A client once asked me when counselling and psychotherapy would be over. It was a really good question, and there are actually a multitude of answers.
Today, in honor of APA’s Mental Health Month Blog Day, I thought it would be an ideal time to share some of those answers.
For some clients, therapy is over whenever they say it’s over – I can’t force anyone to stay in therapy. For others, therapy is over when they feel like they’ve achieved enough insight into their problems. And for others, therapy is over when their insurance company can no longer reimburse them (an unfortunate reality).
I see therapy as something that happens at different points throughout our lives, rather than as something with a specific start and end date. Just as we go to a massage therapist when our bodies feel knotted and stressed, I recommend people visit a therapist when their mind and thoughts lead them to feel stressed. Just as we visit our physician “every once in a while” to do a physical check-up, I also think we should visit a therapist “every once in a while” to do a mental health check-up.
With that in mind, here are seven things I look for when deciding whether therapy is coming to a close.
- There is a change in how they talk. Specifically, I notice my client is more goal-oriented in their thinking and speech. They are no longer ruminating over things in the past or worried about their future. Instead, they start talking with more optimism and hope in their voices.
- They recognize their triggers and make better choices. I’ve worked with addicts in recovery who were not bothered by the presence of alcohol. Instead, what bothered them were the people who pressured them to drink. When they recognized that certain people triggered their use, they made the choice to keep them out of their lives. That’s progress.
- An increase in confidence. I’m not looking for massive gains. Just a string of small successes and “feel-good” statements that reflect an honest increase in self-esteem and self-acceptance.
- A reduction in symptomology. Sometimes, therapy is over when people tell me they feel less of the signs and symptoms that brought them into counselling (e.g., less depressed, less anxious, or less angry). I also use a few questionnaires to help figure out the extent to which symptoms have been reduced.
- There is an improvement in their ability to accept what they cannot control. We can drive ourselves crazy if we think we can control everything. An important indicator of progress is when we can separate the things we have no control over versus the things we do.
- They’re able to talk about emotional pain while feeling in control. This is a big accomplishment for survivors of trauma. When you can talk about the traumatic event, or when you no longer feel controlled by the horrible memory associated with the trauma, your sessions are coming to an end.
- They choose behaviours that lead to good health. Along with looking for a reduction in symptoms (sign #4), I also look for a increase in behaviours that lead to improved mood. Making healthy choices that lead to an improvement in how we feel is a sign that we’re on the road to good mental health.
How do you know when you have good mental health? What do you look for?
Hoping your week is filled with much knowledge and growth.
Richard Amaral, PhD