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How to Decide When to End Therapy

The decision to end therapy is often angst-filled.


There's no lab test or imaging study like a CT scan or an MRI to measure how much progress you've made in therapy. But there is a strong movement away from endless navel-gazing—the Woody Allen stereotype of therapy going on for years, even decades, without resolution.

"It's unrealistic to expect a cure for depression symptoms after four to six weeks of therapy," says William C. Sanderson, PhD, a professor of psychology at Hofstra University in Hempstead, N.Y. "But if there's no improvement during that time, we need to evaluate whether you're in the right treatment for you."

Check in regularly
Jayne Bloch, a psychoanalyst in New York City, says it's crucial to set goals with your therapist and have regular check-ins. But, she adds, don't be surprised if the "end date" approaches and old symptoms start coming back.

"I had a patient in long-term analysis, she just wanted to go, but she felt like she had to be angry in order to leave," Bloch says. "She felt the only way to leave is to just set the date and leave being angry. It's not that different than the process of leaving home—often kids leave their parents feeling they have to rebel."

Good and bad reasons to end
Charles, 59, a Midwesterner, describes how he finally decided to end therapy. "I got paired up with a psychiatrist who really cared and was competent to make things better. But after a while, the clockwork way he approached each visit made me wonder what I was gaining or learning," he says. "It's easy to get through sessions by telling your therapists what they want to hear."

If you begin to feel that way, says Hofstra's Sanderson, it may be time to terminate. Gary Seeman, PhD, a psychologist in San Francisco, adds: "Ethically, a patient can't be in therapy with two people at once."

Logistical issues, such as money and access, or an inexperienced or irresponsible therapist can terminate therapy prematurely. Keris Myrick, 46, of Pasadena, Calif., found a therapist through her HMO. After just one session, Myrick says, "she told me everything was fine so she didn't need to see me anymore. But I was adamant that no, things weren't going well. I was having feelings of sadness and was anxious, withdrawing, keeping all the blinds closed, but I guess she thought I was all right."

Many patients with chronic depression hope to keep their relationship with their therapist for as long as possible. Lisa, 42, from Huntington, N.Y., likens talk therapy to "going to the gym."

"Your mental health is with you for the rest of your life and it will be as good to you as you are to it," Lisa says. "The reason people are so desperate for end dates is because they see therapy as detention or punishment. But if you're in the right kind of therapy, it's the greatest reward you can do for yourself."

Last Updated: April 15, 2008


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