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When and How to End a Psychotherapy

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There’s no neat answer to any therapy-related question really, including the one I often get asked about when it is best to end therapy. Some talking therapies are offered to clients with a prescribed number of sessions from the outset, such as those offered by the cash-strapped NHS. So CBT (cognitive behavioural therapy) may involve six sessions – or even less, CAT (cognitive analytical therapy) uses a model of (usually) 16.

Some talking therapies are offered to clients with a prescribed number of sessions from the outset.

But many therapists in private practice don’t frame their work in this pre-destined way, and an ending may not be so clearly on the horizon from the start of the work. Whatever the type of therapy you choose though, you may well know when you are ready to end – and ultimately, this should be your decision.

It may be that you find yourself experiencing more and more ‘successes’ outside of the consulting room – ‘successes’ being measured against your original goals, such as drinking less, flying off the handle less, being kinder to yourself. Perhaps you have a far better measure of those parts of you that used to take hold, and get in the way: the angry, jealous, sad or guilty part. In turn, this may mean that you feel resourced enough to take the stabilisers off, and try out new ways of being without therapeutic support. There may well be a tipping point, and only you will know when this comes best. In short, it may well be that you are feeling better.

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Or, of course, it maybe that you simply can’t afford therapy any more, or that you realise that your therapist isn’t as skilled or supportive or even likeable as you’d hoped. As with any relationship, some work well and some just don’t, including the therapeutic one. But while talking such things through may feel very risky with some relationships, this should never be the case in a therapeutic one: a therapist should be able to handle challenge, criticism or disappointment with professionalism, reflection and compassion.

A therapist should be able to handle challenge, criticism or disappointment.

But bear in mind that therapy can often hit a tricky stage though, when you may feel tempted to call it a day. Examining psychological wounding and, perhaps, parts of ourselves we are least proud of can be uncomfortable at best, overwhelming at worst. Putting things ‘back’ to where they were before such close analysis may well feel to be an easier way of being.

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It may well be appropriate to take a break from therapy at times like this, but good therapy should help to discern when this is the case, or whether an opportunity has arisen to work through something profoundly important. Perhaps you have a pattern of running away when the going gets tough, perhaps you have suffered painful endings in the past. There may well be something worth thinking through, before deciding to leave or not.

So, if your therapist disagrees with your wish to end, I hope it is because he has your best interests in mind. But you should never feel forced, and the ball should always in your court.

Julia Bueno is an Integrative Psychotherapist in private practice in London. Her first book, about miscarriage, The Brink of Being is published in Spring 2019. You can connect with her on Twitter @JBueno_UKCP 





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