Therapist Thinks I'm Done

[puddingduck]

Today my therapist let me know that she thinks I've outgrown therapy, that I don't have any big 'problems' anymore and that it seems like I have to come up with things to focus the session on every week. So she asked me what I want to do. I know what she means because I've worked through my big anxiety and depression problems that made me start seeing her last year, but I still have anxiety from daily things. We see each other weekly or biweekly so I told her I thought I could see her less and she suggested an appointment date that's a month and a half away. That freaked me out because that's a *long* time away. I don't know what I'll be like in two weeks, let alone over a month away. I settled for an appointment in about a month instead.

I know she's right that I don't need weekly appointments anymore and I really am feeling a lot better lately than I used to, but after I left the session, it hit me and I feel really upset and distressed now. It feels like losing a friend. I feel way worse at this moment than I have about anything else in weeks. It feels like it's causing me more harm than good.

I have a pretty fast-paced, demanding, high-stress lifestyle right now and while I don't have a big trauma or anything to work through, I struggle with stress and anxiety from things on a daily basis. What I wish is that I could see her every couple weeks just to talk through everyday anxiety and social issues, but she clearly doesn't think that that's productive.

How do you cope when your therapist thinks you need to move on? I hate that this is making me feel so stressed out.

[MyNameIsTerry]

First off, well done for getting better.

When I had CBT, it started off weekly but after a while the therapist suggested extending the times inbetween to allow for more complex or more difficult goals & issues to be dealt with. Initially this was a change to fortnightly, then monthly, then quarterly for the last couple of sessions. This worker for me because I couldnt always achieve certain things or move forwards. My CBT was only ever 12-14 sessions anyway so it made sense.


Its only natural to feel some dependence to someone who you have worked with so closely. They may know things about you that noone else does afterall.


Its also normal to fear change.


Maybe this is partly why they want to do this? To assess the impact, see how you cope, etc.


Have you learnt ways to control your issues that you can fall back on? Perhaps it would be useful to use them? Perhaps they would help and would be another achievement for you.

[anthrokid]

I can assure you that your therapist wouldn't suggest longer intervals between appointments unless she thought you could cope. Take this as a compliment I am assuming the UK is like Australia in that all therapists have a duty of care, and cannot dismiss you as a patient or reduce sessions unless they have cause to believe you are okay. It sounds like you have made a lot of progress! It is natural to be upset and nervous at the idea of not having someone around so often who has very much been a pillar of support through anxiety. Just remember, you can always book a sooner, emergency appointment if something serious pops up.

[MyNameIsTerry]

I can assure you that your therapist wouldn't suggest longer intervals between appointments unless she thought you could cope. Take this as a compliment I am assuming the UK is like Australia in that all therapists have a duty of care, and cannot dismiss you as a patient or reduce sessions unless they have cause to believe you are okay. It sounds like you have made a lot of progress! It is natural to be upset and nervous at the idea of not having someone around so often who has very much been a pillar of support through anxiety. Just remember, you can always book a sooner, emergency appointment if something serious pops up.

Just for reference. (it would be interesting to see what other countries do as well)

Yes, they have duty of care in terms of your safety e.g. they check if you could harm yourself or others or be potentially suicidal. My CBT therapist did this at every session. You continue to see your GP throughout though.

My CBT therapist dismissed me regardless of how I was. It was explained at the start that they only gave X sessions. However, they add a couple of follow up review sessions much later to see how you are but wouldn't offer furthe help. At this point, it's all back to your GP who can refer you for Level 4 care. The GP refers to that service if required but it can be a long wait, mine area is 12 months. Based on the reference to weekly & bi-weekly by the OP, they may be at Level 4 as pyschotherapy which recommends closer sessions and takes place over a longer period of time. I would imagine this would mean they have a stronger duty of care since they would be dealing with more advanced cases.

Thats what I found in my city based on the IAPT model. It's a bit ragged in the UK though as some regions don't have CBT set up well...mine was a charity funded by the NHS.

[Dying_Swan]

Hi Puddingduck

I can understand you feeling apprehensive about this. How long have you been having therapy for? Do you know what type of therapy it is? I ask because I know I've become quite attached to some therapists in the past, and I know it can be difficult to move on without proper closure. Ideally, the process of ending therapy should be something that's worked on together rather than done suddenly, particularly if it's been longer term therapy.

I wonder if you could go fortnightly for a while and then reduce to monthly etc? I am sure your therapist would understand that stopping abruptly or having large intervals at this stage might be quite challenging for you?