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Best Practices for Ending it with Therapist
July 14, 2012 9:52 PM   Subscribe

Terminating with psychotherapist after six sessions: I think I should. But, I wonder how to do it properly? How much of an explanation do I owe the therapist?

I'm not even sure I've given this therapist a fair shot. I had two goals (two issues I hoped to unscramble) upon walking in; one of these goals was fairly straightforward but the therapist and I have hardly mentioned it. The other goal was more vague.

So, I have goals.

It seems we've spent our time so far addressing kind of background-y, superficial things, like how was my childhood and with whom do I live, how's work, and that sort of thing. And, to that end, I've been increasingly put off by my therapist's apparently narrow, disapproving viewpoint up to where, at our last session, I was actively trying to keep my defensiveness in check. (And, I'm not a defensive person, gosh darn it!)

Our sessions thus far have made me not want to open up about the "straightforward" goal. I don't trust her. I think it'd be a waste of time and the sensitive parts of my soul would feel vulnerable! But, if I were to decide to spill the beans to her and her reaction was unkind, I'm sure I'd get over it.

Actual examples of the therapist in action might help, OK, but if I rattled off a few examples from the most recent session, they would individually sound not-so-bad. Taken together, it just seems like too much. Like we have bad chemistry(?) Examples: she has mentioned more than once that I am financially dependent on my partner, which isn't true. I'm not financially dependent on my partner and I would not leave my partner if suddenly I had a gazillion dollars. It's as if she doesn't believe it. Speaking of dollars, I mentioned that the one downside to my job is the hours. Not the number of hours per week but the fact that I prefer to work in the morning and I am currently busy with work in the evenings to late-night. It's not a huge deal to me, and I'm otherwise quite happy with work, but when I told her that having the AM as my downtime feels like my job saps my entire day, she said, "Well, that's what work is!" as if it's my first job or something. I mean, I've had full time employment for almost 20 years. I'm not a newb. I have a few more examples- she made a bold statement about one of my friends based on a single anecdote- it seemed reckless to toss out a diagnosis-type-thing like that. Etc. Etc. She comes off as judgmental to me, but I give her the benefit of the doubt, we just don't jibe.

At every session she has given me at least one helpful insight or tool, so I held out hope, until our latest meeting, where I left there thinking, "What the crap was THAT?!"

Now, I would think I could just tell her what's on my mind, right? Tell her I'm not so comfortable with the way things are going, and that I think I might benefit more from some other therapist. Right? What do you think?

She has decades of counselling experience. I have had one good and one not-so-hot experience in therapy previously, and I've been told I'm a good patient.

I know I could just walk away, but I want to do this right. When does one know when it is time to move on? What (specifically) do I tell this woman? My first impression of her was great. She is possibly great, just not for me.
posted by little_dog_laughing to Human Relations (17 answers total) 2 users marked this as a favorite
 
"It's not possible for me to keep seeing you. Thank you for your time."

Why would you want to add more? It sounds like she has a listening problem. That's her problem. Your feedback on this issue will not change her.

Move on.


PS. When you try therapy again, try stating your goals up front, and be very very specific. My understanding a few years ago is that there is a "new-ish" flavor of therapy where the therapist only addresses what you want to address. The example I was given when this was discussed (no kidding!) was if a professional escort came in wanting help with how to better handle clients, then no judgements about the profession, just therapy to help the client do their job better with their clients.

You want this type of therapist. I don't know if it has a name, but i do know this is available.

Good luck.
posted by jbenben at 10:07 PM on July 14, 2012 [3 favorites]


It seems to me like this relationship between yourself and the therapist is not necessarily a healthy one or one that fosters personal growth. You became defensive at times, avoided sharing certain information, and as you stated "she is possibly great, just not for me."

Patients have different needs. While this therapist might be great with others, you need to move on and find another therapist that you can get along with.

The reasons that you've shared make sense, but the reality is that you don't need to share any of these reasons with your therapist.

Simply tell her "Thank you for your time, but I have decided to seek therapy elsewhere." Make sure that you pay the therapist for the final session and then start seeking therapy elsewhere. Good luck!
posted by livinglearning at 10:08 PM on July 14, 2012


little_dog_laughing: "How much of an explanation do I owe the therapist?"

You owe your therapist financial compensation and nothing else. Pay your bill and take your leave.
posted by chairface at 10:21 PM on July 14, 2012 [10 favorites]


Pay your bill and leave - it's a service, like anything else. If your needs are not being met, you go elsewhere.
posted by heyjude at 10:37 PM on July 14, 2012


Six sessions is plenty to know if you're clicking with your therapist. You say you don't trust her enough to share one of your two therapy goals. Not a good sign. Just don't go back. If you have your next session booked, cancel it. Done.
posted by ThatCanadianGirl at 10:53 PM on July 14, 2012 [1 favorite]


I personally feel that you've given her three extra chances already. Three sessions is enough to see if she's working with you on your issues. I would send a note with whatever balance you already owe and go.
posted by halfbuckaroo at 11:01 PM on July 14, 2012 [1 favorite]


Just don't reschedule another appointment.
posted by KogeLiz at 11:10 PM on July 14, 2012 [1 favorite]


Progress in the first 5 sessions tends to predict longer-term progress. I.e. if it isn't clicking now, it probably won't suddenly improve.
http://www.goodtherapy.org/blog/symptom-change-cbt-willingness-0710121
(Not sure that is the same study I originally read about that result in - a more interesting study would be seeing if that is patient or therapist determined, eg if a different therapist would be more effective, which this does not show).

Further, regarding her experience as a therapist, that can be a disadvantage, e.g.
"More experienced therapists reported higher alliances and more progress but their patients did not agree." http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2012-17516-001


I would cancel any future appointment, and find a new therapist. A good match in only 1 out of 3 therapists is not unusual. I had... oh, 5 crap/completely-ineffective therapists in a row at one point?
Followed by several good therapists, so, it's often the luck of the draw, not you.
posted by Elysum at 11:51 PM on July 14, 2012 [2 favorites]


Yeah, just tell her your terminating, and that's all. It's fine to do this on a phone message and not see her again.
posted by OmieWise at 4:40 AM on July 15, 2012


Don't schedule another appointment. If you've already scheduled another appointment, call as soon as possible and say, "Thank you for your time; I will not be seeing you in the future."

Don't pick up/respond if/when she calls back.

The advantage with therapists is that they never, NEVER answer their phones. It always goes to voicemail. So have your script ready, give it, and move on with your life.
posted by arnicae at 6:56 AM on July 15, 2012


Therapy is a relationship and yours seems to not be working. Before you just break it off and try elsewhere, though, you need to overcome some of your own ideas which are contributing to the problem.

You say
I've been increasingly put off by my therapist's apparently narrow, disapproving viewpoint up to where, at our last session, I was actively trying to keep my defensiveness in check.

Don't keep it in check. And it's not defensiveness to disagree/dislike something someone says. You owe yourself (and perhaps your therapist) the truth and the experience of expressing it. She angers you and you need to learn to take your anger seriously. Therapy isn't about submission. Nor is it about politeness. I understand it can feel uncomfortable or unsafe, but you're ready to leave anyway, so what's there to lose?

I'm not financially dependent on my partner . . . It's as if she doesn't believe it.

She's not there to tell you things as an authority which you must accept because she's the therapist. In this case, you need to say what you told us. Including the part of feeling she ignores/doesn't believe you.

Our sessions thus far have made me not want to open up . . .

You need to open up at least to tell her this. Or, if that's too scary, just to tell her you don't feel safe with her. Or as much of this as you're willing to risk. Being passive with an expert is the wrong position to take in therapy. You don't want to open up because (tell her!) she won't believe you, understand you, will judge you, what ever it is you feel. Yeah, talking this way to a relative stranger is weird, but that's why it's therapy. Trying to pretend to be "normal" is what's inappropriate for therapy--it would be like going to the doctor and denying you have any disease.

She comes off as judgmental to me, but I give her the benefit of the doubt, we just don't jibe.

Don't! It's not a benefit, first of all, and if you're ready to leave, you're giving her nothing of the sort.

I left there thinking, "What the crap was THAT?!"

Never do that! (Say it. It's not the benefit of the doubt to keep this a secret.

You don't say what your goals are but I'm willing to bet changing how you speak to your therapist will further them even if you end up deciding she's not for you.
posted by Obscure Reference at 7:09 AM on July 15, 2012 [3 favorites]


You know, finding a therapist you can work with is a little like blind dating. When it all comes together it's great, but some combinations of people just do not work out. All you have to say is "this does not feel like a good match to me, but thank you for your time."
posted by DarlingBri at 9:11 AM on July 15, 2012


You've done your part. The Patient/Therapist relationship is like any other relationship, it takes a while to see if it's good, and if it isn't you need to move on.

As others have said, pay the bill and don't schedule another appointment.

If for some weird reason your shrink calls to discuss (I doubt seriously that she'll do that,) just say, "I'd like to work with someone else." Then hang up. That's it.
posted by Ruthless Bunny at 10:46 AM on July 15, 2012


No explanation required. Politely decline to return.
posted by ead at 11:51 AM on July 15, 2012


Obscure Reference is the rightest.
posted by DMelanogaster at 12:47 PM on July 15, 2012


A good rapport is crucial for therapy; you have to feel comfortable opening up and being completely honest with someone to delve deep into yourself with them.

It sounds like you're already guarded and wary around this person, and closing off more as time goes on - with good reason, I might add. I've ended things with particular therapists for similar reasons, and it was the right decision every time.

I would simply thank her for her time, and say that I felt we weren't a good fit so I would not be returning.
posted by Someone Else's Story at 1:14 PM on July 15, 2012


Also, agreed - ending a relationship with a therapist is not the time to pull out the "That won't be possible" Miss Manners etiquette card.
By which I mean, passively avoiding the conversation isn't a necessary when a therapist isn't working out, and won't improve your future relationships with therapists.

The point where you use the "That won't be possible"/no explanation required etc in social situations, is when you need to disengage, and are afraid the other party is going to keep trying to fuel drama, and will not keep a good faith effort to maintain good relations.
If it is not that situation, it is really healthy to talk with someone about how a particular relationship didn't work out for you, in the context of trying to improve the progression of future relationships.
posted by Elysum at 1:38 PM on July 15, 2012 [1 favorite]


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