Endings in Therapy

Endings are a very natural part of life, and, therefore, a very natural part of therapy and a key part of the whole therapeutic process and journey. Endings in therapy are often not talked about and can be a difficult subject to broach and also to manage. Like with endings in life, there are many ways that therapy ends. These can either be intiated by the client, initiated by the therapist, or created by mutual agreement.

If we look back over our lives, then endings of relationships or experiences may well follow a pattern. It might be that you can just ‘close the door’ on people or relationships, it might be that you find endings hard, it might feel like a deep loss, it might be that you end things when things get tough, you might end things before someone else can, endings might feel like a really positive experience, it might induce panic or anxiety, you might experience any ending as an abandonment, you might find endings really easy to manage, or something completely different. All of those are more than ok, and very human reactions. These may all come into effect during endings with your therapist, and, with therapy being a healing tool, allowing yourself to have a positive and comfortable ending, can be liberating and freeing and change patterns you have experienced so far.

It’s important to be able to understand all the different ways that therapy can end, so that if you are in, or go into therapy, you can be aware of the potential outcomes.

Firstly, let’s look at if you, the client, ends the therapy.

-If the client feels they are getting towards having achieved all they want or have gotten all they need out of therapy– This is the ideal outcome. Ideally, the person will come to a therapy session and talk about having achieved what they want. Depending on the nature of the work, an ending will need to be worked towards. For longer term relationships and work, the ending process will need to be longer than if the person has only come for 2-3 sessions. If someone has only been working with me short term, then the discussion and ending process may last all of 10 minutes, and, for longer term relationships and work, it could take weeks, or months, depending on the length of time we’ve been working together and the therapy we have been doing, as well as what that particular person needs.

-If a client feels therapy won’t work– This is really, really common, and, experience tells me that this is most common just when things are starting to change, and the mind panics and puts resistance in the way. That resistance makes clients think therapy won’t work as a way to stop them coming and stop the change, and this is very, very natural. Change can be terrifying, and can feel a threat because the psyche has had to develop the way it has, to be able to survive. Most people come to therapy when something that their mind or body created to survive, is no longer productive, however, the mind still thinks it is. Therefore, being on the verge of changing it, can feel like a threat to survival, even though, you know it’s not really. So, if anyone thinks that therapy won’t work, it’s always best to come and talk it through with your therapist and explore what is going on. After that, we can decide a way forwards that works for the client, whatever that might be.

-If a client doesn’t want therapy to work– This is a very common situation because change, in whatever way, as I’ve already mentioned, is terrifying and something people can only do when they are truly ready. Sometimes people come to therapy because someone else has wanted to, but they don’t. Sometimes people come when they aren’t ready, because they feel they ‘should’. It’s also very common for people to gain, in some way, from a situation. For example, someone who has anxiety may use the anxiety as an excuse to not do things, rather than say ‘actually, I don’t want to do X’, because having a reason like anxiety, is easier. This situation is something that most people experience on their therapeutic journey, and more than ok. As with the other areas, this is something that is worth talking through with your therapist. It might be that now isn’t the right time to be in therapy, but talking it through will allow someone to understand more about the situation. Equally, it might be that some part of the person doesn’t want therapy to work, but other parts do, and you want to persevere and understand and work with whatever is causing you the difficulty.

-If a client doesn’t think I’m the therapist for them– This can happen. Therapy is all about relationships and if someone wants or expects me to be something I’m not, then that can be a real problem for the success of therapy. It’s ok for someone to tell me if I’m not the therapist they want. We can discuss it and, if there is a need, then I can look to make a referral to someone who may be better placed to work more successfully.

-If a client does not like something I have done– This is something that can also happen in therapy, especially in the early days, when we are getting to know each other, and we are working out what kind of therapy someone needs and how I can best meet that need. I don’t always get it right, but I do always encourage feedback from people. The only way we can work successfully is for me to hear anything someone wants to share about our work together. I want to hear if someone is struggling, or didn’t like something, or something I said bothered them in some way. All of that is part of the therapeutic relationship, and it’s important to share. Then we can both learn from it and discover what needs to happen instead, so that each individual can get the best result for them.

-If the client can’t afford it or there is a change of circumstance– This is a sad and difficult one, especially during long term work, but a realistic issue none the less. Like with everything else, I would always encourage people to talk it through with me. I may not be able to adjust my costs, or change time or day (depending on what the need is), but we can discuss what the options are.

It’s also possible that I may initiate an ending.

-If I think another therapist would be better placed to work with someone– This may happen if I feel another therapist could offer someone who has come to see me, better therapy, or if I don’t have the area of expertise to work with someone. It may also happen if there is a conflict of interest in some way, such as I know the person from elsewhere and it’s unethical to work together, or I know someone you know and that knowledge may get in the way of therapy. If we do meet for an initial consultation, and it only becomes clear then, then I will always discuss this with you, and look to find a therapist who could and would be able to offer you what you need. There are different therapists around that I can refer onto and, because I’m only interested in what is best for my clients, I have no problem doing that if I feel it is in your best interest.

-If I were to be off sick or had a life event that would mean I couldn’t work for a significant period of time– If I had an acute problem and knew I was going to be off for a chunk of time, then it might be that I might offer my clients the option of seeing another therapist in my absence. This would allow people to still be in therapy and get their needs met, but the choice would totally be up to each individual for what they wanted to do. When I returned to work, it would then be each client’s choice, whether or not they came back to me.

It’s not uncommon for a client to just tell me between sessions they aren’t coming back, sometimes explaining why, but other times not. Times like this leave me to consider what is going on for the client for someone to make a choice and not feel able or want to talk it through. It is, of course, more than ok to make that decision, and I will always respect my client’s right to choose whether or not to come, but, if this is something you have done, or are considering doing, it is always worth thinking about what you’re choosing to do and why, and how it will benefit you. It might be worth considering if you can then speak with your therapist about it.

Sometimes people just don’t turn up. I imagine that making a choice to do that is a hard one, especially if someone has been working with their therapist for a while. Even if this is the case, and someone doesn’t turn up for an appointment with me, if the person chooses to come back in the future, then I would be more than ok with that.

My door will always be open for anyone that I have worked with, unless we have discussed otherwise (which may happen for various reasons, such as the type of therapy we have been doing, or if a client has made a referral for a partner to come and see me- I can’t see both partners at the same time, or something completely different).

My own view of endings is that, because therapy is always a relational experience, and there are two people working together to achieve the best outcome, that the ideal ending would be brought to the room, where it can then be talked through and explored. It’s important to me to hear how all my clients feel therapy is going, whether it’s a positive experience or a negative experience. The more my clients share with me, the more therapy will benefit them, and the more I can tailor my therapy to meet my client’s needs, and the endings are included in that. That said, sometimes that isn’t possible, for a variety of different reasons.

Having a planned ending (sometimes with the planning and discussion of only 10 minutes or a full session, or a planned ending that lasts a few weeks or months, depending on the length and type of therapy) can bring around fresh and deep healing in itself and can bring appropriate closure, to allow someone to move forward, whatever the reason for ending.

Talking about endings can be very scary and difficult but if you’re in therapy, it is a necessary and unavoidable part of the process, so, whatever you’re experiencing, if you can find a way to communicate about it with your therapist, then you might find it helpful for you. If not, that’s ok too, just do the best you can for you.

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