When it’s time to break up with your therapist

By Melissa Mahtani, CNN

(CNN) — Finding a therapist can be hard, especially with demand so high these days and many not taking on new patients.

A survey by the American Psychological Association showed more than half of practitioners (56%) have no openings for new patients. That’s despite nine out of 10 adults saying ​they believe there’s a mental health crisis in the country, according to a 2022 CNN/KFF poll.

So, once you have found a specialist, deciding to break up with them can be even harder.

You’ve gotten up the courage to make that first appointment and had a few initial meetings revealing your most intimate details and vulnerabilities, and that’s always going to be a bit awkward.

“The first hour of therapy in anyone’s life is one of the oddest hours they will ever experience,” said Dr. John Duffy, a psychologist and author of “Rescuing Our Sons: 8 Solutions to Our Crisis of Disaffected Teen Boys (A Psychologist’s Roadmap).”

“There’s a bizarre amount of vulnerability that you need to offer to a perfect stranger, to even gauge whether you have a connection in terms of personality or approach.”

What if it’s more than a little bit awkward? How do you know if this therapist is not the right one for you? CNN talked to several experts to find out when to leave a therapist, and if so, how to do it.

Is the problem you or your therapist?

Before you stop seeing your current therapist, try to figure out if it’s really not working or if you’re just uncomfortable, experts say.

“You might be talking about difficult things that you haven’t talked about in a long time and feelings of sadness, fear or anger are coming up,” said Dr. Andrea Bonior, a psychologist and professor of psychology at Georgetown University. “But ask yourself, does it feel like we’re working towards something?”

Bonior stressed that it’s important to be honest with yourself about what you need help with and how forthcoming you’re willing to be.

“Often, we’re not disclosing how much we drink, or how much we’re screaming at our kids, because we’re afraid of being seen for who we really are. Maybe we carry a lot of shame in there. If we are really honest with ourselves, we’re not telling the therapist the whole story.”

She advised telling your therapist that you feel uncomfortable, or even writing them a note beforehand because while therapy may not always feel good, it should be helpful.

Know what you want from therapy

Be clear about what you want from therapy, even if that changes over time. Do you want space to talk about what you’re going through without much feedback, more of a give-and-take situation, work to do between sessions or something else?

“Some people want a therapist who is going to be giving them a ton of homework and be really active and challenge them,” Bonior said. “For other folks, that would not be what they want. They want somebody who’s a little bit more quiet and nurturing and just creates an environment that gives them the space to talk.”

Shop around for a therapist

If you don’t feel you’re getting anything out of the sessions, or if you feel you’re not a good match with your therapist, you may want to test the waters with others. Even if you researched your first therapist, you may know more about what you need after you’ve had a few sessions with them.

Your medical doctors may have good recommendations. Friends and family who have already had therapy may also have names. Numerous online directories and websites, including the APA and PsychologyToday, commonly list a therapist’s background and areas of focus such as anxiety, grief, family conflict and couple’s counseling.

Many therapists will offer a free initial consultation.

Dr. Sheehan D. Fisher, psychologist and assistant professor at Northwestern University, advised going into these conversations with a list of questions to help you identify who you feel most comfortable with.

Examples of questions include if you will be working on concrete and specific goals, the theoretical orientation they may practice – such as mindfulness or cognitive behavioral therapy – and whether their religious beliefs (or the absence of them) make you feel uncomfortable. Other questions to ask include how flexible the sessions will be and if they take insurance.

Competency isn’t the only key to an effective patient–therapist relationship though.

“Chemistry also matters,” Fisher said, as well as being on the same page about the goals you want to accomplish, feeling safe and feeling a connection.

If that’s not happening, or you don’t feel like you’re getting any closer to your goals, then it may be time to change course and end things.

Endings can be opportunities

Ending a relationship with anyone can bring up feelings of sadness, self-doubt or failure, but the bottom line is to remember that therapy is supposed to be a tool to help you. If you don’t feel it is, then you can walk away.

Do not stay because you’re afraid to hurt your therapist’s feelings. “A lot of people stay in therapy so as not to harm the ego of the therapist, Duffy said. “That is not a good reason to stay.”

Duffy advised using the break-up as an opportunity for growth and being upfront about your feelings. “The way to bring it up is to say something along the lines of, ‘I’m super uncomfortable with bringing this up, I’m anxious, I’m nervous, but I think I might need to talk about moving on to a different therapist.’”

The same can be true for a therapist you’ve seen for a long time. You may have felt they helped you at the beginning but now your growth has plateaued, or you have different needs but feel loyal to them.

The best thing you can do is to be honest with them, Bonior said.

“If you’re afraid that it’s going to be awkward, or that you’re going to hurt the therapist’s feelings, remember that their professional role is to talk about things that can be awkward and difficult. That’s literally part of their job.”

Don’t ghost your therapist

Whatever the circumstances, one of the worst things you can do is stop seeing your therapist without any explanation.

“The irony is the people most likely to ghost are the ones who can be kind of avoidant, and somewhat socially anxious and are not good at asserting their own needs,” Bonior said. “If you do that in therapy, you’re missing an opportunity to be able to break that cycle.”

“Ghosting also puts you at a disadvantage,” said Fisher, because it leaves you to figure out what you need without the therapist’s expertise. You might not want to see your therapist anymore, but it’s their job to help you find a better match, if you let them.

“As a therapist, we’re responsible and liable for our patients,” he added. “We need to know that they’re safe and that they’re doing well.”

An exception to the rule is if your therapist makes you feel unsafe in any way or is unethical. In these instances, you should stop seeing them immediately and possibly report them to their governing body.

The good kind of break-up

There is the best type of break-up — when you feel you no longer need to see a therapist because you’ve made so much progress and are ready to go it alone.

“It’s actually no different than taking medication. You shouldn’t continue to take it if you don’t need it,” Fisher said.

It’s still not always easy.

“A lot of people, languish in therapy with somebody for a very, very long time because therapy can become a really comfortable, easy space, and it can feel very safe when nothing is actually moving or changing,” Duffy said.

Rather than coasting along, he recommends evaluating your progress every couple of sessions and feeling empowered to own the process. After all, this is meant to be about helping you.

It doesn’t have to be a sudden ending. Breaking up with your therapist can be a gradual phased-out approach, leaving the door open to future visits as and when they’re needed.

Just like going to the gym to take care of your body, therapy is a tool that can help you take care of your mind, whether that requires intensive training or an occasional tune-up.

“I’ve had people come back to me years later and say, ‘I can feel some of my old habits coming back in and I just need two or three sessions to kind of get back on track,’ and that can work beautifully,” Bonior said.

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