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Ask a Therapist: How do you know when you're done with therapy?
Also: Should I care that I'm paying you to care?
Note: the content provided here is not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Content is presented in summary form, is general in nature, and is provided for educational and informational purposes only. Do not delay in seeking the advice of your physician or other qualified health care provider with any concerns you may have regarding a medical, psychiatric, or psychological condition." On to the questions!
Hi Sam,
How do you know when you’re done with therapy? My wife wants me to go, but I want to have a sense of when I will be finished.
J.S., Bonita
Hi J.S.,
Let's start with the easiest possible answer, given your situation: if the only reason you’re going is because someone else wants you to or is making you — your wife, your parents, the court, etc. — you may decide you are done whenever they stop nagging you. On the other hand, if someone else wants you to go to therapy — particularly someone close to you — this may indicate that therapy could be useful for you. Further, developing a growth mindset is often conducive to feeling happier and treating others better. So I’d encourage you to give it a good faith attempt and see what happens.
It gets a little trickier in the case of a person who volunteers herself for therapy and believes going in that it will be beneficial. In that case, knowing when you're done is a bit like an artist knowing when she is done with a painting. There is something intuitive about it, a sense that you could say more, but that what you have already said just about sums it up. There is something poignant about the timing — and you just know.
For those who see therapy as a process of personal growth through storytelling, empathy, awareness, and reflection, or even as a spiritual process, therapy can be a long-term pursuit. There may never be a point at which there is nothing more to explore. Some view therapy as a psychoeducational process, and as we know, many people consider themselves lifelong learners.
For those who see therapy as analogous to a medical process that sets out to treat a particular problem or condition, or as a way to build cognitive or behavioral skills to improve their lives, therapy may be more of a short-term project, one with a measurable definition of completion. Technically speaking, it’s likely that your insurance company (if you’re lucky enough to have insurance) covers only those types of therapy that use what are called in the biz “evidence-based practices." These are approaches that have the backing of randomized controlled trials and other sorts of clinical research. (In this case, your therapist should be documenting the EBPs she is using in sessions, as she is a provider of billable services for which you pay.)
While its appeal is understandable, this approach has been challenged by therapists from a variety of schools that, while they often include the idea of observable results, have not yet "passed the tests" to become EBPs. For example, a Jungian or a transpersonal approach might see transformation as a result of a numinous, peak, or spiritual life experience that leaves you permanently changed in some way. A psychotherapist who specializes in the arts — art, dance, or music therapy — creates change by helping someone convey what had been previously inexpressible but still needed saying. A somatic therapist (who guides people to understand their relationship to their body and nervous system) works to elicit change through new experiences in the body which can change the way we think and behave.
This response doesn’t list red flags that indicate when you should be done with therapy. But hopefully, it gives some sense of what you might consider when making such a decision.
"I mean, I'm a likeable person, right? I mean, you like me, don't you doctor?"
Hey Sam,
Do therapists actually care about their patients? I feel like it’s weird to pay someone to listen to me and care about what I say.
E.P., Oceanside
The answer to this question will of course depend on your particular therapist, so there’s no way to be certain, but I feel confident saying that generally, therapists enjoy relating to and connecting with people more than most folks. I’d say that therapists tend to be people persons.
But you are definitely not the first person I’ve heard from who has this concern. Therapists are sometimes confronted by clients who have the idea that if a person is paid to be in the relationship — if there is cash involved — then the care provided can’t be real.
I would reply that the professional/fee-for-service element of the relationship does not indicate an absence of care, but rather, a commitment to a system of limits that protects both the confidentiality and emotional safety of the client. By keeping the relationship professional, the patient should have the assurance that the therapist will not use the therapist-patient connection inappropriately. And the same goes for any information that comes to light as a result of that connection.
Further, I would say that many relationships in life involve financial entanglements and agreements — including those with spouses and children — but that we still expect to find true care within those dynamics, despite their transactional aspects. I think what may be the driving force behind this question is the concern, "Would you like me if you didn’t have to like me?" Again, that depends on your particular therapist, and their general level of curiosity about and compassion for others.
I also think it’s useful to see caring as a skill that can be developed. Hopefully your therapist exemplifies this. We can grow in loving-kindness. So yes, you might say that the therapist is paid and expected to care — and ideally, he or she should be able to do that.
Finally, I would say that while there are limits to the type of relational contact a therapist can have with a client while maintaining their license, no one can prohibit the heart from loving. Therapists in training are required to have individual mentors or confidential groups where they are able to process their own feelings about patients, in order to make sure they don’t dominate the therapeutic relationship. This is called supervision, and before being licensed, training therapists receive a minimum of 104 hours of these sessions in order to be eligible for their exams.
Here's something you might be interested in.
Ask a Therapist: How do you know when you're done with therapy?
Also: Should I care that I'm paying you to care?
Ask a Therapist: How do you know when you're done with therapy?
Also: Should I care that I'm paying you to care?
Note: the content provided here is not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Content is presented in summary form, is general in nature, and is provided for educational and informational purposes only. Do not delay in seeking the advice of your physician or other qualified health care provider with any concerns you may have regarding a medical, psychiatric, or psychological condition." On to the questions!
Hi Sam,
How do you know when you’re done with therapy? My wife wants me to go, but I want to have a sense of when I will be finished.
J.S., Bonita
Hi J.S.,
Let's start with the easiest possible answer, given your situation: if the only reason you’re going is because someone else wants you to or is making you — your wife, your parents, the court, etc. — you may decide you are done whenever they stop nagging you. On the other hand, if someone else wants you to go to therapy — particularly someone close to you — this may indicate that therapy could be useful for you. Further, developing a growth mindset is often conducive to feeling happier and treating others better. So I’d encourage you to give it a good faith attempt and see what happens.
It gets a little trickier in the case of a person who volunteers herself for therapy and believes going in that it will be beneficial. In that case, knowing when you're done is a bit like an artist knowing when she is done with a painting. There is something intuitive about it, a sense that you could say more, but that what you have already said just about sums it up. There is something poignant about the timing — and you just know.
For those who see therapy as a process of personal growth through storytelling, empathy, awareness, and reflection, or even as a spiritual process, therapy can be a long-term pursuit. There may never be a point at which there is nothing more to explore. Some view therapy as a psychoeducational process, and as we know, many people consider themselves lifelong learners.
For those who see therapy as analogous to a medical process that sets out to treat a particular problem or condition, or as a way to build cognitive or behavioral skills to improve their lives, therapy may be more of a short-term project, one with a measurable definition of completion. Technically speaking, it’s likely that your insurance company (if you’re lucky enough to have insurance) covers only those types of therapy that use what are called in the biz “evidence-based practices." These are approaches that have the backing of randomized controlled trials and other sorts of clinical research. (In this case, your therapist should be documenting the EBPs she is using in sessions, as she is a provider of billable services for which you pay.)
While its appeal is understandable, this approach has been challenged by therapists from a variety of schools that, while they often include the idea of observable results, have not yet "passed the tests" to become EBPs. For example, a Jungian or a transpersonal approach might see transformation as a result of a numinous, peak, or spiritual life experience that leaves you permanently changed in some way. A psychotherapist who specializes in the arts — art, dance, or music therapy — creates change by helping someone convey what had been previously inexpressible but still needed saying. A somatic therapist (who guides people to understand their relationship to their body and nervous system) works to elicit change through new experiences in the body which can change the way we think and behave.
This response doesn’t list red flags that indicate when you should be done with therapy. But hopefully, it gives some sense of what you might consider when making such a decision.
"I mean, I'm a likeable person, right? I mean, you like me, don't you doctor?"
Hey Sam,
Do therapists actually care about their patients? I feel like it’s weird to pay someone to listen to me and care about what I say.
E.P., Oceanside
The answer to this question will of course depend on your particular therapist, so there’s no way to be certain, but I feel confident saying that generally, therapists enjoy relating to and connecting with people more than most folks. I’d say that therapists tend to be people persons.
But you are definitely not the first person I’ve heard from who has this concern. Therapists are sometimes confronted by clients who have the idea that if a person is paid to be in the relationship — if there is cash involved — then the care provided can’t be real.
I would reply that the professional/fee-for-service element of the relationship does not indicate an absence of care, but rather, a commitment to a system of limits that protects both the confidentiality and emotional safety of the client. By keeping the relationship professional, the patient should have the assurance that the therapist will not use the therapist-patient connection inappropriately. And the same goes for any information that comes to light as a result of that connection.
Further, I would say that many relationships in life involve financial entanglements and agreements — including those with spouses and children — but that we still expect to find true care within those dynamics, despite their transactional aspects. I think what may be the driving force behind this question is the concern, "Would you like me if you didn’t have to like me?" Again, that depends on your particular therapist, and their general level of curiosity about and compassion for others.
I also think it’s useful to see caring as a skill that can be developed. Hopefully your therapist exemplifies this. We can grow in loving-kindness. So yes, you might say that the therapist is paid and expected to care — and ideally, he or she should be able to do that.
Finally, I would say that while there are limits to the type of relational contact a therapist can have with a client while maintaining their license, no one can prohibit the heart from loving. Therapists in training are required to have individual mentors or confidential groups where they are able to process their own feelings about patients, in order to make sure they don’t dominate the therapeutic relationship. This is called supervision, and before being licensed, training therapists receive a minimum of 104 hours of these sessions in order to be eligible for their exams.
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