,” she said.
There are many reasons a rut can happen, the experts said:
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You’ve made as much progress as you can in therapy at this time.
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You would benefit from a different therapist or approach.
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You need a new therapy goal.
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You don’t need sessions as frequently as you did in the past.
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Your expectations aren’t aligned with those of your therapist.
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You’re not ready to explore past trauma or a difficult issue.
Mx. Kelly had experienced some of these roadblocks in her relationship with her childhood therapist.
“When I did try to bring up new things I was told we could work on it in the ‘next session,’ but that never came to be,” they said. “I hit a point where I started feeling so low.”
So Mx. Kelly began searching for a new therapist — it took more than six months, but they found someone who took their insurance and was a better fit.
If you’re feeling stuck, your therapist will ideally sense it too, said Regine Galanti, a therapist in Long Island who specializes in treating anxiety with exposure therapy.
“When I’m having the same conversations for more than two weeks in a row — that makes my warning bells start to go off,” she said.
That’s when it’s time to re-evaluate a client’s therapy goals, she added.
What can you do about a rut?
Don’t jump the gun by quitting therapy after one or two unproductive sessions, experts said.
“It’s unfortunately not uncommon to occasionally have a therapy session that feels like a dud,” said Alayna Park, an assistant professor of psychology at the University of Oregon.
But if after three or four sessions you feel like you haven’t learned any new coping skills or gained a better understanding of your problem, then it’s time to speak up, either during the session or in an email.
Dr. Park suggested a few ways to kick off the discussion: “I feel like my progress has stalled,” or “I would like to transition to learning new or different coping skills,” or simply: “I feel like I’m in a therapy rut.”
It’s also valuable to ask your therapist how many sessions you might need, what your progress ought to look like and how your therapist is measuring it, said Bethany A. Teachman, a professor of psychology and the director of clinical training at the University of Virginia.
Although it can make some people feel uneasy to voice their concerns, the experts said, a good therapist will not get angry or annoyed.
“Good therapy empowers patients” to do hard things, Dr. Teachman said.
How do you know if it’s time to take a break?
If you’ve talked with your therapist about your concerns and nothing has changed, you may want to consider taking a break.
Stepping away can offer “a sense of agency, and time to evaluate if the current therapeutic relationship is the correct one,” Dr. Woody Cooper said.
During this break, you can take time to think about your feelings and behavior, explore different types of therapy or try out another therapist, she added.
Annie Herzig, an author and illustrator who lives in Fort Collins, Colo., decided to take a step back after a few months of seeing a new therapist, when she hadn’t noticed any improvement in her mood.
Ms. Herzig, 43, finally sent her therapist an email saying she wasn’t getting what she needed from their sessions.
Taking time away was helpful — Ms. Herzig found a different therapist who she has now been seeing for four years.
“I feel energized at the end,” Ms. Herzig said of their sessions together. “Even if I cry my eyes out.”
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The sudden death of Kyle Busch has drawn attention to a rare but devastating medical progression: when pneumonia escalates into fatal sepsis.
An ER doctor spoke with Fox News Digital about how sepsis can trigger a rapid health decline.
“Sepsis is actually not a specific disease or diagnosis, but rather the syndrome that occurs when the body has certain abnormal findings and a presumed infection,” said Dr. Kenneth J. Perry, a South Carolina-based emergency medicine physician.
HOW PNEUMONIA PROGRESSES TO SEPSIS: DOCTORS EXPLAIN AFTER KYLE BUSCH’S DEATH
The markers of sepsis include elevated white blood cell counts, a high or low temperature, and elevated heart and respiratory rates, according to Perry. Because of this, a patient with pneumonia is often already technically septic by definition.
In the wake of Kyle Busch’s sudden passing, there is a focus on the rapid decline from pneumonia to fatal sepsis. (Getty; iStock)
While many people assume a worsening infection means bacteria are multiplying uncontrollably, it often has more to do with the body’s internal environment.
“It is often not the bacteria itself that is causing the specific decline,” Perry said. “In most cases, it is a cascade of inflammatory processes that are set in motion by the infection.”
When this inflammation spirals out of control, the body moves from having a manageable infection into severe sepsis. This is when otherwise healthy people can rapidly deteriorate.
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“The concerning thing that can happen with any individual … is that sepsis can then lead to low blood pressure, worsening vital signs and organ damage,” Perry said.
“As multiple organs fail, it becomes very difficult for the medical team to treat and can sometimes lead ultimately to death.”
“The medical evaluation provided to the Busch Family concluded that severe pneumonia progressed into sepsis, resulting in rapid and overwhelming associated complications,” the family shared in a statement. (James Gilbert/Getty Images)
It is very unlikely to have pneumonia and not have any symptoms, according to Perry. Early signs can mimic a severe flu, including fevers, chills, a productive cough, and chest or back pain in cases where the lung is infected.
When sepsis begins to take hold, time becomes the most critical factor. “We have known for a number of years that early antibiotic therapy is beneficial in the treatment of sepsis,” Perry said.
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If you or a loved one are managing an infection at home, the doctor says the following red flags mean you should bypass the clinic and head straight to the emergency room.
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- Shortness of breath or difficulty breathing
- A racing heart rate or fever that continues to worsen even after starting treatment
- Severe chest pain associated with a productive cough
The slide into sepsis is, in most cases, a cascade of inflammatory processes that are set in motion by the infection, the doctor said. (iStock)
While cases like Busch’s are tragic, Perry stressed that this shouldn’t cause widespread panic. Most patients with pneumonia do very well with standard oral antibiotics.
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The NASCAR star’s rapid decline underscores the importance of medical vigilance and “having a primary care physician with whom you have a good relationship,” according to the ER doctor.
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“Monitoring symptoms while having easy access to primary care is a very beneficial and appropriate plan for most patients,” he added.
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Popular glucagon-like peptide-1 (GLP-1) weight-loss drugs may help slow the spread of some cancers, according to new research to be presented at a major medical conference.
Research led by Cleveland Clinic found that the medications may reduce the spread of several obesity-related cancers, including lung, breast, colorectal and liver cancers.
The findings will be presented at the 2026 ASCO Annual Meeting next week in Chicago.
WEIGHT-LOSS DRUGS NOW LINKED TO CANCER PROTECTION IN WOMEN, MAJOR NEW STUDY REVEALS
According to a press release, the real-world retrospective study included 12,112 patients with the following types of obesity-related cancers, ranging from stage 1 to stage 3.
Popular GLP-1 weight-loss drugs may help slow the spread of some cancers, according to new research to be presented at a major medical conference. (iStock)
- Breast adenocarcinoma
- Prostate adenocarcinoma
- Non-small cell lung cancer (NSCLC)
- Colorectal adenocarcinoma
- Hepatocellular carcinoma (liver cancer)
- Renal cell carcinoma
- Pancreatic adenocarcinoma
Half of the participants started a GLP-1 medication – semaglutide, tirzepatide, dulaglutide, liraglutide, lixisenatide or pramlintide – after their cancer diagnosis.
The other half began taking a DPP-4 inhibitor comparator “gliptins,” a different class of diabetes medications, the study noted.
WEIGHT-LOSS DRUGS’ IMPACT ON CANCER RISK REVEALED IN NEW STUDY
Compared to the patients taking gliptins, the GLP-1 users were found to have significantly lower progression to stage 4 disease for four types of cancers.
The biggest risk reduction was for non-small cell lung cancer (50%), followed by breast cancer (43%), colorectal cancer (31%) and liver cancer (38%).
Compared to the patients taking gliptins, the GLP-1 users were found to have significantly lower progression to stage 4 disease for four types of cancers. (iStock)
“Our study found that use of GLP-1 drugs, compared to DPP-4 inhibitors and other antidiabetic drugs, was associated with a meaningful reduction in cancer progression across four solid tumor types,” said lead study author Mark David Orland, MD, of the Taussig Cancer Institute at Cleveland Clinic, in the release. “It provides early evidence that future studies are worth pursuing.”
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Three other types of cancer – prostate, pancreatic and kidney – also had lower rates of spread among those taking GLP-1s, but those differences were “not statistically significant,” the researchers noted.
“Our study found that use of GLP-1 drugs … was associated with a meaningful reduction in cancer progression across four solid tumor types.”
Tumors with higher levels of GLP-1 receptors — proteins that help cells respond to GLP-1 hormones and drugs — were also linked to better survival outcomes, according to the study findings.
Overall, patients whose tumors had more of these receptors were about one-third less likely to die during the study period.
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The incidence of adverse side effects was similar between GLP-1 and gliptin groups.
The findings suggest that GLP-1 pathways may directly influence how some cancers grow or spread, though researchers say more studies are needed to understand the mechanism behind this effect.
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The study, which has not yet been peer-reviewed, had some limitations, according to the researchers. As it was retrospective and observational in design – as opposed to a randomized clinical trial – it couldn’t prove that GLP-1 drugs directly prevent cancer progression.
The findings suggest that GLP-1 pathways may directly influence how some cancers grow or spread, though researchers say more studies are needed to understand the mechanism behind this effect. (iStock)
Other factors, such as participants’ health conditions, weight loss and metabolic improvements, may have influenced the results, researchers noted.
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For some specific cancer types, there may not have been enough patients represented to detect statistically significant differences.
Further randomized clinical trials are needed to evaluate these preliminary findings and to determine the specific ways in which GLP-1s control cancer progression.
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