If your car gets an excellent tune up, you don’t go back week after week to make sure it is “tuned”. You pay the bill and don’t think about it until the next time your car is balky. But when to end psychotherapy is far less clear. Deciding when you’ve done enough work or determining when therapy just isn’t helping can be very difficult.
You know that therapy shouldn’t last “forever” but when is it time to take a break or end the relationship?
Good Reasons to Leave
Success: The happiest reason to leave is that you’ve accomplished your goals. You understand yourself better. You feel more confident. You have learned some new tools for managing yourself and your life. You know that you aren’t perfect. No one is. But you feel that you have what you need to go forward in your life, imperfections and all. You and your therapist agree that you’ve used therapy well and it’s time to move on. You understand that if sometime in the future you need a “tune up”, you can return.
Therapist misbehavior: You feel your relationship with your therapist has become questionable. You feel too dependent. You question whether the therapist’s behavior toward you is ethical. You dread going to sessions because you feel disrespected, abused or exploited. In such situations, leave. Leave immediately.
There’s little rapport: You and your therapist just don’t click: It’s simply true: Some personalities work better with each other than others.
According to the American Psychological Association, “Patient and therapist characteristics … affect the results.” In other words, the most important factor for whether therapy “works” is whether the relationship is one where you feel safe and supported and helped. If that’s not the case, it’s fine to transfer to another therapist.
You need different expertise: Perhaps you went to your therapist with a specific problem and have done reasonably well. But as therapy progressed, problems or issues emerged that are not within your therapist’s expertise. In such cases, your original therapist can refer you to someone who is more able to meet your needs.
Discomfort with the model: Research does not show that any therapy model is consistently superior to others in terms of client report of success. If you like the therapist but are uncomfortable with their methods, do your research. Find out what type of therapy is most appealing to you and look for a therapist who can address your problems in a way that makes sense to you.
Guilt: You realize that you are only going to therapy because you feel guilty about leaving your therapist. Therapists are not emotionally or financially dependent on you. Tell the therapist how you feel. Your therapist will be able to reassure you that, as much as they like you and value the work you’ve done together, it’s fine to end therapy.
Practical reasons: Paying for therapy may be a challenge for you. It was worth doing without some things when you were in crisis but now it’s less clear that therapy should be a priority. Fitting therapy into your life may be difficult, especially if it involves finding childcare or taking time off from work when you have little vacation time. These are absolutely legitimate reasons to take a break or terminate.
Talk it over. If you still need therapy, our therapist may be able to offer less expensive options or may have some ideas about how to manage other practical concerns.
Not So Good Reasons to Leave
Pessimism: You have areas that you agree need attention, but you feel pessimistic about your ability to deal with them. You aren’t confident your therapist has what it takes to do it either. This is potentially an important moment in your treatment. You and your therapist need to address your fears so you can venture into what may be the most important part of your therapy.
Progress is stalled: Maybe you like hanging out with the therapist for an hour each week, but when you are honest with yourself you know that you aren’t getting anywhere. Talk about it with your therapist. The two of you may be able to identify what is blocking you and redirect your treatment. If not, you might benefit from taking a break.
Many people leave therapy in order to try out what they’ve learned for awhile to see if it was enough. If so, the break becomes a termination. If, however, you realize you still have work to do, you can always go back to your therapist with renewed commitment to the process.
Avoidance of issues: You’ve talked around and around a painful issue. Your therapist has encouraged you to finally address it. You’re scared. Rather than deal with the fear, you decide to drop out of treatment. But confronting the issue is exactly what you need to do if you are to heal. Talk to your therapist about how best to go about it without putting you into the teeth of your worst fears.
Anger: Maybe the therapist touched on an issue that makes you so uncomfortable that you are upset. Or maybe you are angry at your therapist because they said something that seemed tactless or disrespectful. Therapists are human. They do make mistakes. Going to the next session may help you learn new ways to deal with conflict in a relationship and/or generally manage your anger. If anger is a way to avoid an issue that is triggering, you and your therapist may be able to find a way to reestablish safety so you can talk about it.
Don’t Quit — Terminate.
Whether frustrated or satisfied by your therapy experience, it’s usually a mistake to just drop out by canceling the next appointment or by just not showing up (therapist misbehavior being the exception). If you want to quit out of discouragement, frustration, fear, or anger, your therapist may be able to redirect the work or identify other options that would be useful to you.
When therapy has been helpful, it is more supportive of the work you’ve done to schedule a last session. A termination session is the opportunity to sum up the work you’ve done, to give yourself credit for the changes you’ve made, and to outline ways to maintain your progress. When you’ve liked your therapist and feel you’ve done well together, leaving gracefully makes it more possible to go back should you ever feel the need to.