How to End Psychotherapy

Much advice on terminating psychotherapy operates on a cynical premise, namely, that the therapist is going to try to keep the patient in therapy for selfish reasons. The phrase, "Remember, she works for you" abounds in forums related to psychotherapy. This profoundly misses the point, and the cynicism does not serve either party. Terminating psychotherapy in a patient, thoughtful way consolidates the progress and growth that has happened in treatment.

Instructions

• 1

  Think about why you want to end psychotherapy. Do you feel that you have accomplished what you set out to accomplish? If so, that is an excellent reason to terminate treatment. Many people find so much value in psychotherapy that once the initial issues that brought them into therapy are more or less resolved, they wish to continue therapy to deepen self-knowledge and to work with other issues. If you feel that ending is the right thing, begin talking to your therapist about this. If your reasons for ending are financial or time constraints, or the feeling that you don't desperately need therapy anymore, explore this with your therapist. Psychologist and "Psychology Today" blogger Ryan Howes points out, "Therapy may be the first time you can talk through the feelings associated with ending and wrap up a relationship on a good note ... especially if the client has a history of bad endings."

• 2

  Take your time. Depending on how long you have been in treatment and your therapist's theoretical orientation, a good termination can take between a few sessions and a few months. Howes advises, "In therapy, cut and run is like skipping the last chapter of a novel, the part where the loose ends are tied up. You can learn what the future may hold and get a sense of closure." Resist the temptation to hasten the ending, or to disregard your therapist's input on the issue.

• 3

  Figure out with your therapist when and how you will end. Deciding to have four more sessions, for example, creates the space to more fully process the work done together. Resist the urge to gradually cut back on therapy, and consider taking the time you need to come to a complete ending. Howes states, "Fading away is not termination; it's mitigating the difficult feelings associated with ending. Cutting back sessions communicates, "I can handle seeing each other less often and with less intimacy, but an absolute ending is too much." He explains how the flow of the therapy eventually weakens, and the quality of the therapeutic relationship changes. By facing head on ending the therapy and ending the therapeutic relationship, you create a corrective experience of loss. Saying goodbye is an important part of ending.