When and how to end your therapy sessions, according to experts

Emma Clarke
·Contributor
Updated ·6 min read
therapy
In order to get the most out of your therapy, it's important that you connect with your therapist or counsellor. (Getty Images)

Although once a taboo subject, therapy has become much more prevalent since the early 1990s – with one in eight adults now receiving mental health treatment in the UK.

The majority of those who seek help have issues with depression (59.4%), followed by obsessive compulsive disorder (51.6%) and general anxiety disorders (48.2%). But there are still a great many (75%) with mental health problems in England who may not have access to or receive the help they need.

Even when you do receive treatment, it can involve quite a long process to find the right help for you and adjust. With therapy, in particular, it is important to feel a connection – and that you have clear goals you are working towards.

When waiting lists are also high – in 2022/23, although 89.3% of people finishing a course of Talking Therapies treatment via the NHS got their first appointment within six weeks, average waiting times between first and second appointments in England were 62.5 days – it can be a particularly difficult spot to be in if you’re not quite gelling with your counsellor or feeling like progress is being made.

So, in terms of therapy; when should we end our sessions? And how do we broach the topic with our therapist if it's not the right fit?

Two women in armchairs are sitting and talking. Woman psychologist practicing with patient women. Coach session between girlfriends. Therapist's gestures. Female talking in the office
The number of sessions are usually outlined by the therapist at the start. (Getty Images)

In 2022/23, 1.76 million people in England were referred to the NHS Talking Therapies programme – and of the 1.22 million who then entered treatment, only 672,000 completed their course of treatment.

Psychiatrist Dr Sham Singh says that the amount of sessions we "should" book depends on the modality of therapy, the issues needing to be addressed, and the goals set by the patient and therapist.

"For short-term, goal-focused therapies like cognitive behavioural therapy (CBT), you might typically start with six to 12 sessions," he explains, "while longer-term approaches like psychodynamic therapy might not have a defined endpoint."

"Ultimately, therapy should be guided by progress and regular reviews rather than a rigid timeline. Early, open discussion is very important with regard to expectations and how therapy may progress," Dr Singh adds.

Dr Dwight Turner, psychotherapist and spokesperson for the UK Council for Psychotherapy, also says that it can take a few sessions to build up the patient-therapist rapport.

"It can be helpful for the therapist to suggest between four to six initial sessions in order for the relationship to begin to take shape," he outlines. "This then would help the client to get used to the therapist as well, and for them to approach any issues which might arise in those initial stages."

Dr Turner continues: "There should be a review at around session four to ascertain what is going well in the therapy and what is not – and to see if the relationship is a good fit. Beyond this, any idea of the number of total sessions is dependent upon the client’s presenting issue, and the level of their distress."

Sometimes, when you reach the end of your course, you may feel you need more sessions. (Getty Images)
Sometimes, when you reach the end of your course, you may feel you need more sessions. (Getty Images)

Dr Turner explains that if the therapist or the patient feels more sessions are required than the course allows for, the former may advocate for a course extension with their supervisor or practice director.

"Another route forward can be that the client is referred onwards to other, longer-term services, or they are placed back on the practice waiting list (although this may mean a longer wait)."

In this instance, Dr Singh advises: "Other options, such as private therapy or group support, could be discussed. These need to be openly discussed in a collaborative way."

Smiling young businessman working online on a laptop while sitting at a table by a window in a modern office
Therapy usually comes to a natural end. (Getty Images)

Yes, according to Dr Singh. "Of course, therapy can sometimes outlive its usefulness, particularly if it creates dependency or if it serves to sidestep problems outside the therapy room," he explains. "Therapy works best when it empowers individuals with skills to handle their lives independently. The purpose and direction of therapy can be assured through periodic reviews by the patient and therapist. Therapy should always foster growth and self-sufficiency."

Dr Turner agrees that therapy does have a natural end. "What can happen is that for some clients they have become so attached to the therapist that ending can be difficult. It is therefore ethically important for the therapist to assess when the therapy has ended, and to assist the client in separating from the therapist – thereby taking whatever insights into their world they have gathered in the process of therapy, and utilising these in the wider world," he adds.

How to end therapy – or find a different counsellor

Midsection of female entrepreneur shaking hands with coworker at workplace
When you reach that point – or if you are struggling to connect with your therapist – it's important to have that dialogue. (Getty Images)

If a patient feels their therapist isn’t the right fit, they should feel empowered to bring up their concerns during a session, Dr Singh says.

"A good therapist will welcome this feedback and might help facilitate a transition to a more suitable professional," he adds. "This could be frustrating, especially with the NHS, where it often requires a referral and, consequently, waiting lists. If faster access to therapy is needed, alternatives one might look into include private therapies or community mental health."

Likewise, Dr Turner stresses that clients have every right to end therapy if they feel their present therapeutic relationship is not working.

"First of all, though," he says, "I would advise speaking to their therapist about the issue, as there may be something in the way the therapist is working which needs considering, or there may be something unconscious which needs addressing in the client's material."

Should they still wish to move on, then this is totally fine – encouraged even. "They may want to look on the BACP and UKCP websites for alternative therapists, or to contact local charities for accredited therapists as well," Dr Turner advises.

If you are in need or urgent help, please call 111 and select the mental health option, or contact 111 online.

CALM's helpline and webchat are open from 5pm until midnight, 365 days a year. Call CALM on 0800 58 58 58 or chat to their trained helpline staff online, it’s free, anonymous and confidential.

You can also contact Samaritans free on 116 123 or view other ways to get in touch with the charity. Or for more information about mental health and how to get help visit Mind.

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