By Arielle Cohen, Programs Manager

In recent articles, Families for Depression Awareness addressed the initial steps you and your loved one can take to find a therapist and navigating difficult conversations with a therapist. While it’s challenging to begin seeing a therapist, it can feel even more overwhelming when it’s time to end the therapeutic relationship.

Based on common experience, it’s likely that the first therapist you see will not be the “right” therapist for you. Because a foundation of trust and connection with the therapist is essential to encourage open and honest communication toward recovery, we urge you to listen to yourself and your loved one and take action if the therapist is not the right fit.

Although it may feel daunting and nerve-wracking, our 5 manageable steps can reduce the stress of telling a therapist you won’t be working with them any longer.

 

Step 1: Identify the reason(s) for wanting to end the therapeutic relationship.

For you: If something feels off, take time to identify what aspects of your relationship with the therapist are not working. If you notice particular issues or concerns, you can use this to inform what you’d like in a future provider.

For example, a common reason many people don’t connect with their therapist is that the person reminds them too much of a parental figure. If you had a strained relationship with your mom and the therapist reminded you of her, it’s going to be hard to connect and feel safe with the provider. In the future, the you may choose a therapist that doesn’t identify with the same gender, age, or upbringing as your mother.

For your loved one: Listen when your loved one says they dread going to therapy or raises concerns about the therapist. Make sure you don’t dismiss the person’s concerns by saying things like “give it more time” or “therapy can be hard, stick with it.” While it’s true that therapy can take time to build trust and rapport, your loved one’s concerns are valid and deserve attention.

Instead, ask questions to see if there may be a resolvable issue or if it’s time for your loved one to consider seeing a new therapist. Try questions like

  • Can you identify the particular reasons why the therapist doesn’t work for you?
  • How long have you been feeling this way?
  • If the issue was resolved, would you feel comfortable continuing to see your therapist?
  • Do you think you could talk to the therapist directly about these concerns?
  • Are you open to trying to meet with a different therapist?
Step 2: Consider the status of wellness and plan for the bigger picture.

For you: Are you leaving your therapist because you’re doing fine with coping with your stress and maintaining wellness? If yes. then it’s likely that you can end your relationship to your current therapist without finding a new provider.

However, just because you don’t want to see this particular therapist doesn’t mean you’re ready to step away from therapy completely. Consider using our Depression Wellness Analyzer to assess changes in symptoms and level of wellness.  If you’re still having difficulty managing stress or experiencing symptoms that interfere with the quality of your life, we suggest that you find a new provider.

For your loved one: Your loved one could be ending therapy because they are sustaining their wellness. Therapy may have served its purpose, which could be apparent by your loved one’s well-managed symptoms, coping mechanisms to handle the stress of life, and positively-changed mood.

However, your loved one may be ending a therapeutic relationship at a time when they could use additional support. Consider this example:

Your loved one living with bipolar disorder is experiencing a manic episode and they are making decisions that are out of character. If the person loved their therapist for years and suddenly cut ties, observe if your loved one may be experiencing other apparent signs of mania like, but not limited to, increased energy, decreased need for sleep, racing thoughts, or being impulsive. In this example, a caregiver could call the provider to report the additional observed symptoms and consult for the best steps the caregiver can take.

If your loved one decides to move forward with ending the relationship, suggest that they make an appointment with a new provider before ending with the current provider. If your loved one is open to seeing a new provider, ask if and how they would like your support. If the answer is, we suggest taking a break from the conversation, continue to observe your loved one’s level of wellness, and revisit the conversation at a later time.

Step 3: Decide how you will communicate.

Even though passively ending the relationship by “forgetting” or “putting off” scheduling appointments might feel like an easier way to go, there’s value in talking directly with your therapist and gaining closure. Learning how to say goodbye, especially in the context of a safe therapeutic relationship, can help to build tolerance and resilience for ending other relationships when necessary. 

For you: While talking in person might seem like the best route to go, it can also feel like the hardest. Many of us utilize telehealth services and do not have the option to meet in person. It’s appropriate to have the ending conversation with your therapist via email, phone call, or telehealth platform, or make an appointment in-person. Choose the communication platform that feels safest and most effective to you. 

For your loved one: Talk with your loved one about the different available methods of communication. Help the person determine which option, email, phone call, telehealth platform, or in-person meeting, feels the most appropriate, effective, and safe.

Caregivers can also

  • Help your loved one practice the conversation and different ways it might go
  • Sit with your loved one during the conversation with their therapist
  • Use your typing skills as your loved one states what they want to say
  • Proofread their email and provide constructive, supportive feedback
Step 4: Communicate the decision.

The advice is the same for you and your loved one: Commit to taking action and communicate your decision to stop your sessions with the therapist!

Nerves may kick up, but remember that it is a therapist’s job to hear feedback and respond in a safe manner. Therapists have faced rejection and are trained how to thoughtfully and professionally “terminate” the patient-provider relationship or end a contract with a client. They may be sad to lose you as a client, but ultimately, they want the best for you.

On the hopefully rare occasion the therapist responds inappropriately, remove yourself or your loved one from the conversation immediately. Report the incident to the appropriate licensing body based on your provider’s licensure. If you are not sure how to report misconduct, call 211 for referrals.

Step 5: Reflect and follow through all the way.

For you: You’ve done it! It may have seemed overwhelming at the start, but you accomplished your goal. We’re proud of you for recognizing a need and taking the steps for change. After taking time to savor this positive change, it’s time to follow through with seeing your new therapist (as needed) and maintaining your wellness by practicing good self-care.

For your loved one: Your loved one’s done it! You can reinforce this positive change by expressing how proud you are of your loved one. Help your loved one savor the feeling of accomplishing a difficult goal and ask how you can help them follow through on their next steps.

You and your loved one deserve quality care from a provider you trust. Commit to finding a therapist that supports healing and your unique road to recovery.


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