updated 2/18/2007 12:39:13 PM ET 2007-02-18T17:39:13

The hard part is over.

  1. Don't miss these Health stories
    1. Splash News
      More women opting for preventive mastectomy - but should they be?

      Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

    2. Larry Page's damaged vocal cords: Treatment comes with trade-offs
    3. Report questioning salt guidelines riles heart experts
    4. CDC: 2012 was deadliest year for West Nile in US
    5. What stresses moms most? Themselves, survey says

You had a problem you couldn't resolve alone, took the time and effort to find a therapist and have been going for regular visits for a few months — maybe even a few years.

But how do you know when you're ready to get up off the couch permanently?

Many patients don't. But some therapists say that their work over time tends to draw to a natural conclusion — often to their clients' surprise.

"Most people's expectations and the presentation in the media and the movies is that it's this ongoing sort of psychoanalysis," says James Morris, a licensed marriage and family therapist and teacher at Texas Tech University in Fredericksburg. "They think there's no end. It just keeps going and going."

Plan ahead
Perhaps the best thing people starting therapy can do is think hard about what they want to get out of the experience so they can recognize progress, Morris says. When patients picture what they want their lives to look like in the future and what they want to do differently it helps both them and therapists project a logical endpoint for sessions. It can organize the whole treatment process, too.

"You set up a clear contract upfront and say, 'This is what we're working on,'" Morris says. "They might find it difficult to articulate what the problem is, but it's the therapist's job to elicit all of that and get the conversation out on the table."

Geri Kerr, a licensed marriage and family therapist based in New Jersey, says another signal that therapy has run its course is a general shift in the conversation. Change might come in the form of more small talk or just an overall drop in intensity, but it's usually obvious to the patient and therapist simultaneously, she says.

Honesty is the best policy
If you're thinking of putting an end to your therapy, be honest and open about it, says Dr. William Callahan, a psychiatrist in Orange County, Calif., and member of the American Psychiatric Association. Your therapist might be unhappy or try to talk you out of it if he or she feels there's still work to be done. But should they react defensively or with anger, Callahan says, it's a red flag that they might not be so great at goodbyes. It could be a smart time to move on.

Patients, he adds, should always feel comfortable getting a second opinion if things aren't working well in a relationship with a therapist.

"It's possible you could get more from another person," he says.

Therapists also say that if patients are beginning to question whether they need counseling anymore, they could benefit from a break. Sometimes people come to Kerr's office wanting to work on a couple of things, but at a certain point decide they don't want to go any farther. They're simply not ready. And that's OK, she says.

"It's not a therapist's responsibility to send a person back out with a 'perfect life,'" she says. "Everybody comes from their own background. It's important for people to identify the issues they want to solve."

© 2012


Discussion comments


Most active discussions

  1. votes comments
  2. votes comments
  3. votes comments
  4. votes comments