Ending psychotherapy or counselling should ideally be a part of therapy itself and as such a part of reparative therapeutic relationship. If done appropriately, endings can have a therapeutic impact also and can offer the client a new experience as to how relationships in life can be handled. Even though therapy relationships can differ based on the approach used and also based on the “depth” of psychotherapeutic work, ending therapy should ideally be planned ahead and agreed as part of treatment.
In this post I will focus on ending psychotherapy or counselling relationships naturally—i.e. in a planned manner. If you are interested in ending therapy unexpectedly, you will find more about it here: Terminating Psychotherapy or Counselling Unexpectedly
Ending therapy is part of therapy and therapeutic in itself
Ideally ending psychotherapy or counselling should be part of therapy in itself—a natural end in terms of therapy goals being met and treatment having ended successfully. Such therapy endings need to be incorporated into the treatment plan and also need to reflect the approach and “depth” of therapeutic work, the client’s presenting problem and other important aspects of the therapeutic relationship.
When psychotherapy takes the form of relationship that serves as reparative experience for other relationships in life, the same will also go for endings. How we handle endings in psychotherapy can serve as learning tool for the client later on—along with how they handle feelings that come up. Ending therapy can hence be therapeutic in itself—a part of the process towards personal autonomy.
Ending psychotherapy successfully means appropriately dealing with the feelings that arise
Endings are planned and discussed in therapy space so that they do not leave an emotional rupture in the therapeutic relationship. If they did, that could cause the conclusions that the client makes in therapy to spill out of therapy and as such affect relationships in the client’s general life. And that can also mean a relationship with oneself.
Nearing the end of therapy can be—especially if therapy was long-term and relational in nature—stressful for the client and feelings of grief and loss can arise, along with feelings of betrayal, anger and even denial that the end is near. If not dealt with appropriately, this can leave a rupture that will last even when the relationship has ended physically.
Ending therapy depends on the approach, the client and their presenting issues
Not all endings of psychotherapy relationship are the same nor should they be. First of all, endings will depend on the setting therapy is conducted in. If therapeutic work is focused more on cognitive and behavioural aspects or the client is predominantly looking for symptomatic relief without looking into deeper developmental and affective aspects of their psyche, psychotherapeutic work will generally not call for complex ending process.
I have a similar experience in short-term NHS setting, especially when therapy is focused on containing the client and how they cope with life situations.
Ending psychotherapy as therapeutic intervention
However, ending therapy when one is undergoing it on a “deeper” psychotherapeutic level and, as such, changing archaic elements of their intra-psychic process is quite a different thing. In such instances it is important to dedicate time to close the therapy process appropriately and appropriately attend to any residual feelings that accompany ending of therapy.
Feelings of loss, grief, fear, anxiety, abandonment, rejection, helplessness—all these and many more can arise during the process. If dealt with appropriately, ending therapy can actually act as a reparative experience for the client. The client can integrate this experience as a new way of engaging in their relationships and as a new way of ending them and dealing with loss in life.
However, just as an appropriate ending can be a reparative and therapeutic experience for the client, an inappropriate ending can act as strengthening of their improper and often outdated archaic beliefs—about themselves, others and the world.