Beyond Blue

Beyond Blue


Knowing When It’s Time to End Therapy

posted by Beyond Blue

Part of my anxiety in job searching has to do with therapy and how I will pull it off if I have to work a 9 to 5 office job. Which, then, lead me to the thought: Is it time to take a break? How would I know when that time comes? Other people around me are clearly crazy and they aren’t spend their lunch hour in therapy.


Alas, I decided my graduation day is off in the far distance because I still always leave my therapist’s office feeling about 10 pounds lighter and equipped with an arsenal of power tools with which to treat my negative intrusive thoughts.

In my life, and maybe in yours, it always tempting to end therapy exactly when you need as part of your recovery plan, especially during a huge transition, like going to work for someone after 15 years of calling your own shots.

Thus, I thought I’d reprint this helpful passage from a Johns Hopkins Health Alert I just received. Published by the doctors of the John Hopkins Mood Disorders Clinic, they contain, at least in my estimation, the best advice you are going to get on the internet. If you want to subscribe, you can find out more information here.

***

Most people think of psychotherapy simply as counseling. In fact, the term psychotherapy is used to describe a variety of different talk therapies that treat emotional, behavioral, personality, and psychiatric disorders. Psychotherapy involves a commitment to a series of appointments with a licensed mental health professional, enabling a relationship to form between the therapist and the individual.

If you’ve been in psychotherapy for some time, how do you know when your treatment is completed and you no longer need to see your therapist?

This is something that you and your therapist should decide together. Some types of therapy, such as cognitive-behavioral or interpersonal therapy, are meant to be time limited; you and your therapist will set goals that can be achieved over a few months. When you’ve reached these goals and are generally feeling better, it’s probably time to stop therapy sessions.

Knowing when to say goodbye is tougher with more open-ended types of therapy such as psychodynamic therapy, which delves more deeply into how your past is affecting your present. This treatment doesn’t have a timetable for completion, and measuring goals is more subjective. But it seems logical to stop once you feel better, have resolved your major issues, and feel like your life and relationships have improved.

As with antidepressant medications, it’s not a good idea to quit therapy abruptly or without discussing it with your therapist. Some therapists find it best to taper off slowly, perhaps decreasing sessions from weekly to biweekly, then to monthly, and finally to telephone check-ins as needed. Of course, if you haven’t seen any improvement after six months, it’s probably time to consider a different type of therapy or medication or a change in therapist.

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  • Tea-With-Dee

    It may be idealistic to be able to forgo therapy in conjunction with bipolar or unipolar depression. However, in many states, Massachusetts being one of them, therapists/councilors are not licensed to prescribe medication. Treatment is contingent on receiving both disciplines simultaneously especially with government financed health insurance.
    Therese, I wish you well on this new chapter in your life as you re-enter the corporate working world. You are a gifted and talent writer who is very inspiring. I’ll look forward to reading your future blogs as you bring us along on your spiritual journey. May peace be with you and the healing spirit burn alive within you.
    Dee
    tea-with-dee.blogspot.com

  • Frank

    Therese, I went for therapy while going through my divorce in ’98. The therapist decided when I was ready to end therapy. I had a different situation – and it made good sense to stop when we did. But there was a tiny bit of apprehension on my part that my progress and good feeling would evaporate. It didn’t. I was empowered to know that I was handling life just fine. But I would have scurried back to therapy if I’d bounced up against another period of depression. Your readers are going to be pulling/praying for you on this job. You are too grounded to make any strategic errors. Do what you have to do – and stay the course for your counseling. But don’t listen to me! Blessings…
    Frank,

  • Anne Costa

    Transitions are HUGE triggers for exhaustion, anxiety and forgetting to be gentle and take care of ourselves so i would never consider stopping at that time. I am quite sure I am the only one in my office that runs to the therapist every month but for me it is as important a meeting as the ones I schedule with my boss and my staff. It is a as necessary to my job performance as all the other ways I receive trianing and support on the job and off. I wouldn’t give up that hour for all the tea in China!!

  • joe gonzalez

    Therese, i’m about 15 years come back from a country i love dearly and where i thought i’d establish base. This country has a very sensitive and highly acomplished population either practising psychotherapy, or benefiting from it. I myself have more than 8 years strict Freudian analysis under my belt. At the outset, i was as scared as anyone : ” Me ? Mental therapy ? ” Until, by sticking it out, i found some of it’s principles. Freudian psychoanalysis follows basically Socrates’ ( one of two of them ) most cherished guidelines : ” Know yourself.” And is started to do just that in a more acceptable manner under analysis. i have a friend who’s a highly accomplished and sought after professional who did 35 years pf analysis. I myself have – all told – some 45 years of therapy. And know what ? i’m in no hurry or worry to quit. Each time i go, it’s just another huge step forward ( there have been some ‘ so-called therapists ‘ whom i permitted to toy with my mind, but those were very brief and uneventful episodes in my history )another huge step forward in that maxim that dominated Socrates’ life, and recently, even the other one, ” Everything in moderation.” So, as u can surmise, i feel therapy is an immense privilege, and don’t think,
    unless the grim reaper comes calling, and even about that i am happy about, that i’ll ever completely quit it. Unless, of course, my therapist ( and i never take on one whom i don’t respect or have rapport with ) says to me : ” Joe, your work in therapy’s done. Now just go live and apply what you’ve learnt along with all your other good qualities. ”

  • Crystal

    My Husband asked me recently when or if I was ever going to quit therapy. I have been in therapy for over 9 years with the same psychologist. I have been through so much with her and I have made great progress. I went from barely being able to get out of bed and leave my house to being stable and I’d say pretty happy. We did change our meetings to twice a month instead of weekly for a while now and that has been working great. Sometimes I feel like I have nothing really important to work on in therapy anymore but on the other hand it is nice to have someone who I trust completely to listen to me and my minor problems. I do have bipolar disorder, anxiety, depression, and anorexia but for the most part they are all under control. I just wonder if I should be thinking about quitting therapy. I know I don’t want to quit and the thought of it makes me upset but how do you know how long to continue? Is it supposed to be forever? I mean that would be fine with me actually but I think my Husband is really beginning to think about why I am still in therapy when I am doing so well. I am afraid he will want me to quit and I don’t want to. How do I know when it is time to move on? Anyone got any advice for me?
    Crystal

  • kathy

    With a 9-5 job, more people than ever need psychotherapy! I would never give that up. That is just part of sleep, exercise, nutrition, and all the other things we need to do to take good care of ourselves. Unfortunately not everyone has the insight or health insurance or luck in finding the right therapist and developing a therapeutic relationship that provides them the support to keep moving in a positive direction in their live. Never give up therapy when you are starting a new job, changing jobs, or any other major life event is my motto! Your the best Therese and will do great in whatever corporate world you move into. Bestest…Kathy

  • claire notwicz

    This is my first time using the computer to respond to someone.
    I also have bipolar disorder but can function and keep my job and family life together. My husband also wants to know if I’m going to get over going to therapy. I’m glad I have ignored him and stayed in therapy and on my meds. I realize now that I must take time for me and if I stop therapy I will have no “me” time. I’m blessed that my insurance covers it so we don’t argue with it due to finances.
    So decide to have “me” time and when you leave it lets you freely give to others. Like a diabetic needs diet and exercise my life prescription is exercising my mind in therapy. My meds are like insulin I can’t think my brain chemicals better they need help from an outside source.

  • Brit

    Unemployment made this decision inevitable, if not easy. I am out of work, and can no longer afford therapy. Now, when I perhaps need it more than ever, I cannot afford to get the help I need to deal with the distress and hopelessness I feel. Right now, I would give absolutely anything to have the “problem” of making a therapy appointment around a 9-to-5 job. Absolutely anything.

  • Tamara

    Hello to all! Great article as usual & the comments as well(for me anyway) they always make me feel as if I’m not alone in my daily stuggle w/ depression, anxiety & PTSD. Also my journey to try to heal & climb out of this huge hole I feel like I have fallen into & as hard as I try can not seem to dig my way out. I’ve suffered to some extent w/ depression since I was a teen from stressful family situations & some severe health problems that most people do not have to deal w/ at such an early age, but never anything I couldn’t seem to snap out of w/ a lil time or maybe a script from my doctor to help me through these short term bouts, which is what I call them now, compared to what I’m going through now & have been for the last 8-10yrs(it seems it became 100x worse than anything I’ve ever felt before & due to several horrible life changing experiences that I never thought could happen to me(never say never because it can!)Yes, stupid thinking on my part…I know! Well after years of trying different medications & therapy(going through several different therapist… some great/some not so great!), this last time I have gone a lot w/ my youngest daughter(who was sexually abused by my now ex-husband, then again by a so called friend about 5 years later) & again I thought, Dear God how can this happen to her & our family again??? It still boggles my mind! I just Thank God the 2nd time wasnt as severe, but she didnt forget this time like she did with her Dad, mainly because of age. About a year & a half ago she asked if she could take a break or stop going, I struggled for months debating whether I should honor her wishes & not force her to go to therapy, as she felt like it was not helping anymore, not a good repore w/ her therapist & it seemed that the sessions just reminded her each time she went of what had happened to her, so I finally decided to let her stop going & see what would happen. The first 4-5 months were not bad & I thought maybe she was right & things are going to work themselves out, but it seems the last couple of months have been a nightmare for both of us & everytime I mention going back she starts crying & throwing horrible fits because she doesnt want to go back, even though I feel it would help her, esp. if she found a different therapist, which would be a must for her if she did return(unfortunately, the one therapist who we both loved dearly & helped her & myself the most is not allowed to see us anymore…thx to a very nasty, uninformed & arrogant Judge in the case w/ her Dad who was obviously paid off by my ex & said it was because she was talking to much about the abuse to my daughter…Well, that’s what she was in there for, sheez what a piece of work…but thats the unbelievable Judicial system I’ve had to deal w/ for the last 7-8 years who let this man get away with this scott free, paid his way out, plus DSS messed the case up so bad before it had a chance to go to court, they almost had to drop the case to avoid a law suit from both parties, yes, they are reason for a lot of my problems as well, just feel very sad that no justice was done for what was done to my daughter, but the second time, oh you can bet this man was arrested, esp. after that judge told me I could not speak with my daughter about the abuse, so I never was able to talk to my daughter about people like him, or maybe it would have never happened & they all knew it! So they wasted no time taking this case to court, funny part about this case, this man did not have the money to pay an expensive attorney to represent him, how ironic! Ok, back to the story, sorry just a long painful experience & I tend to wonder off a bit while discussing it, so now Im stuck in a situation with her, do I let her continue to suffer inside, which is what I feel is happening or do I force her to go back? Also, its very hard to find a good therapist in this area that will accept our insurance. I sometimes wish I would have never stopped, we did wean down before stopping completely, so I do feel we did go about it the right way, maybe it was just too soon to stop going altogether? I’m just baffled as to what to do & I dont have the money for gas to drive an hour or two away nor do we have the time while she’s in school. Oh Boy…what have I done? Any advice would be greatly appreciated. :)
    I also wanted to tell Crystal that if your feeling upset just thinking about not going to therapy anymore then I would wait until those feelings are gone before I even thought about stopping, don’t let people influence you, you do what you feel is right for you. I suffer from some of the same problems like depression & anorexia, but no bi-polar & they are serious issues, I would hate to see you slip back into those bad patterns again, esp. w/ the anorexia, I know it’s hard to snap back again once you start not eating again(just from my own experiences). I just think you should feel good & confident that you will be fine w/ not going to your therapist, if not then I dont think it’s time to stop. Just my feelings, I hope that helps & yes sometimes it is a lifetime thing, if it helps then do whats best for you, not what other people think is best or what others are doing…some can stop w/ no problem, others cant, I wish now I would have not stopped going with my daughter last year, maybe it was too soon?

  • claire notwicz

    HELP I need to get my last name off the comments section. I am new to using the computer and didn’t realize I should only have used my first name. Any help would be appreciated as unfortunately mental illness still carries a stigma. I cannot afford to jeopardize my job status. If you need me to answer any questions regarding this please write back. I have tried the phone number but don’t get a response.
    If it could just say Claire that would be great.

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