Defining the End of Psychotherapy

This post was co-authored by Savannah Fifield, M.A., MHC-LP.

Have you ever wondered when therapy was going to end? Maybe you felt like you needed a “break” from therapy. Maybe you just outright “ghosted” your therapist, and stopped returning correspondence altogether. Unfortunately, these are common issues for many people going through psychotherapy. What are the virtues of sticking with it or taking some time away?

How and When to Define the End of Psychotherapy

A great way to understand the end of psychotherapy is to look at the beginning. This is when treatment goals are established and any other issues or diagnoses are discovered. For example, expressing trouble with relationships might prompt an initial goal of evaluating how your current and past relationships have been initiated or maintained. Or you might say “I’m overwhelmed and I don’t know why.” Your therapist may help to evaluate if there are executive functioning issues and determine whether medications need to be considered (with the aid of a psychiatrist). After identifying possible core issues in executive functioning, your psychotherapist may need to help you cope with “here-and-now" problems.

The Common Process of Psychotherapy

Psychotherapy is a unique collaborative learning environment created to solve problems in your life. In this process, you will learn new skills, knowledge, and concepts that could help in navigating life more effectively (American Psychological Association, 2012). Some examples of what you may learn in psychotherapy are emotional awareness, problem solving, finding purpose, and improving interpersonal relationships.

Psychotherapists use different forms of psychotherapy with the purpose of finding a combination that works best for you. For example, Cognitive Behavioral Therapy (CBT) addresses dysfunctional behaviors and maladaptive thought patterns. It is often used to treat depression, anxiety, and other mental health disorders. A psychodynamic approach explores your unconscious thoughts and underlying wishes, fantasies, and fears (Brown et al., 2014). This form of therapy assists in addressing and improving interpersonal relationships.

Different forms of psychotherapy address various aspects of mental functioning, each one with a unique style and approach. However, all forms have three similar concepts: the relationship between the patient and psychotherapist; expectations and goals set during sessions; and implementation of health promoting actions in the patient’s life (Wampold, 2014).

How to Know When It's Beneficial to End Therapy

Deciding to end therapy is one that should be considered carefully and thoughtfully. There are many emotions that may come up that prompt the thought to discontinue. It would be best to work out this decision with your psychotherapist, as you two are collaborators in the process. Here are some questions that may be helpful to ask yourself and your therapist:

1. Am I getting better?

Asking this question should prompt you to refer to your initial goals in treatment. Maybe you’ve made some progress, but not as fast as you would like. Maybe you think that no progress has been made at all. Make sure to speak with your therapist about why you are feeling stuck as you may not have a clear picture of what progress would look like. It’s possible that you’re experiencing psychological resistance which could lead to avoiding emotions and/or rejecting change. These behaviors hinder your own involvement in the therapeutic process. This may be a part of a larger cognitive and emotional process that we call ambivalence. It happens for many reasons, but being able to recognize when this is happening and acknowledge it with your psychotherapist is the first step to overcoming resistance.

2. Is the treatment relationship going awry?

Like all relationships, psychotherapy relationships have a set of rules and etiquette. Conflict or tension may form between the patient and therapist. This is considered the “real” start of the therapeutic process, as these types of conflicts are usually a part of a person’s life in other contexts. Speaking about this conflict is important and requires a great deal of trust from the patient. Another possible reason for the conflict could be a lack of skills on the therapist’s end. For example, a therapist who cannot maintain emotional boundaries during sessions could lead to confusion about whose problems are being assessed and solved. If this issue cannot be resolved even after speaking together, find another therapist who has those skills.

3. Do I need time to live life on my own?

Building your independence may be something you have been discussing during sessions and ending therapy on your own terms can continue building those skills. You may notice yourself using the skills you have learned more frequently outside of therapy. These could be coping skills, emotion regulation, interpersonal relationship skills, or practicing meditation and mindfulness. If you think you’re ready to step off on your own, you may want to discuss with your therapist about tapering down and then ending therapy.

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4. Am I running away?

Past behavior predicts future behavior. If you’ve “fizzled out” relationships, or ghosted people in your life, you may want to do the same with your therapist. These are types of avoidance behaviors and are maladaptive. They may unfortunately play into your fears of abandonment and continue a cycle of avoidance. The big question is: What is it that you’re running away from? If you can stick around and work this out with your therapist, then this would be considered a major inroad in treatment.

Conclusion

A common misconception is that ‘being happy’ is the end goal of psychotherapy. Happiness is only one emotion experienced on a wide spectrum of experienced emotions. What people often find themselves looking for is fulfillment and direction in their lives.

The outcomes of therapy and personal growth are not always linear. Avoid expectations that you will never have bad days during therapy or after terminating treatment with your psychotherapist. The reality is that everyone has bad days and moments where their emotions feel overwhelming. Progress in therapy occurs when you can implement the skills and tools you have learned to identify and better manage your emotions.

To find a therapist, visit the Psychology Today Therapy Directory.