Terminating Psychotherapy or Counselling Unexpectedly

Psychotherapy or counselling relationship should ideally terminate when the end goal is met. This is the goal that the client and therapist set as their therapy goal (in transactional analysis we call them treatment contracts). This kind of ending is an ideal one. However, sometimes we find a client terminating psychotherapy or counselling relationship unexpectedly—prior to therapy coming to its natural end. I will focus on the latter scenario of terminating therapy in this post.

If you are interested in natural therapy endings you will find more about it here: Ending Psychotherapy or Counselling Naturally

I will also refrain myself from technical, academic and overly intellectual jargon. I figure that if, as a client, you want to learn more theory on terminating therapy relationships, you won’t have trouble finding it. So, I will limit myself to my own experience and my views when the topic of endings comes up.

Factors that influence terminating therapy

Inclination to terminate therapy will depend both on the setting therapy is conducted in, the presenting problem the client brings to therapy and also the approach a therapist will use based on these two factors.

I work both in the short-term NHS setting where clients get a handful of sessions—often limited to six—and also in the long-term private setting, where a client has an opportunity to fully and deeply address the underlying issue of their presenting problem and perhaps even find new things they want to enhance for themselves.

In short-term therapy goals of therapy are often different as there is a limited amount that can be done in six sessions. However, this is not the case in longer-term work where the therapist and the client can address deeper archaic issues that have their effect in the everyday life of the client—maybe not even being aware of that as the therapist and the client sit together for the first time.

As a therapist working predominantly using transactional analysis psychotherapy, I greatly respect the decision and autonomy of the client as to what aspects of themselves they want to change. If I feel this is something that cannot be done, I will raise that with the client and explore options at hand. This means that, should the client not want to address deeper archaic content that might be the cause of their difficulties in life and would rather focus only on the symptomatic relief, we will do so.

But we will do so if this is, on one hand, possible and, on the other hand, provided that this does not represent avoidance to from the problem that the client initially brought to psychotherapy. In any case, this is something that I transparently discuss in therapy with the client.

The therapeutic relationship, approach to therapy and the influence on terminating therapy

So, why is all this important when a client is contemplating terminating psychotherapy or counselling relationship unexpectedly?

When one is not dealing with deeper and more archaic parts of their personality in therapy but rather addressing their behavioural or cognitive elements of their symptoms, the client will usually be less prone to terminating the therapy relationship based on their core intra-psychic issue. And even if they do so, they will be less prone to having the termination of therapy result in them leaving it with unresolved residual feelings. There will be a similar effect of premature termination of therapy in the short-term setting.

The “deeper” the therapy, the deeper the therapeutic relationship, the more importance and meaning terminating therapy will have

However, terminating psychotherapy relationships unexpectedly is quite different in the long-term psychotherapeutic work—especially when therapy is addressing deeper intra-psychic or developmental content. Often therapeutic relationship itself will be the basis for client’s change, which also means that the feelings that come up between the therapist and the client are the ones that are usually a mirror of the feelings and relationships the client presents outside of the therapy room.

This also means that when therapy progresses in deep relational manner it is hard for the client to avoid potentially unpleasant feelings—such as anger, anxiety, separation anxiety, abandonment depression, feelings of rejection, confusion, shame and guilt, fear, irritation, agitation, etc.

This will especially be the case when therapy is strongly challenging the archaic beliefs of the client. As old habits, thinking patterns and feelings and views of the self, others and the world are challenged, this tends to stir things up for the client, so unpleasant feelings are not uncommon nor should they be unwelcome in the therapy space. On the contrary, they are the path towards autonomy if addressed appropriately in the safety of therapy relationship.

The fear of change can also be important factors when talking about terminating psychotherapy. (Related reading: Therapy and The Fear of Change)

As can be the ever present pursuit of happiness and potential disappointment in not achieving it. (Related reading: Will Therapy Make Me Happy?)

However, when these difficult feelings arise, there can be a tendency of the client to terminate therapy in order to avoid them. Or they want to terminate it because they feel that this is a step back in their psychotherapy. Deciding to do so leaves the client without the possibility to deal with these feelings in the therapeutic relationship and use that to change their old behavioural, thinking and feeling patterns outside of therapy space in the future. However, this is in fact an opportunity for a reparative experience, alteration of old habits and integration of healthier and more recent views of one’s self, others and the world.

So, how do we deal therapeutically with unexpected termination of therapy?

Because terminating psychotherapy can be based on client’s perception of these difficult feelings being something unwanted or even as an evidence of the rupture of the therapeutic relationship, it is even more important to use this in therapeutic manner.

Some therapists hence contract a termination period with their clients and use that as space to address the difficult feelings or potential ruptures. this offers an opportunity for the content to be addressed appropriately and used therapeutically so that the client is not left with an unresolved experience—one that would confirm their archaic beliefs about themselves, others or the world. However, this does not mean that the general termination period cannot be altered with a certain clients—at least I am the advocate of that. The decision to do so would, of course, depend on the “depth” of work a therapist is engaged in with a particular client and the approach they use.

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