Have you ever needed to fire someone? It’s not a great feeling, even if you’re unhappy with the person’s performance. It is why I think so many of us do the “letting go” poorly. I want to take a few moments to share how to fire your therapist well. It starts earlier than you think.
How to Set Yourself Up for a Successful Ending
Therapy should not be forever, right? Most of us seek therapy when we are at a crisis point in our lives. It may be a failing relationship, a series of difficult circumstances, or a mental health diagnosis like depression or anxiety. Although a few cases will require regular therapeutic care over the course of multiple years, most clients enter therapy only for a few weeks or months. Knowing that the arrangement is short term helps us plan for the ending. Although it is impossible to predict how many sessions a client will need, we still know that the need will eventually come to an end.
The best way to have a great ending is to start with a thorough and open beginning. I like to have a conversation during the “informed consent” review about how we will end when the time comes. I’ll include a paraphrase of that conversation later in today’s blog. When I frontload the beginning of therapy with an idea of how it will end, it reassures both the new client and me as the therapist. When a client is tempted to quit therapy at an inopportune time, I can remind him that we talked about how we would end. I can also affirm for the client that I want to see him succeed by completing therapy or helping him find a better resource.
Therapy as a Relationship
Therapists all have different approaches and theoretical orientations, but most believe that the therapeutic relationship is invaluable. That means that I believe that my clients get just as much out of being in the client-therapist relationship with me as they do from any of the techniques and interventions I might use.
Because therapy works best as a relationship, I like to use relationship terminology to explain the dynamics of ending therapy. I explain that no one likes to get “dumped” or “ghosted.” Most people smile when I say this, because they are surprised that I’m talking about therapy this way. But they understand what it feels like to be dropped by someone significant in their life. While I am in no way saying that there should ever be a romantic component to therapy, it is an intimate relationship in the sense that you share things that you might not share with anyone else.
It helps both the client and the therapist to do good work if they know the other cares about them as a person. I want to know if a client does not like the work we are doing, or if she is thinking something else (or someone else) would be more helpful. I also want my client to know that if I find myself unable to do the work, I will make arrangements so that she continues to get care. Transparency is important at the beginning, middle, and end of therapy.
A Quick Paraphrase of My Termination Agreement
The last section of my informed consent document contains some language about how therapy should end. But rather than reading it word-for-word, I use the discussion as an opportunity to make an agreement with my client. Here is roughly what I say:
“Therapy works best as a relationship. You will grow and change the most if we can trust each other. We will come to know some things about each other. Although it is a relationship, it is unlike any other relationship in that you want this one to end sooner rather than later. You don’t want to pay me to sit on my couch forever and ever. Since we know it will end, it’s important to talk about how it will end. Nobody likes to get dumped or ghosted.”
“So if you come to think that you have gotten all you needed from therapy, or you aren’t getting what you need, or you think I’m not the therapist for you, I want you to have a conversation with me. It can be as simple as this. ‘Hey Ann, I think this is going to be my last session.’ I will go over the progress you have made and help you plan next steps or find other resources that might be helpful.”
“In the same way, if I become aware of a reason why I can’t serve you anymore–like I found out that we’re neighbors, or your case is out of my expertise, or our schedules don’t line up–I will give you a couple of sessions to process the relationship coming to a close and help you transition to another therapist if that is what you want. That way neither of us feels dumped and we can have good closure on the relationship. Does that sound like something you can agree to?”
Most of the time I get really positive feedback from this conversation. People like to know that out of all their relationships, at least this one will have both boundaries and a chance at success. They feel respected and they know that I also want that kind of respect.
Now, does it always end this way? Of course not. People get busy and forget to schedule, or other circumstances occur and therapy ends abruptly. However, in certain cases, having this discussion at the beginning allows me to press forward when therapy gets difficult and clients are tempted to drop out without talking through it.
So How Do I Fire My Therapist?
I included the brief transcript of my conversation because I believe my readers are mostly therapists and therapy clients. Whether you are a therapist or a client, you can adapt my transcript in the context of your therapy.
Therapists who have not had any conversations about termination: it is not too late. If your relationships with clients are generally easy, you can have a casual conversation about this at any time. If your clients are more likely to panic when you bring up termination, you might present it as a periodic updating of paperwork. Let your clients know how much you value the work you do together, and that you want to make sure they are getting everything they need. They will appreciate knowing how to talk to you about it.
If you are a therapy client, you can feel free to ask your therapist questions about how she approaches termination. You can explore how your therapist feels about you bringing up areas where you are not getting what you need. Many skilled therapists will be able to pivot and offer you a different approach if something isn’t working for you. If nothing else, you can use some lines from my transcript. “Hey Rebecca, I think this week will be my last session. I wondered if you would go over what you see as my progress during the time that I’ve worked with you. I’m curious what you would suggest for next steps.”
Termination as Growth
If you started reading this hoping to encounter a dramatic scene (“You’re fired!”), I’m afraid I’m offering you something much more gentle and, well, therapeutic. I believe that even through the termination process, we can grow and learn about good endings, respect, and boundaries. It’s actually part of the therapy!
My encouragement to you as a therapy client is this: don’t ghost your therapist. Don’t send a break-up text. Therapists are people with feelings and will wonder what they did wrong. But more than that, use your therapy termination as a chance to grow. Ask for real feedback and be open to ideas for your continued progress. You’ve paid for sessions with this therapist, which means you care about your transformation. Don’t skip out on it before you’ve had your money’s worth. If you haven’t had a proper termination, you’re not done yet.
Therapists: have the discussions early and often. Let your clients know how to say goodbye to you when it’s time. Find out along the way if you’re being helpful. And don’t take it personally if they dump you.