When and How to End a Therapeutic Relationship

No one likes to say goodbye. Whether you are in a wonderful relationship or an unpleasant one, ending a relationship has a negative association. Romantic endings can be devastating, coworkers can be bittersweet, a friend can be heart wrenching, and an enemy can be scary. Depending on the relationship and the reason it is over, endings can affect us in number of ways. This is the same for our therapeutic relationships. Regardless of the why, having a healthy ending to a relationship, can be even more impactful than the relationship itself.  

The best endings in therapy are usually caused by wellness. You are doing great. You have challenges in your life and you have learned how to handle and cope with them. You used to melt down, feel lost, or make situations worse… now you identify, manage and thrive. You know longer hear your “therapist” in your head…. WWTD? You hear your own voice. Is life perfect? NO- Perfection doesn’t exist, but life is pretty good, and when it isn’t, you have the skills and the support to cope on your own. You are READY. This is the ultimate goal for all therapeutic relationships. Ask yourself: 

• Do I feel better? 

• Do I have a positive outlook for my future? 

• Am I hopeful?  

• Am I able to handle situations without making it worse? 

• Have I started prioritizing other things than therapy?  

• Do I feel healthier? 

• Are other areas of my life stable? Improving?

Other reasons to end a relation are not as straight forward. Sometimes you are feeling stuck. You are no longer receiving benefit for the treatment provided and you find yourself regressing. This can be confusing because you may have a great relationship with your therapist and it still may not be helping. Remember, this is a therapeutic relationship and if the relationship is no longer effective, something or someone else may need to help you with the next chapter. Usually, not one therapist can do it all. You may have resolution in one area and then need the specialization of another type of therapy. While this may be the most challenging relationship to end, it must be done. As a therapist, our goal is to help you reach your goals, not hinder your process. Ask yourself: 

• Am I feeling stuck? 

• Am I getting worse? 

• Have I been avoiding sessions, not doing the work? 

• Do I feel like I am on a loop in session?

Now, I know what some of you are thinking, “Can’t I just ghost my therapist?” Yup, you can. However, for those of us who have had patients disappear without a trace, it doesn’t feel good. Believe it or not, your therapist does care about you. We do think about you when you aren’t in our office. When you disappear, we wonder why. We are human. So, the question is, how do you know if it’s time to end a therapeutic relationship and how is it done? 

In the Beginning:

1. Discuss termination from the beginning and create goals to accomplish. Set an intention to discuss progress so that when you have monthly/quarterly check-ins, it doesn’t feel like a break-up when the end is near, rather it becomes a natural part of the journey.

2. Throughout treatment, check-in to evaluate the therapeutic relationship and your concerns. We don’t need to save everything until the end, we are constantly evolving. 

3. Create a plan for decreasing sessions with an end date. Maybe this is over several months, or a few weeks… maybe your sessions are shorter or you just make space for check-ins. You can test the waters and still have support. 

During your last sessions: 

1. Accept your emotions and urges. There are a lot of feelings around ending a therapeutic relationship- be honest with yourself and with your therapist. Are you happy? Sad? Scared? Do you have the urge to avoid? Do you have the urge to self-sabotage? Take the time in session to process and share together.

2. Cope ahead for Emergencies. Make sure you know who your supports are, the skills you have, and identify the things that work for you. Plan and prep for your future.

3. Look at your growth. Look how far you’ve come. Trust me- your therapist will have a lot to say about this and you need to hear it! 

4. Share what didn’t work. Discuss what got in the way of treatment. Look at the things that weren’t effective, so that you don’t have to deal with that again in the future.  

5. Discuss what’s next! Look at what you still hope to accomplish. Where are you heading? What are you going to need to get there. 

Healthy endings are incredibly therapeutic. You need to be able to do this in your relationships and having that opportunity to model it in therapy, is worth your while.  

Okay… but what if I don’t like my therapist or I think I need something different than what they are providing? Fair. Guess what- the above doesn’t change. Checking in, addressing goals, and making a plan to exit, albeit much shorter, is skillful! Also, asking the therapist for their suggestions and recommendations. Chances are good, they may have a great referral or a better fit for you. The goal is to be honest about what you need. Yes, this is a relationship but it is also a service. If we are not providing what you need, going elsewhere is imperative. We also know there are others reasons for termination that fall outside of your control: authority figure getting in your way, financial restraints, time/obligations, readiness, etc. We don’t want you hanging around or avoiding the topic because you don’t want to hurt our feelings. Trust us, we have done this before and we can handle this.  

Ending treatment effectively, is a crucial part of therapy and the healing process. Being able to have positive endings to your relationships is a skill and in a therapeutic relationship, you have the chance to model healthy endings, create an opportunity for growth, and set the stage for your next chapter. This is something you GET to do, not something you HAVE to do. Give yourself the space and courage to advocate for yourself and put your needs first. You deserve it.