My last entry addressed the question of how to decide to end therapy either when goals are being met or when there is a general lack of progress.  This second article on ending therapy looks at issues related to the process of therapy itself and the relationship between the therapist and client.

The first issue addressed is what to do when you are feeling uncomfortable, frustrated, or in emotional pain.  Does the discomfort mean therapy is working and the pain is part of getting better, or does it mean something is not right and you should quit?   This is an amazingly difficult issue for a lot of people, especially early on in therapy when they’re not sure if they’re in the right place. Therapy causes people to feel incredibly vulnerable, and when one is just starting out it’s common to feel like the therapist doesn’t understand them or doesn’t do good work. How do you know if that gut feeling is right, or if it’s just the intensified vulnerability telling you that counseling is scary?  There’s no easy answer to the question.  It’s the main reason that people are told to “shop around” for a therapist before making a commitment. If you shop around then you can go with the therapist that feels most comfortable. But while it’s important to feel comfortable with your therapist, being comfortable doesn’t mean that the therapist is going to help.  I always go back to goal setting, collaboration, and mutual evaluation of how things are going.  If you’ve got a therapist that you feel comfortable with and that does sets and evaluates goals collaboratively then you’re probably in a good place.  Then, when things get uncomfortable in the middle of therapy, as is discussed in the article, it’s easier to talk about what’s going on and whether the discomfort means that you’re getting into important work or that it’s time to take a break.

The second issue addressed is about ending therapy when the therapist is engaging in unethical behavior.  It may seem obvious that when the therapist is attempting a personal or sexual involvement it’s time to find a new therapist. It’s not always so black and white though. There’s a lot of debate about whether therapists should talk about their own personal issues in therapy.  A lot of people will tell you that personal disclosures should never happen, but I’m not so sure.  I think personal disclosures can normalize problems and solutions for the client, and should be used if they will be helpful.  Gift giving and meeting outside of session should be completely off the table, though, and any time that the therapist’s personal disclosures feel even a little questionable, or if you feel like they want you to counsel them, it’s time to say goodbye.

I recommend reading the article, as it gives other types of examples and suggestions about what to do when you’re unsure about the relationship or progress of therapy.  Bottom line if you’re unclear is go and talk to someone impartial.  Find another therapist, a friend, or a professional association and see what they think about it.  http://www.psychologytoday.com/blog/the-ethical-therapist/201106/two-more-good-reasons-end-psychotherapy