Last week, I broke up with my therapist. But this isn't the first time I've ended a chapter in my healing journey. As a teen, I would ghost therapists when I felt unmotivated. As a young adult, my therapist could not get rid of me. I had kept my motivation, and when Sharon* declared that it was time for me to use my coping skills without her, I was devastated. I wanted to stay in her care forever, and remain close with the greatest source of support I had ever known.
Therapy is a remarkable and unique experience, where we become incredibly close with a stranger. In the safe space of shared laughter, tears, trust, and secrets, it is easy to forget that this relationship laden with intimacy is temporary. When either party suggests ending the relationship, it can feel very similar to a breakup with a friend or partner. This was the first time that I was actively participating in the end of my journey with a provider by announcing my decision to end therapy. And it felt...weird.
I worked with Ava* for about 2 years, and I made incredible progress under her care. In recent months, I reflected on my growth and concluded that I felt ready to stop our sessions. The end of our relationship came faster than expected, however, when Ava informed me she is changing her accepted insurance plans. This left me with a tough choice as a client: take on the out of pocket cost of treatment, or end our relationship now.
The phone rang. Our session began, and my decision leapt out of my mouth without rehearsal. "I think I'm good to end therapy, actually. I've been doing well, and I know where to find you if I need help again." No tears or shaky voice so far. But anxiety started to creep into my mind. What if she doesn't agree? What if I upset her? What if things get bad again? What if I need her?
Before Ava could respond, I added: "But what do you think?"
She replied in a calm tone: "I believe in you, Cait. And I'll support you either way." Then the tears came. Once again, Ava encouraged me to follow my heart - even when it meant our separation. My choice was now clear. Our journey together had come to an end. We spend the rest of the session expressing gratitude to one another. I thanked Ava for her flexibility, her "no B.S." attitude that cracked through my defenses, and the new insights she brought to my life. She thanked me for my vulnerability, remarked on my progress, and expressed hope for my future. Overall, this breakup is my best one by far.
When I hung up, my eyes were still wet. But confidence in my decision remained. I've developed a trust in myself through my work as a client - the same trust I hope to instill in my current and future clients. As I reflect on those who will graduate therapy soon, my heart fills with pride. While I will continue to think of them and wonder how they are doing, I also remember that true support lies in valuing client autonomy. I believe in my clients' ability to determine when it is time to end our relationship, just as Ava believed in me.
Growth does not have an endpoint, so it can be hard to know when it's time for therapy to end. Here are some positive indicators that you might be ready to graduate from therapy:
Symptom reduction: Symptoms fluctuate for all clients, but if you are finding sustained overall reduction in bothersome symptoms (less worry, improved mood, increased confidence) it may indicate readiness to end therapy.
Improved coping/relationships: Utilizing your coping skills outside of therapy is one of the most important steps in healing. When you consider graduating therapy, feel free to take stock of your improvements in communication, coping with emotions, and interacting with others.
You want to graduate from therapy: This is an important one! You may have made stellar improvements, but you might also feel there is more work to do. Or maybe you do not feel ready to stop seeing your therapist. The client's desire to end therapy is an extremely important factor that influences the duration of treatment.
Sustained improvement: As I reflected on ending therapy, I noticed that my session content over the past 2 months had changed from navigating problems to reporting successes. If you find that you are handling life's challenges with improved ease, you may be ready to graduate therapy.
In a perfect world, the above reasons would be the only determinants of when therapy should end. However, there are practical limitations to every helping relationship. Other factors that can impact the length of therapy include:
Financial strain: Each client has their unique range of funds to spend on mental health treatment. You may be considering ending therapy if your provider has changed their costs or accepted insurance plans, or if you are experiencing financial strain due to other needs. If you want to continue therapy despite financial barriers, consider reaching out to the Maryland Pro Bono Counseling Project: https://probonocounseling.org/ for assistance in obtaining affordable care. You may also go to the therapist directory on Psychology Today and select "sliding scale" on the price range to find cost friendly therapists in your area.
Changes in availability: Sometimes clients or therapists experience life events that change their availability. If you want to continue therapy with a provider who has different availability, ask your recent therapist for referrals.
Therapist - client fit: While few therapeutic relationships are always easy, some can feel very tense or uncomfortable due to a clash in values or treatment approaches between a client and their provider. When this happens, ending therapy may be an effective way to start anew with a provider better suited to your needs.
You may have both practical and positive indicators that influence your decision to end therapy. Regardless, it is important to take some time to intentionally reflect on your decision. You may do this by identifying the pros and cons of this decision, talking it out with a friend or family member, or reflecting on how you feel before/after sessions. Ultimately, you are in charge of your healing journey.
"But what if I do need to go back to therapy again?" Where do I start?
If you find that old or new symptoms are making life difficult, you might be interested in starting therapy again. In this decision you have options, such as:
Returning to an old provider: This can be a great option for clients that have a strong connection of trust with a past therapist. However, it's important to note that this provider may not have the same availability, office, or fees as before.
Choosing a new provider: This is a great option if you did not have the best therapeutic fit with your past provider, or if you are experiencing new symptoms that your previous provider is unfamiliar with.
Obtaining Referrals: This option can provide the best of both worlds: you may consult your old therapist to find a new counselor. This way, a professional that understands your personality can match you with a new, compatible therapist. This new therapist may be an even better fit based on their fees, availability, skill level, or approach to treatment.
Even though breaking up is hard to do, it is not a purely negative experience. Trust in your ability to know what is right for you, and remember that help will always be out there if you need it again.
*names have been changed to protect the identity of those involved.
Caitlin Cordial, LGPC
About the author:
Caitlin is an artist, fisherwoman,
and aspiring plant mom.
She helps clients struggling with
anxiety, trauma, and family drama
to reshape their relationships
with themselves and others.