Finding the courage to take the leap and get some therapy for yourself can be hard. It also takes time to develop a relationship with your therapist that allows you to trust them enough to be open and honest. This is especially true when you might be someone that has a history of trauma, abuse, or problematic relationships. That trust is hard earned and you may even feel like your therapist is one of the only people that you can actually be honest with about your feelings. Unfortunately, therapists are normal people too (well, most of us). That means that sometimes life gets in the way and they are no longer able to keep seeing you for therapy. This could be do to relocating, changing jobs to a different agency, not being approved as a provider for a specific insurance panel, or other personal reasons that you would never learn about. And when this happens… it usually doesn’t feel so good. Here’s a question that I recently got on episode 158 of the Hardcore Self Help Podcast:
I’m wondering if you have any advice for how to decide if you should stay with a therapist when a change makes continuing very inconvenient? Mine is moving her practice about an hour away, but I’m sure this would be applicable to others whose insurance has changed or who have had some other big life event occur.For background, I’ve been seeing a trauma therapist for about six months now. I’ve only recently become stable enough to really start digging into processing my trauma, and am feeling set back and defeated at the prospect of having to start over with someone new. I’ve made a lot of progress with my current therapist. She has said I’m welcome to continue with her if that’s what I want to do, but my abandonment issues have me concerned about my ability to trust her anymore anyway.
First off. It’s always allowed to be a bummer. It sucks when your therapist moves or leaves. It’s normal to feel a lot of different emotions because of it. Even though your therapist (hopefully) hasn’t died, it is still a loss and you might go through some of the common stages of grief such as denial, anger, and bargaining. It’s normal for it to feel like a betrayal, even if you can realize that those feelings are somewhat irrational. If you’re in a position like this, I want to first remind you that it’s not personal and you have options.
Whenever the potential of stopping treatment comes up, it is something that you should process with your therapist. You should talk about the situation, the options, and even your feelings about it all. A lot of people will be afraid to tell their therapist that they feel abandoned or betrayed. However, that sort of raw vulnerability can be the start of a really important conversation. It’s important to realize that psychological treatment is always temporary in nature. You’re not going to see one therapist throughout your whole life and one therapist is not going to be the single key that solves all of your emotional problems. Having a good experience with a therapist is a proof of concept. You have proven to yourself that you are able to open up. You are able to trust someone with your burdens and them not hurt you in return. You have proven to yourself that you can work toward growth. That’s amazing.
It’s also important to avoid jumping the gun and catastrophizing the situation. You might not be completely out of luck. While you may or may not be able to continue therapy in the same way that you did before, there might be another option. These days, it’s totally common for therapists to see people both in-person and online. Internet-based therapy has been shown in the scientific literature to be effective for a variety of mental health conditions. There are a variety of platforms that can be used, but if you’ve ever used a video conferencing app like Skype or Zoom, you get the picture. Therapists just use a video chat platform that is compliant with privacy laws. There is also the old standby of phone sessions. In some cases, you can work out a hybrid model. Maybe you make the trek to go see your therapist in person once a month or every few months and on the other weeks, you do an online session. Whatever the particular arrangement looks like, it’s important to discuss options before simply writing off therapy forever.
Your current therapist can also help you make a plan for continuing care, even if it turns out that you need to find a provider that is more local. They could help you search, provide opinions about other potential therapists. In some cases, you can have your current therapist coordinate with a new therapist so that you don’t have to do so much legwork in re-establishing a relationship. You can also use your current therapist as a bridge and see them every once in a while during this transition phase.
If you do have to end services with your current therapist, it often makes sense to try to avoid doing it abruptly. Rather than just not showing up one week, instead work toward closure by wrapping things up nicely together. I often do this through some sort of collaborative project such as writing down key lessons from the course of therapy or even quotes from sessions. This will help you feel less abandoned because it’s not like they are just dropping you without a care. You will have some sense of finality and something to take with you from this meaningful process.
So overall, here are the key takeaways when dealing with your therapist leaving:
- It’s not personal.
- You have options.
- Process your feelings of abandonment WITH your therapist.
- Remember that therapy was a proof of concept that you can trust someone.
- Consider online therapy or telephone sessions.
- Work with your current therapist to establish a transition plan.
- If you have to stop, try to have some sort of closure.
Bonus!
After publishing the podcast episode, I got this update from the person that wrote in. Pretty cool!
I just wanted to send a thank you for answering my question! Plus a little update. I got the confidence to go back and process the feelings of abandonment! I actually ended up deciding to stay with my therapist. We’re figuring out the telehealth option. I’m super happy with that decision, especially now with the context of knowing that I would be okay if I had chosen otherwise.What was super helpful for me was your advice about how she isn’t the end-all be-all of my recovery. That made me to realize I needed to change my outlook on therapy. I was (figuratively) looking for a crash diet rather than just trying to work towards a lifetime of eating well, and reframing that feels like a game changer. Thank you so much for that insight.
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