The Power of Each Other: Wellness and Well-Being
  • Home
    • About Laura
    • Contact Dr. Burlingame-Lee:
    • News!
  • Resources & FAQs
    • Resources
    • FAQs >
      • Coaching FAQ
      • DBT FAQ >
        • How does DBT work?
        • What are the goals in DBT?
        • How does a DBT Skills Training Group Work?
        • Assumptions about our participants
        • What are some problems that might come up?
        • DBT Skills 1: Introduction and Mindfulness
        • DBT Skills 2: Interpersonal Effectiveness
        • DBT Skills 3: Emotion Regulation
        • DBT Skills 4: Distress Tolerance, Part 1
        • DBT Skills 5: Distress Tolerance, Part 2
      • Payment and Insurance
      • First Appointments: What to expect >
        • What to expect at your first coaching appointment
        • What to expect at your first therapy appointment:
    • Forms
  • Blog: Posts for the Journey
    • Blog Survey!
  • Love the Questions Journal Prompts

When Is It Time To End Therapy?

8/6/2014

0 Comments

 
In my work, one of the hardest things I face is letting a client know that it’s time move on. There are many reasons for ending therapy, and I’m going to explain some of them so you can see how complex the decision can be. I’ll start with a couple of reasons why clients end therapy.

Picture

Why do clients stop coming to therapy?

Clients end therapy for many reasons. One of the most common is that they don’t feel comfortable with the therapy or the therapist. In my mind, that’s a very good reason because if you’re not comfortable or don’t feel safe, then you’re not going to be able to benefit as much. Many people who end therapy for this reason simply don’t keep a scheduled appointment or never call back for another. From my end, it’s frustrating and still understandable. I wouldn’t want to work with someone I didn’t feel comfortable with or felt I couldn’t trust.

Another reason clients leave is financial. Therapy is expensive, and insurance benefits aren’t always very good. Insurance policies may limit the number of visits, require a high deductible, or have a high co-pay. These are all barriers for people wanting to pursue therapy. Some therapists don’t accept insurance, for a variety of reasons, and that can cause difficulty for clients as well. Many therapists charge between $90 and up to $175 (or more) per session, and that’s a financial burden for many. Specialized services (such as testing) can cost even more. Honestly, if comes down to putting food on the table or gas in the car versus therapy, I don’t blame people for choosing food or gas. Survival comes first, and I understand that.


There are emotional reasons for stopping therapy as well. Fear of the unknown and of change, feeling vulnerable, feeling hopeless that things can change or that no one can help are all reasons that some people stop therapy. These emotions are powerful, and there is a reason that we feel them. However, they can keep us stuck and far away from our goals. When I have a new client, I will often tell them that I admire them for being there. I really do, too - it takes guts to walk into a stranger's office and talk to them about things that hurt or make you feel vulnerable. 

Unfortunately, some clients have also experienced judgment, boundary violations, or other forms of abuse at the hands of therapists. While I wish I could say that all therapists are ethical and respectful, unfortunately that isn't the case. In these cases, clients learn that they can't trust the very people who were supposed to help them. Sometimes, they are afraid of retaliation, and sometimes they are angry - and sometimes both at the same time. They have been hurt. There is a reason that state licensing boards and codes of ethics exist, though, and that reason is to protect the public.

Why would a therapist end therapy?

When a therapist ends therapy, there is usually a very good reason. I’ll save the best for last, and go through a couple before that. When a client starts therapy, most therapists will work with her or him on setting some goals. Over time, if these goals are not met or we see our clients getting worse, we are ethically obligated to refer to another therapist for care. This is a difficult boundary to see, and many clients do not want to end therapy for this reason. When therapy goes on for a long period of time, and the therapist does not see improvement, then it is probably time to refer. Some clients have difficulty with this decision and others may feel relieved. 

Another situation that might lead to a therapist stopping therapy or referring to another provider is when a client does not cooperate with the treatment. Here’s an example. The work I do in therapy is based on skills training, working with unhelpful thought patterns or emotional reactions, and dealing with problem situations or relationships. If I work with a client who does not want to work with these, or refuses to do so, then I’m simply not able to help. Yet another situation occurs when a client’s situation changes or reverts to a problem that I am not trained to treat. Substance use/abuse is one of those problems. Unwillingness to work on those behaviors means that anything I do will likely not work, because the substance use gets in the way of coping effectively.

One of the most frustrating situations for me happens when I find out that a client has been taking advantage of me. I used to have a very generous sliding scale (as low as $25/session) and found out that a few people were taking advantage of that generosity. While I take some blame for this – I now require income verification and use household income as the guide – I also do not like being taken advantage of. Thankfully, this situation has been very rare, and I have learned from it. My sliding scale is much more in line with other professionals and I require that verification of income before I agree to accept sliding scale.
Picture
The last reason that we might end therapy is the best: There are clients who feel they have healed enough, reached their goals, and simply don’t need therapy anymore. These clients have worked hard, integrated new patterns of thinking and being into their lives and have moved on to a place where they feel confident in taking on the world without my support. In these cases, I am simultaneously very happy and somewhat sad, as I have usually developed a close, supportive relationship with them. Many of these clients have let me know over time that they are doing well – and that is incredibly fulfilling. Some come back for an occasional “booster session,” and that’s ok too. That tells me that they are basically doing well, and might need some minimal support to get through a rough patch. I have to admit, though, I love seeing people walk out of my office feeling better about themselves and their world. It’s one of the main reasons I do this work.

Please note: The information contained in this blog is not meant to be therapy or treatment. These entries are provided as information only. If you wish to talk with Dr. Burlingame-Lee about the services she offers, you may call her at (970) 776-6043 or send an email message to: thepowerofeachother@outlook.com. Dr. Burlingame-Lee’s services include individual and group therapy, life and creative coaching, and workshops and seminars on a variety of topics including self-esteem, coping skills, body image, and journaling.

 If you are experiencing a crisis or emergency situation, please call 911 or go to your nearest emergency room. You don’t have to be alone, and there are people who care and will help.

Copyright 2014 by Dr. Laura Burlingame-Lee



0 Comments

Your comment will be posted after it is approved.


Leave a Reply.

    Laura Burlingame-Lee:

    I am someone who thoroughly loves life and believes in the power we have to help each other. I think that having a hot cup of tea, a good book, and a warm, purring kitty are some of the most soothing experiences available in life, and loving my family, hearing the sound of children laughing, feeling rain on my skin, and smelling the salt air by the ocean are some of the best possible things in life! 

    I believe we all have inner wisdom, and that learning to listen to it is one of the hardest and most rewarding things we can do. I believe we all have gifts and talents to share, and that we have the opportunity every day to learn something new. We learn, we grow, and we shine!


    I'd love to hear from you!

    Need to find something? Search the blog:
    View my profile on LinkedIn

    RSS Feed

    Home

    Archives

    August 2022
    July 2022
    September 2017
    August 2017
    January 2016
    October 2014
    August 2014
    July 2014
    April 2014
    March 2014

    Categories

    All
    Acceptance
    Accountability
    Accountable
    Accreditation
    Accredited
    Achievement
    Achieving
    Action
    Action Planning
    Active Trust
    Affirmation
    Affirmations
    Afraid
    Alone
    Anger
    Angry
    Antidepressant
    Antidepressants
    Anxiety
    Appointment
    Appointments
    Art Journal
    Assertive
    Assertiveness
    Attitude
    Beck
    Behavior
    Black Or White Thinking
    Boundaries
    Boundary
    Care
    Caring
    Cat-I
    CBT
    Certification
    Certified
    Chain Analysis
    Change
    Changing
    Checking In
    Check-ins
    Choice
    Choices
    Coach
    Coaches
    Coaching
    Code Of Ethics
    Cognitive Behavioral Therapy
    Cognitive Behavioral Therapy For Insomnia
    Cognitive Distortions
    Cognitive Errors
    Cognitive Triad
    Comfort
    Comfortable
    Commitment
    Commitment Planning
    Commitment Strategies
    Compassion
    Compassionate
    Compassionate Detachment
    Control
    Controlling
    Copeland
    Coping
    Coping Skills
    Counseling
    Counselor
    Counselors
    Courage
    COVID
    Cruelty
    Daily Hassles
    DBT
    Depressed
    Depression
    Dialectical Behavioral Therapy
    Dichotic Thinking
    Differences
    Discomfort
    Distorted Thinking
    Distraction
    Distress Tolerance
    Dream
    Dream Analysis
    Dreaming
    Dreams
    Dream Symbols
    Effective
    Ellis
    Emergency Room
    Emotion Regulation
    End
    Ending
    ER
    Ethical
    Ethics
    Ethics Code
    Evaluating Goals
    Fear
    Forgive
    Forgiveness
    Frustrated
    Frustration
    Fun
    Goal Planning
    Goal Progress
    Goals
    Goal Setting
    Goal Strategizing
    Grief
    Happiness
    Happy
    Heal
    Healing
    Health
    Healthy
    Helpless
    Helplessness
    Hero
    Heroes
    Hopeless
    Hopelessness
    Hospital
    Hospitalization
    Hotline
    Hotlines
    Hurt
    ICF
    Identity
    Image Rehearsal Therapy
    Insight
    Insightful
    International Coaching Federation
    Interpersonal Effectiveness
    Introversion
    Irrational Beliefs
    Irrational Thinking
    IRT
    Journal
    Journaling
    Joy
    Judgment
    Judgmental
    Letting Go
    Licensed
    Licensure
    Loneliness
    Lonely
    Mean
    Measurable Goals
    Medical
    Medication
    Mindfulness
    Minimization
    Mistrust
    Mood Stabilizer
    Mood Stabilizers
    Motivate
    Motivation
    Move
    Moving
    Moving On
    Negative Thinking
    Negative Thinking Patterns
    New Normal
    No
    Nonjudgmental
    Nonjudgmental Stance
    Obstacles
    Opposite Action
    Organization
    Organizing
    Overgeneralization
    Pain
    Painful
    Personality
    Personalization
    Plan
    Planning
    Play
    Playful
    Playing
    Positive Psychology
    Post Traumatic Stress Disorder
    Posttraumatic Stress Disorder
    Precipitating Event
    Prioritize
    Prioritizing
    Process
    Process Writing
    Procrastination
    Progress
    Prompting Event
    Psychologist
    Psychologists
    PTSD
    Rabbit Hole
    Radical Acceptance
    Reaching Goals
    React
    Reacting
    Reaction
    Reinforce
    Reinforcement
    Relationship Skills
    Relax
    Relaxation
    Resiliency
    Resources
    Responding
    Responsibility
    Responsible
    Rest
    Restful
    Resting
    Results
    Reward
    Rewards
    Role Play
    Role-play
    Sadness
    Safe
    Safety
    Saying No
    Schedule
    Self Acceptance
    Self Assurance
    Self Awareness
    Self Care
    Self Control
    Self Esteem
    Self Liking
    Self Soothing
    Self-soothing
    Setting Goals
    Should
    Shoulds
    Skills
    Solitude
    Stigma
    Stigmatize
    Stigmatizing
    Stinking Thinking
    Stop
    Stopping
    Strategies
    Strategizing
    Strategy
    Suicidal
    Suicidal Feelings
    Suicidal Thoughts
    Suicide
    Suicide Hotline
    Suicide Hotlines
    Support
    Supporting
    Supportive
    Taking Action
    Task Management
    Termination
    Therapist
    Therapists
    Therapy
    Thinking
    Thinking Patterns
    Thoughts
    Time
    Time Management
    Tough Times
    Trained
    Training
    Transition
    Transitioning
    Trauma
    Traumatic
    Traumatized
    Trigger
    Triggers
    Trust
    Trust The Process
    Uncomfortable
    Visual Journal
    Voice
    Vulnerability
    Vulnerability Factors
    Wellness
    Wellness Action Recovery Plan
    Wise Mind
    WRAP
    Write
    Writing

Proudly powered by Weebly