Without a doubt, the decision to seek therapy can be difficult. In an ideal scenario, we choose a therapist we are interested in working with, begin therapy, make therapeutic gains, and ultimately decide to discontinue therapy.
A question that is often asked by patients as they approach termination is
“What now?”
Perhaps the most important thing to consider is that therapy does not last forever. In fact, it is not supposed to. At some point, you will need to take what you have learned in therapy and apply this knowledge to everyday life situations.
When should therapy come to and end?
Since termination is a sensitive topic to discuss, it is imperative to feel comfortable with the therapist you are working with. Being comfortable with your therapist will allow you to be more likely to provide honest feedback regarding the therapeutic process. By doing so, you will have more autonomy in the sessions and your therapeutic gains will likely be greater.
Honesty
really is the best policy in a therapy setting. If for any reason you find your therapist’s approach unhelpful, do not hesitate to provide feedback. It is not helpful to keep these thoughts to yourself, as they may negatively impact your commitment to and progress in therapy.
In order to measure therapeutic gains, some therapists use outcome measures such as The Therapy Assessment Form or The End of Therapy Form. These measures were developed to assess therapeutic progress and also to determine when a client may be ready to discontinue treatment (Evans et al., 2003). The use of these measurements may also help patients to quantify their progress before making the decision to discontinue treatment.
How to differentiate “lapses” and “relapses”
During the course of treatment, your therapist will likely help you to identify specific triggers and maladaptive patterns of behaviour. It is helpful to recognize that we all have good and bad days. Having a “bad day” does not automatically mean you have relapsed or negated the progress that you have made.. On the contrary, having the ability to differentiate between a “lapse” and a “relapse” will help you maintain the progress you made in therapy.
A “lapse” can be defined as a momentary return to problematic behaviours, which may last for a short period of time. On the contrary, a “relapse” can be defined as a complete return to problematic behaviours, with an increased inability to control one’s actions.
For example, if you are someone who experiences social withdrawal as a symptom of depression, you may want to observe how long you go without communicating with loved ones when you are feeling low. If you notice that you take a day to yourself and return to your normal interactions shortly thereafter, you may consider this a “lapse”. When this happens, it is encouraged to practice self-compassion and to remind yourself that we all need alone time occasionally. However, if you notice that your withdrawal symptoms last for more than a couple of days and you find yourself actively distancing from others, you may consider this a “relapse”. In these situations, it is encouraged to discuss this with your therapist to determine treatment approaches and techniques to help you through this.
What happens after therapy?
Therapeutic success is highly correlated with involvement and accountability. When you make the decision to seek therapy, you must be aware of the commitment it requires. It is important to attend all scheduled appointments, complete therapeutic exercises, and track your own progress.
Throughout the course of therapy, you will gain tools and resources that you can use throughout your life. It is encouraged that you keep these resources available for future use, even after your treatment is discontinued. One way to be proactive is to develop your own toolkit with the resources you receive in the course of treatment. Having your very own toolkit may promote self-sufficiency and help you to adequately deal with difficult situations.
Written By: Angela D’Unian, M.Psy, R.P.
Edited/Reviewed by: Chantal Legere, M. Psy. and Dr. Stacy Lekkos, C. Psych
References
Evans, C., Connell, J., Barkham, M., Marshall, C., & Mellor-Clark, J. (2003). Practice-Based Evidence: benchmarking NHS primary care counselling services at national and local levels. Clinical Psychology & Psychotherapy, 10, 374–388.
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