Therapy endings or new beginnings: understanding the patient experience of termination in a time-limited relational therapy

The literature on psychotherapy termination describes various patient experiences including feelings of loss, separation, abandonment or feelings such as accomplishment and gratitude at the termination phase. This study aims to better understand the experiences of patients at termination, and to explore whether it aligns with our current understanding of psychotherapy termination. Twenty-eight patients were interviewed following a 30-session brief relational therapy at an urban outpatient clinic. Using a combination of interpretative phenomenological analysis methodology and thematic analysis, common themes were grouped, analyzed, quantified, and discussed. Consistent with previous literature, themes of loss and sadness were common throughout patients’ experiences, however, the nature of that loss/sadness differed from patient to patient. Various themes around loss that emerged included loss of the relationship, therapeutic work, routine, intimacy, support, and friendship. In addition to themes of loss, themes of worry or anxiety, accomplished or unaccomplished/frustrated, and gratitude were identified. Some patients expressed relief to be finished with therapy. These patients also identified an unresolved rupture between themselves and their therapist. Lastly, feelings about length of treatment were identified and discussed. The conceptual, empirical, and clinical implications for all the results are explored.