"Why doesn’t my therapist want to see me anymore - what have I done wrong?" and "I want to end therapy, but my therapist says I can’t stop." These are two of the many questions clients have asked the Get help with counselling concerns service in relation to the ending of their therapy. 

Ending therapy, whether it’s planned or unplanned, or a decision made by a client or their therapist, is a recurring theme within the Get Help service. No matter how the ending came about, there’s no doubt that endings are an extremely important part of the therapeutic process, and a poor ending can have a profoundly negative impact on a client.

We’d say that wherever possible, the ending shouldn’t come as a surprise and therapists should be aware that endings can be difficult. They would usually start talking about the end of therapy several sessions before it’s due. With short-term therapy the ending will often be discussed at the very beginning, with a planned beginning, middle and ending explained in the first session.

Discussing the end of therapy early on means that clients have time to get used to the idea, and that any anxieties or new problems that come up can potentially be dealt with in the remaining sessions.

 

Although it’s good practice to discuss endings together, unfortunately sometimes this isn’t always possible. Some of the reasons a therapist may be unable to provide ongoing care could be due to retirement, illness, a fitness to practise concern, changing work patterns, funding or working within their competence.

 

I would say that a large number of the concerns we receive relate to an abrupt ending by a therapist, often leaving clients feeling traumatised. In these cases, clients have sometimes compared their feelings to those of grief. Clients can feel let down and even blame themselves, wondering if it was something they’ve done wrong. Trust can be broken and they can worry that this may happen again with another therapist, which can put them off looking for a new one. It can often take some time to come to terms with a poor ending.

Although therapists don’t have a duty to treat clients indefinitely and they don’t need their client’s permission to end sessions, they do have an ethical obligation to keep their client’s best interests in mind. It’s important that clients are informed about an ending as early as possible, and that any ongoing therapeutic needs are sufficiently met if their therapist decides to, or has to, end the relationship prematurely. Often therapists will help to make alternative arrangements to ensure their clients’ needs will be taken care of and clients won’t feel abandoned should they, for whatever reason, be unable to work with them.

In the event of an unplanned ending, if the therapist has worked in an ethical way throughout the therapy and made contingency plans for this kind of event, the impact of the sudden ending will be minimised for both parties.

However, it’s not only therapists who end therapy - sometimes clients also decide to stop attending therapy. This might happen if they feel they no longer need therapy, or they’re no longer finding it useful, or perhaps they don't feel emotionally strong enough to continue at that time. Maybe they feel that the therapist isn’t the right one for them, or other life events or circumstances may get in the way of them attending. Avoiding an ending might even be the client repeating a life pattern of avoidance, so sometimes it may be appropriate for their therapist to challenge their behaviour. However, at the same time, it’s important for a therapist to be respectful of their client’s decision to leave therapy, and clients shouldn’t feel they have to stay in therapy against their wishes. They have the right to decide when to stop as well as the right to look for another therapist at any time.

We’ve published a client information sheet specifically about endings, where we've discussed this important subject in more detail.

See Ending therapy (pdf 0.1MB)

The confidential Get help with counselling concerns service is available Monday to Thursday, 9.30am to 4pm, by phone and email.

Call us on 01455 883300 option 2, 07811 762114, 07811 762256 or email us at gethelp@bacp.co.uk

Please note on the 2nd 3rd 9th and 10th November due to staff availability we won't be able to respond on those days.

Anything you say will be confidential and you can speak with us anonymously if you prefer. Due to the number of enquiries we receive, we do try to limit the calls to a maximum of 30 minutes, where possible.

Sarah and Kathleen

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