Quitting the Couch: Five Reasons People Leave Therapy Prematurely

After being in therapy for several years and in a particularly low place, a friend of mine asked her therapist if he thought she should look into taking anti-depressants. “I would recommend it if I thought you were in a crisis,” he said, as part of his response. This sentence jumped out and stung my friend. She felt completely invisible. Hadn’t her therapist seen how much pain she was in? Did he think she was making a big deal out of nothing?

Upset, she confided in me that she was leaving therapy. She was mad at her therapist and felt like he clearly didn’t understand her. Besides, she said, she’d been going for a while now and her problems still weren’t solved! She was shelling out a lot of money, after all. So what was the point?

As I empathized, we started talking about the many steps she could take that would lead to a different conclusion. It’s an unexpected but solid rule of thumb that whenever the urge strikes to cancel therapy and not go back, that’s the time you could use therapy the most. The best response to that urge is to talk about it in that same office that you are trying to exit.

Although people leave therapy prematurely for a wide variety of reasons, the most common can be addressed in the following ways:

1. “My therapist ticked me off.”

Therapists are not all-powerful; they’re human beings. And like all human beings, they make mistakes. In addition, sometimes they misunderstand you, miss something that’s important to you, or just see an issue from a different perspective. And they are doing all that while in a deeply personal relationship with you. So if you’re in therapy for any length of time, it’s almost a guarantee that you will be mad at your therapist at some point.

Despite how it feels, that moment is actually a rich opportunity. Most of us have some difficulties around confrontation in our lives. Maybe we get carried away and yell, or maybe we bottle it up and sulk. Whatever we do, it’s probably not what we would consider “ideal.” When you’re mad at your therapist, you can try out a different behavior while expressing your anger in the Petri dish of the therapy office. If the therapist is worth his or her salt, he or she will hear you and help you process what’s happening for you so that you can move through the anger. He or she will not try to talk you out of it, or burst into tears like perhaps your mom does, or get angrier back at you like your dad. It will be a different experience from the norm, and satisfying because of it. He or she will honor what you’re feeling and look at how it informs your work in therapy as a whole. He or she may even use it to understand you better. The result can bring the two of you closer, making your subsequent therapy sessions more fruitful.

2. “I can’t afford it anymore.”

When our finances change for the worse, a first response is to scale back by eliminating “non-essentials” like gym memberships, eating out, and, unfortunately, therapy. However, if you’ve been downsized or your business is struggling, you may be experiencing increased levels of stress and anxiety, plummeting feelings of self-worth, increased feelings of shame, and even hopelessness. It is during bleak times like these that you can benefit most from the continued support of a caring therapist.

So what do you do if it’s just too pricey? Try explaining the situation to your therapist and find out if he or she will adjust the fee. Most therapists work on a sliding scale, meaning they move their fee up and down within a certain window based on what their clients can afford. The reasoning behind this practice is that the frequency and nature of therapeutic treatment should be based on what is in the best interest of the client, not what is in their wallet. Tell your therapist what you can afford, and the two of you will likely be able to negotiate a mutually agreeable fee.

3. “I don’t think it’s going anywhere.”

At social events over the years, I have overheard several variations on, “I don’t really know what I’m doing in therapy. I’m not sure it’s working.” If you haven’t yet made it clear, either to yourself or your therapist, what you want to get out of the work, your therapy may be stalled. Suggest formulating a treatment plan together that lists your goals in therapy as well as strategies toward achieving those goals. You may also want to establish a “check-in/check-out” procedure with your therapist. This would entail you stating in the first five minutes or so of the session what you would like to get out of the time that day. Then, in the last five minutes, you would review that intention and assess whether or not it was accomplished. If so, how? If not, why not?

Sometimes, though, a different situation arises. The urge to leave may strike precisely because you ARE about to get some serious work done. Denial is in some senses a healthy coping mechanism to protect you from issues that are too painful to look at if you’re not ready. Could it be that a painful realization is lurking around the corner? If you talk about the possibilities behind this uneasy desire to leave, your therapist could help you establish comfortable boundaries and pace the work into smaller steps so that you can feel safe again. That way, you can stay long enough to deal with that important, if frightening, issue you’ve been avoiding.

4. “Maybe I’m just not cut out for therapy.”

At the very beginning of therapy, people often encounter the case of it just not being a good “fit.” A mismatch happens as often in therapy as it does in dating, and it relates mostly to the intangible–the vibe between the two of you. It’s also possible that, on occasion, you have landed in the office of someone who simply is not a very good therapist.

The key at this point is not to give up therapy, but to do some comparison shopping. Try to get some personal referrals, or read as much as you can about each therapist. Many therapists offer free initial consultations, either on the phone or in person. Commit to trying out no less than three and then picking your favorite. Remember, you are the customer in this business relationship. You are picking the person with whom you are going to share the most intimate details about yourself, so it’s important that you feel comfortable with them. It’s okay to be choosy.

5. “I’m just going to call and cancel.”

There are many times when it is appropriate to leave therapy. Maybe the reason you came to therapy, like a phobia or a life adjustment, has been addressed and resolved. Or maybe the insight and awareness you have gained has empowered you to grapple with the struggles of life on your own. If you are leaving for reasons like these, your therapist will be an active and proud participant in your “graduation.”

A good practice is to honor this change with at least one termination session. It might be tempting to leave a voicemail or send an email letting your therapist know that you won’t be coming in any more. That way, you don’t have to face what you imagine will be an uncomfortable goodbye. But once again, if it’s hard to do, that’s a good sign as to where your growing edge is.

Many of us have difficulty with endings, particularly in relationships. Therapeutic termination is a perfect practice ground for fully experiencing a goodbye. The closure makes the experience as a whole richer and complete. During a termination session, therapists will often review with you what you felt you got out of therapy, how you have felt yourself grow, what if anything you are still working on for yourself, and what the two of you appreciated about each other. Even though your relationship with your therapist is a professional business arrangement, it is also be a deep personal connection where private and intimate moments have been shared. Termination highlights that connection and allows each of you space to reflect on all the therapy has meant.

My friend confronted her therapist with her feelings, and felt gratified not only by his genuine apology, but also by how seriously he took her experience and the earnestness with which he wanted to understand her better. She also left feeling empowered and proud of speaking up for herself. Perhaps most importantly, she realized that her confident demeanor often led her to feel distanced from others who didn’t understand her vulnerable side. She has since started practicing showing that vulnerability to loved ones, thereby building a stronger support system. And the therapy is now anything but stalled.

© Copyright 2009 by Kate Korsh, LMFT, therapist in Santa Monica, California. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

  • Leave a Comment
  • sara d.

    sara d.

    July 17th, 2009 at 8:19 AM

    Thank you Kate.. about every couple months I feel like quitting therapy and this list was very helpful for me. But, I’m still mad at my therapist for being so dang nice all the time! :)

  • Ginny


    July 17th, 2009 at 11:46 AM

    I am feeling some of these very things right now and have been debating about whether or not I should continue to go to my sessions. Sometimes they are great but then there are other times that it completely feels like a waste of time, like she does not even hear or understand what I am saying. And then there is always the money issue. It gets expensive going for an hour every few weeks, especially since I have no health insurance. There is a part of me that insists that this has to remain a priority for me, but there is another side that just encourages me to call and cancel my next appojtment to see if I can just get through everything on my own. There have become more times than not where this does not seem to be an expense that I can justify anymore.

  • VictoriaL.


    July 18th, 2009 at 8:51 AM

    Quitting therapy won’t solve anything. You can walk out of a dozen therapist’s offices. You can’t hide from yourself.

    I liked how you explained that, Kate. Thank you and well done to your friend.

  • Craig H.

    Craig H.

    July 18th, 2009 at 11:08 AM

    When you go to a new therapist, does the new therapist have any contact with the old one?

    I want to know what happens to the case notes. Can you request them or a copy of them from the therapist when you terminate your contract?

  • Kate Griffith

    Kate Griffith

    July 18th, 2009 at 4:53 PM

    I’m so glad to see that readers found this article helpful, and also that it raised some important questions and concerns! These issues are exactly the type of material that can be brought into session and discussed directly with your therapist. Hopefully, your therapist can not only address the concern, but can explore with you what led up to these questions, what your hopes and fears are around talking about it with your therapist, and how this discussion may impact your therapeutic relationship and future growth.

    Thanks so much for your feedback, and good wishes for your upcoming sessions!

  • Nina


    July 19th, 2009 at 12:25 PM

    Why oh why do we do these things to ourselves? Therapy is a process, not just a quick fix for our issues!

  • John


    July 19th, 2009 at 2:19 PM

    Deciding when to leave therapy is a difficult process – for both the client and the helper. This is a great conversation!

  • Matthew


    July 20th, 2009 at 1:24 AM

    I am so glad to have read this. I was going through a very low phase with therapy. I have decided to rethink my decision of quitting therapy after reading this.

  • Jay


    July 20th, 2009 at 10:44 AM

    You know, therapy for me is like a car and house payment- just seems like this is something that is going to be in my life forever

  • Keely Kolmes, Psy.D.

    Keely Kolmes, Psy.D.

    July 20th, 2009 at 11:54 AM

    I love this post. So clear and well-written. Of course there are many times when it makes sense to end therapy, but I do think it’s great to offer clients information on when they may get more out of it and when it may be premature. Of course, hopefully, if clients do end prematurely, they will feel that it is okay to return and address some of these issues.

    @Craig asked whether new therapists have contact with the old ones. Usually, if I see a new patient who has recently worked extensively with another therapist, I will ask the client if they are willing to sign a release of information to have me speak to the previous therapist, if they think it will be useful. We cannot speak to the other therapist without the written release of information.

    Also, clients can always request their notes. Depending upon the laws of the state, therapists have a certain time period in which they must respond to this (written) request. Most therapists will prefer to release a summary of the records rather than a photocopy of the entire chart. Patients can be expected to have to pay any clerical fees for copying. (In CA, we have 10 days to provide a summary and 15 days to comply with request for the full record.)

    California psychologists must maintain the chart for a minimum of 7 years following the termination of therapy.

    Hope that’s helpful.

  • Craig H,

    Craig H,

    July 20th, 2009 at 5:54 PM

    Keely, thanks for the answer! I wondered if permission was needed. I’d not worry about going to a new therapist and them having my notes. I think it would be good to help them hit the ground running. However say the original therapist disliked me and that influenced their notes. Wouldn’t the new therapist form a preconception of what I’m like from their notes? I hope I’m making sense.

  • Keely Kolmes, Psy.D.

    Keely Kolmes, Psy.D.

    July 20th, 2009 at 10:01 PM

    Craig, I think I understand what you’re asking. It’s certainly possible that a therapist’s subjective experience with you could influence their diagnosis and assessment, although I’d sincerely hope that this was not conveyed in the chart.

    I don’t generally ask prior therapists to forward the entire chart. Part of that is that I like to learn about my client from my client rather than through someone else’s impressions. But there are circumstances in which it makes sense to speak to the former therapist. If I get a release of information, I’m generally having a 5-10 minute phone conversation with the other therapist in which I’m asking pointed questions about length of treatment, diagnostic impressions, and potential risk issues (suicide risk, etc.). I *always* discuss with the client the types of questions I’d like to ask, and I’d hope the client would let me know if s/he worried that a poor connection with the therapist might influence the information I’d receive.

    When I’m in the position of being asked to give the same, I may mention it if I had a difficult time connecting with the client or if we had ongoing conflicts because this *may* be useful information diagnostically (about the client). But then, it could always simply just be about me or our personality match (or mismatch). What I’m trying to say is that I’d hope that any negative responses could be contained and directly communicated in this manner so as not to seep into diagnosis/interpretations that would be passed along more indirectly. I would also hope for the same from clinicians making referrals to me.

    While it’s definitely possible to inherit someone else’s negative feelings about a client, I’ve had enough experiences getting a referral of a “difficult client,” who I found delightful, and referring my own “difficult” cases to others who were able to make a great connection. So I’d hope we would all feel free to allow that sometimes it’s just poor chemistry and not necessarily about the client and hopefully clinicians aren’t using the chart to act out in reaction to their clients! But I won’t deny that it’s possible for that to happen.

    I hope that makes sense.

  • tiffani


    July 21st, 2009 at 2:58 AM

    These are some pretty good reasons and although I’m not in therapy or ever been, I can see where the money and not getting the help can be understandable.

  • Craig H.

    Craig H.

    July 23rd, 2009 at 9:18 AM

    Thank you again Keely! That was kind of you to go into all that. :) You set my mind at rest.

    Thank you Kate too. I had rushed in with questions and no thank you for a very good article. Sorry! Better late than never.

  • Lisa S.

    Lisa S.

    November 3rd, 2009 at 8:55 AM

    I just decided yesterday to leave therapy because it was just too much. After working together more than one year, I felt that we were making progress. However, it was far too overwhelming. I left a message on her voicemail to let her know if & when I felt ready to continue.

  • Sue


    September 14th, 2011 at 8:51 AM

    This post is a idealized view of problems in therapy. Therapists also handle impasses WORSE than anyone’s parents, using their training and the power imbalance to intimidate and abuse an overwhelmed client.

    And while there might be foaming subterranean reasons for problems, there’s the other possibility the situation is just as it appears–therapy is stalled, someone might find personal growth in other ways outside therapy.

    Therapy relationships would be much healthier, with less chance for abuse, if consumers were encouraged to retain their own judgments what is good for them. Therapy is only one of many tools to approach life, not a be-all-end-all.

  • Heidi


    March 10th, 2012 at 2:20 AM

    Some therapist are very burnt out and angry and take it out on their patients. If they work for the govrnment its probable. Some use power plays and intimidation when they think therapy has stalled. Its funny how you all act like therapist are angels. Many are not and can be bad just like anyone else.

  • Jules


    June 2nd, 2012 at 7:52 AM

    I agree with the above poster, Heidi. I left because my T could not handle anger. And this wasn’t even anger directed at him, it was about something that “irks” me… a political issue. He responded by raising his voice, becoming confrontational and controlling, an humiliating me in order to “break through” my defenses. THere is a LOT of bad therapy out there. One of my goals was to learn to trust my own judgement. Well, I did, and I kicked this “therapist” to the curb, and I have no regrets. I do find it to be a more than a little scary to hear that making this decision is “wrong” and premature. I am adult, and I worked hard to be able to make good judgments. Staying in a relationship due to desperation or fear of abandonment presents its own pathology. Quitting bad therapy turned out to be therapeutic in its own right.

  • Stella


    August 10th, 2012 at 3:36 PM

    What is never discussed is the fact that sometimes people leave therapy because they actually feel better. My therapist has done a great job, but after 2 years i have felt i had to quit by email because every discussion on the subject went nowhere despite feeling stalled for weeks, and also feeling as if for now the work we have done has been succesful. I was irritated that she never picked up on my cues and even suggested that i came 3 times a week instead of twice, when frankly i have been having a severe case of deja vu in every session as i struggle to find new things to say. Why is it not ok to leave therapy at this point with a view to returning as and when it feels necessary? I feel very guilty about ending things by email and it would be easy to say that this is a habitual pattern which needs to be worked on, but then again i dont actually feel the need for it at the moment and its a heck of a lot of money to shell out. She also has not responded at all to my email which i find exceptionally aggressive. If she responded suggesting that i come back for a few termination sessions i would have agreed, but i felt backed into a corner with this. Which is annoying after all the good work she has done. I am really like a different person in so many ways….and enjoying life more than ever…

    Any thoughts on this? Should i recontact her? Should i just leave it? Or will i end up finding another therapist to discuss all this?

  • Jenrad


    November 20th, 2015 at 3:58 AM

    I see this is a bit old Stella but I’m wondering how you got on. A couple of years ago I had to leave via “I’ll be okay now thanks” via email after five years, every time I had said I’d really improved -with examples- she would say I still had a long way to go and even though this and that hadn’t worked she’d just done a new workshop and found something that would be really helpful for me grrrrrr. After a few months break I hit a crisis and now two years on with new guy I feel I’ve come as far as I will for the moment but 6 months ago the therapist got all teary when I said I wanted just to skip a couple of sessions as I was feeling burnt out, it’s been pretty deep. This made me feel so guilty grrrrr. Then twice I have gone in and paid him to explain why I need to change the schedule. $$$$$. I like the first comment about the car. Unfortunately it’s not like friends either who may or may not deserve an explanation for a breakup as at the end of the day it’s the therapists job and they need to accept that but I think egos and insecurity and income worries kind of get in the way.

    I hope you followed your instincts and got a good result. Over the years I’ve found the going it alone inbetween seeing someone has really helped me as I get to know how I cope and use the strategies I’ve developed. Also when I started with this person they wouldn’t help me debrief from the bad stuff from the previous therapist, some kind of therapist brotherhood – sisterhood code so I felt really alone and had to sort it myself. He just batted it back at me. She had been a dear but everything I had she’d had it herself and worse. I may as well have talked to any of my sisters lol.

  • Tom


    October 24th, 2012 at 2:17 PM

    Interesting topic. I’ve been to a few therapists over the years. Half of the time I’ve bowed out as I felt I wasn’t getting anywhere and moved on to a different therapist. That helped. One therapist related that he and his therapist wife were in therapy together for 12 years before they felt good enough with their situation to finally stop seeking help. That chilled me as to his efficacy. My therapist girl friend and he would also go into “therapist speak” (aka their discourse community) and I felt either left out or ganged up on, very uncomfortable. Two other times therapists have suggested stopping and taking a break as the work was working. I thought that very professional of them as they could have kept me coming for years. One even checks up on me every few months to see how I’m doing.

    Taking a break when you feel stuck is a good thing.

  • Carol


    December 21st, 2012 at 8:28 PM

    I’ve read that therapists aren’t allowed to correspond by email because of the confidentially laws. The internet can be hacked into or read by others in other ways. Maybe this is why your therapist didn’t answer your email regarding the termination of treatment.

  • Andy


    March 20th, 2014 at 7:46 AM

    I read this article with interest. I wonder if it is written from a psychodynamic/analytic stance. Whilst valid, I approach therapy using a different theoretical model – my comments come from that context.

    I was very concerned to read ‘It’s an unexpected but solid rule of thumb that whenever the urge strikes to cancel therapy and not go back, that’s the time you could use therapy the most.’ This sounds like the sort of comment that would be made in a pyramid scheme or cult. This circular reasoning disempowers and invalidates the patient. Patient’s want an outcome, otherwise why go to therapy. I’m not going to keep seeing my mechanic because he needs me financially or he says something like well if you drive away you might have a breakdown. I want my mechanic to do a specific job of helping me with a specific problem. Therapists should be aiming to do themselves out of a job; not to foster dependence. The needs of the patient should be placed above the financial and emotional needs of the therapist (or the therapeutic model). The above discussions somewhat over-complicates matters in places. Whilst all aspects of therapy can be potentially complex, having a GENUINELY collaborative, open discussion about the pros and cons of discountinuing therapy seems like a very sensible and worthwhile thing to do for all concerned (or perhaps just for the patient if they met the kind of reasoning mentioned in the article). Lastly, The idea of placing the financial need to attend therapy above other important areas needs to be reconsidered. Therapists are not a leg, they are a crutch.

    Dr Andy Siddaway, Clinical Psychologist

  • anonymous


    February 14th, 2017 at 8:19 PM

    I have to say, as a patient, I agree with Dr. Siddaway. It is so crazy-making being with a therapist who believes every decision, including leaving therapy, needs to happen like this. Not helpful.

  • Heidi


    February 21st, 2016 at 6:45 AM

    Infantilizing idea!

  • Tractari


    May 3rd, 2016 at 4:30 AM

    Hope you get the issue solved soon. Cheers

  • Alejandrina K.

    Alejandrina K.

    February 6th, 2017 at 8:14 PM

    I acquired more interesting things on this weight-loss issue. A single issue is a good nutrition is very vital when dieting. A huge reduction in junk food, sugary foodstuff, fried foods, sugary foods, beef, and bright flour products could possibly be necessary. Possessing wastes parasitic organisms, and harmful toxins may prevent goals for fat-loss. While specified drugs temporarily solve the matter, the nasty side effects aren’t worth it, and they also never give more than a temporary solution. It’s a known incontrovertible fact that 95 of fad diet plans fail. Many thanks for sharing your opinions on this blog.

  • Anette H

    Anette H

    July 15th, 2017 at 1:07 AM

    This has actually been really one of the top articles i have checked out. It was actually very informative.Looking forward for a lot more blogs of this particular in near future

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