All good things must end, including a successful course of psychotherapy. But how does one know when enough is enough?
Certainly there are psychotherapies that naturally end after one or only a few sessions. Sometimes the presenting problems are so uncomplicated, current, and situational that a quick fix is found, and that is that. Some contacts end quickly because a referral elsewhere is warranted. There are other various reasons for one or a few contacts, but one in particular should be mentioned: Perhaps the patient/therapist match isn't a comfortable one. It is important that therapist and patient can be optimistic about establishing a productive relationship.
For those who stay for longer treatments, whether the length be short-term or long-term, the decision about when to terminate psychotherapy can become less than clear. This potential lack of clarity makes the problem interesting for patient and psychologist to consider.
A typical way to approach the problem is for patient and psychologist periodically to discuss the patient's progress. This discussion between my patients and me often takes the form of looking at how the patient is reaching her/his goals. From the start, a person usually begins psychotherapy with some hoped for outcomes. We then work together to translate these outcomes into goals that can be explicitly brought up and assessed to see how well we are moving toward them. For example, goals may be as general as decreasing anxiety , lessening depression , or improving a relationship . Goals can also be more specific like expressing more affection in a marriage or getting a promotion.
As sessions continue, the goals may remain the same but also may be further refined or changed completely as issues become clearer or different. However they may evolve, the goals can be used as markers to determine when therapy ends, most likely when the the goals themselves stop transforming and when the aims of their last iterations are reached or at least satisfactorily approached.
I myself have a particular goal in mind that almost always signals that it is time for a person's therapy to come to an end. That signal comes when the patient expresses confidence about his/her ability to cope successfully with current life circumstances and with whatever lies ahead as well.
Whatever the criteria that may be used for decision making, a collaborative approach to termination is to be desired (Goode et al., 2017). Then, patient and therapist can end the psychotherapy, as hopefully they have been from the start, as therapy partners . They can bid each other a cordial goodbye with best wishes all around.
Goode, J., Park, J., Parkin, S., Tompkins, K. A., & Swift, J. K. (2017). A collaborative approach to therapy termination. Psychotherapy, 54, 10-14. http://dx.doi.org/10.1037/pst0