How Much Therapy Is Enough?

By Daniel A. Plotkin, MD, M.P.H.

The ending phase of psychotherapy is an important part of the overall therapeutic experience, and the decision to end ideally is made by you and your therapist. There is no one right time to end therapy, and no precise marker for how much therapy is enough. The decision is a personal one, and is often influenced by several factors, such as whether you have improved and your therapy goals have been met. Sometimes the individual and the therapist agree that it is time to end therapy and sometimes they have different opinions. In either case, it is a good idea to discuss the issue thoroughly prior to making a final decision.

Sometimes, factors outside of the usual considerations will influence the decision to end therapy. For example, financial considerations may play a role in the decision. This may be the case if you are part of a managed care plan, in a clinic setting or in a research study. Even most indemnity insurance plans have limited benefits (for example, 20 visits annually). Sometimes practical considerations apply, such as when the individual or the therapist move away to a different geographic area.

The Ending Phase of Therapy

Ideally, the actual ending date (the last session) should be far enough into the future so as to allow time to discuss and “process” the ending phase. While there is no one right amount of time to allow for this, it usually involves weeks to months. It is natural to find that feelings of separation, loss and mourning are evoked during this time of saying goodbye, and such feelings should be expressed and understood in terms of the personal meaning for you.

Indeed, in psychodynamic or interpersonal therapies, the ending of therapy is known to be a time for further exploration and emotional growth. Some of the most important insights of therapy may be gained during this period. In cognitive-behavioral psychotherapies, the process of termination is a good time to focus on helping the patient consolidate gains and build confidence for the future. As in the other phases of therapy, the therapist will likely combine elements of the various types of therapy in order to best help the individual.

After Therapy Has Ended

People often have thoughts and feelings about whether some kind of relationship will continue with the therapist. While there are many different ways to manage this, it is not uncommon to allow for some kind of limited contact (such as occasional telephone calls) to occur between the individual and therapist after the formal therapy has ended.


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