Ending a relationship is difficult. Most of us have been on the receiving end of a relationship “break up” of some kind. We know that it doesn’t feel good. Indeed, we know that it can be taken as a rejection (and often that is exactly what it is). Nonetheless, that doesn’t stop some of the same people who decry the insensitivity of those who unceremoniously “dumped them” from doing the very same thing, in the very same way, when they wish to be free of seeing someone else ever again.
With that in mind, here are a few guidelines for thought and action, and some examples of what people do, when and if it comes time to end a relationship with a therapist. Today, I won’t be talking about the sense of loss or sadness that sometimes accompanies therapy’s end. I’ll leave that weighty topic to another time.
1. The “I’ll call you” strategy. Usually, this is delivered by phone message. The patient probably has an appointment with the therapist and cancels it, adding that he will call to reschedule. Experienced therapists know that many people will attempt to end the therapeutic relationship in this way. It avoids a face-to-face conversation which the patient might imagine as uncomfortable, and it avoids actually giving any reason for terminating therapy. It leaves the therapist a bit in the dark, not knowing whether the predicted call will ever come, and probably not knowing what the reason is for the decision to end treatment.
2. The “end of session” termination. Patients often wait until the end of the therapy session to say something of importance, in part because it is uncomfortable or they don’t want to discuss it in any detail, at least not yet. This method of termination has the advantage of being done face-to-face; what it doesn’t do is to allow the two parties to process the reasons for that decision and discuss any concerns. Without some time to talk, the therapist cannot be helpful to the soon-to-be-departed patient, or find out much about the client’s reasons for his decision. Without knowing what those reasons are, its hard for the therapist to learn from any mistakes he might have made, anything he did (or didn’t do) that made the patient uncomfortable, etc.
3. The “no-show” departure. Some individuals who are receiving counseling decide to end therapy by simply being absent from their next scheduled appointment. This is rude, of course, and also risks that the therapist will charge you for the time even though you didn’t come to his office (most therapists expect 24-48 hours notice of cancellation in order to relieve you of the obligation of payment).
4. The “nasty phone call” ending. While this is a rare event, sometimes people want to hurt the therapist because they believe that they have been hurt or neglected by him. They leave an angry phone message and avoid any chance for the therapist to find out why they are hurting, just as they make it impossible to come to a more amicable resolution of the issues at hand.
5. The “I need a break” message. It is, indeed, sometimes appropriate for patients to take a break from treatment. It can get too intense for some, who realize that taking a breather might be helpful. On other occasions, the complications of life outside of the counselor’s office make continued therapy difficult for the moment. However, when giving the message that you “need a break” is simply a way of leaving therapy, with no intention of return, it doesn’t allow for any closure to the relationship, or any of the benefits that such closure provides (which are described below).
6. The “best” way. Whether you have been seeing the therapist for a long time or a short one, the issue of termination is an important one. It is appropriate for you, even from the start of treatment, to ask how long it is expected to last. If you are finding counseling unsettling or unproductive at any point, it is best if you discuss your concerns with the therapist as they happen. Since many people who enter therapy have a hard time with being assertive and direct, it might well be tempting not to talk much about anything that you believe the therapist doesn’t want to hear, and simply to end the relationship unilaterally. Unfortunately, you and the therapist are short-changed if you do this.
Ideally, your concerns should be expressed early in a session, when there is sufficient time to talk about them. Be prepared for your therapist to ask you why you are thinking of ending treatment. You might be surprised that the therapist agrees with you. Alternatively, you might be persuaded if he makes a good case to continue for a while. But if you are certain that it is time to end things, be sure to hold your ground. A good counselor should accept this without trying to make you feel bad about your decision.
Once an understanding is reached about ending treatment, that doesn’t necessarily mean that it must end at precisely that moment. You and the therapist might decide to taper-off sessions or to have at least one additional session to sum up the history of your work together and to say “goodbye.”
There are several reasons for having just such a final session. First, it should allow the two of you to review what you have accomplished, how your life has changed, and what you have learned. Equally, if nothing or little of value has occurred, it can give you the chance to inform the therapist where treatment went wrong. Therapists should be grateful for this information since it allows them to learn, adapt, and improve so that they can help those patients who will follow you into their offices. And, a last session gives the therapist time to point out treatment alternatives or refer you to other available therapists who you might wish to consult.
Finally, a good therapist who has known you for a bit of time usually has some very nice things to say about you, about your courage, wit, grace, intelligence, and the guts it took to look your problems in the face and try to change your life. The last session also gives you a chance to say “thank you,” if that is something that you believe appropriate. The counselor will usually let you know that he would be grateful to hear from you again, just to know how you are doing. And, the door is almost always open if a return to therapy is required.
So, therapy, even when it wasn’t as helpful as you had hoped, can and should end with an expression of respect and good wishes for your future well-being. You will usually feel good about being direct in doing what you believe is in your interest, and having the self-confidence and respect to tell it to the therapist face-to-face. Your therapist will be grateful too, in almost all cases.
No losers here. Only winners.