Back to step one? Is therapeutic progress linear?
Starting therapy can be a challenging experience for anyone, especially when we enter with misconceptions that it will be a straightforward linear progress. Children already face major life challenges such as navigating major developmental changes and social pressures. Third culture kids - or TCKs - are presented with unique challenges including questions about belonging, identity, and managing new expectations set by new social norms and standards.
Conceptualizing therapy as a clear path that leads to steady progress, a magical way to replace stress and sadness, sets unrealistic expectations and adds pressure to the process.
Although we may wish for such things, this isn’t how our brains work. Regardless of the effort or progress we make, setbacks are normal and are to be expected. They are not indicative of our efforts (quite the opposite!), they are bodily signals that change is in fact happening! A more helpful way of understanding therapy is as a cyclical process – there are periods we make significant growth, followed by moments we feel discouraged, slower, or even stagnant. Despite this, it is important to remember that even if we do take a few steps back, it does not mean we are back where we started.
Unrealistic expectations can make the process especially difficult for children. They may feel like they have to be “good” at therapy or show constant improvement to satisfy their parents or teachers. They may fear that struggling means they are failing or disappointing others. It is important to remind them that therapy is much more complex: there is no "right" universal track, and improvement rarely looks the same. Therapy is an individualized process and each person’s path through therapy will look different.
So, what are setbacks in therapy? Are they signaling failure?
Setbacks can feel discouraging. Sometimes progress seems stagnant, moves slower, or is suddenly way more overwhelming than expected. You may find yourself snapping in anger after weeks of practicing emotional regulation, or reminiscing about the friendships you left behind when you have been putting so much effort into making new ones.
In these moments it is very easy to fall into self-blame: “I thought I was doing better”, “therapy is not working”. To simply answer the question, no, these are not signs of failure. In fact, these are signs that change is happening.
Growth is rarely linear. Therapy involves new ways of coping, processing, and adapting. Instability and setbacks are to be expected, just like learning any new skill involves trial and error. Therapy aims to change deeply learned patterns of behaviour, and therefore successes and setbacks are normal. Rather than seeing setbacks as proof that nothing is working, it can be more helpful to view them as signals of where challenges still are, what feels manageable, and what may need a different approach.
Two Types of Setbacks in Therapy
Not all setbacks are the same. While some are actually productive and help us grow, others can push us beyond what we are ready to handle.
The balance strategy setback
This kind of setback is emotionally challenging, yet remains within a tolerable and manageable range that supports therapeutic growth. Balance strategy setbacks highlight the importance of balancing the intensity of the setback with the individual’s current capacity for emotional regulation and tolerance within the session. While some can experience dysregulation, they are able to stay engaged and eventually recover from it. This is just a slight push out of their comfort zone without completely overwhelming them. For example, TCK’s may struggle with relocation grief and building new connections and still make the brave decision to sit with a large group of students during lunch. The experience may feel uncomfortable, accompanied with worries that everyone dislikes them, and reminiscing old friendships. Even so, they manage to return to school the next day and continue interacting with peers. Even though the experience was triggering, the discomfort is ultimately promoting growth.
2. The exceeding proximal development setback
This kind of setback happens when the challenge exceeds what the person can tolerate. The experience may become too overwhelming leading to a shutdown, or avoidance of the situation. The nervous system perceives the situation as dangerous and switches to “fight or flight”, making learning much harder. This results in an exceeding proximal development setback. Returning to the school example, after the stressful lunch, they may become so overwhelmed that they refuse to attend school the next day, or become too dysregulated in class. This shows that the challenge is beyond their capacity. This does not mean the attempt was “bad”, it simply shows the pace, intensity, or support needed for adjustment.
Both of these setbacks are valuable. They help us understand the “optimal zone” for growth, and understand the child’s emotional capacity. They reveal what fears still need attention and what coping strategies are not fully established yet.
What causes setbacks?
Sometimes it is as simple as common life challenges. This could be too much homework, making new friends at school, for TCKs even moving to the new environment can be overwhelming enough. Recognizing that even simple life events can become triggers, is the first step in understanding that progress is not perfect.
How do we handle setbacks?
The way we approach setbacks can help us grow from the experience, and even promote progress in therapy.
Set Realistic Expectations
Many children and adults enter therapy hoping for the “perfect recovery” or ultimate happy ending where emotions disappear forever. These unrealistic expectations put enormous pressure on the process. When therapy is idealized in this way, setbacks may be perceived as failures, and not part of a learning process.
These unrealistic expectations may even prevent people from fully engaging in therapy as they may be too focused on “doing therapy correctly” rather than allowing the process to unfold gradually and imperfectly.
2. Approach Setbacks with Curiosity, Not Judgment
Children may feel ashamed for getting overwhelmed, and believe that their hard work was erased by one difficult moment. As parents, it is important to approach these moments with curiosity. Instead of reacting with panic and disappointments, ask:
Were there any triggers of this setback?
Can the child slowly recover from this experience or is it out of their scope of tolerance?
Curiosity shifts the focus away from blame and towards understanding. Reassure that setbacks are normal and validate that these experiences do not erase their progress.
Sometimes it can help families create a small “toolkit” or set of non-negotiable supports for difficult days. These can be simple routines that provide safety and consistency when emotions feel overwhelming, for example, going for a walk together, spending time outside etc.
3. Practice self-compassion
Self-compassion is essential in this process. Setbacks often trigger self-criticism, but they are simply the body’s way of communicating something that feels overwhelming. Being self-aware of our limits does not have to be accompanied with judgment.
Staying kind to ourselves and accepting vulnerability is like dropping an anchor during a storm, self-compassion helps create stability while emotions eventually pass.
4. Reframe the Meaning of setbacks
The way we interpret setbacks matters. If we view every challenge as a proof of failure, therapy can begin to feel disappointing and exhausting. But when we view them as opportunities of reflection and adjustment, they start becoming more manageable.
Progress is not about sailing through perfectly calm waters, it is about learning how to continue even when waves appear. Sometimes you may still get splashed by the water, and the storm may feel stronger than expected, but that does not mean you have been pushed all the way back to the shore.
Therapy is Not One Size Fits All
Therapeutic progress is largely individualized, and our definition of improvement may also change depending on the context and stage of life.
Here at EKC, we recognize the complexity of therapeutic progress and prioritize individualizing therapy at your own needs and pace. We work with an individual and systemic mindset to create healthier habits in a supportive and open environment, while maintaining realistic expectations throughout the process.
Schedule a call today to speak with one of our therapists and see how we can help your family thrive.