When You Don't Know Where to Turn / A Self-Diagnosing Guide to Counseling and Therapy

by Steven J. Bartlett

Theoretically, psychotherapy is never-ending, since emotional growth can go on as long as one lives.
Lewis R. Wolberg,
The Technique of Psychotherapy

It can be difficult to know when to terminate therapy: difficult for you, the client, and sometimes also difficult for the therapist. Some periods in therapy do not lead to a successful outcome. You may become dissatisfied with the process of therapy or with the therapist. Or, the therapist may become disappointed in your willingness to work and to change. An impasse may be reached where it seems no progress can be made. When this happens, it can be hard to know when to draw a line, to say: "We've tried, but we have to face the fact that we're not getting anywhere." But sometimes this has to be said, and then you may decide to look elsewhere for help.

On the other hand, when your therapy has been successful and has led to clear, constructive results, it may also be difficult to know when to stop. To most clients, what tends to be most important is relief from symptoms. When this is achieved, you may be tempted to terminate. But relief from troubling symptoms is not always a sign that problems have been resolved. Frequently, relief from distress comes about because of problem avoidance. You may have structured your life in a way that circumvents, rather than faces, the things that trouble you. There are times when this is indeed the best solution. However, the tendency is for clients to associate relief with effective therapy, and often this is not the case.

The therapist, on the other hand, may have certain personal values that he wishes to satisfy before ending therapy with you: he may favor, for example, qualities of assertiveness and ambitiousness (or qualities of submissiveness and compliance), want you to develop these traits, and feel reluctant to end therapy until you have done this.

In general, the decision to terminate therapy should be made with a number of objectives in mind:

* Have your troubling symptoms disappeared or at least been reduced to a level that is tolerable?

* Have you improved your understanding of yourself so that you feel a healthy measure of self-acceptance?

* Do you now have a greater tolerance to frustration?

* Have you developed realistic life goals?

* Are you able to function relatively well in social groups?