It is not uncommon for people who are getting treatment for a psychiatric disorder such as borderline personality disorder (BPD) to feel like they want to quit therapy. In fact, it is quite natural to get frustrated with therapy or your therapist, or to feel like psychotherapy is not working. And many people leave therapy before they have reached their treatment goals—research shows that about 47% of patients leave treatment prematurely. Before you make a decision about dropping out of therapy, however, here are some things to consider:
Before You Quit Therapy: What Are Your Reasons?
Before dropping out of therapy, think about your reasons for wanting to leave. You may even want to write down all of your reasons for wanting to quit therapy. Here are some very common reasons for wanting to leave therapy:
- I don’t feel like the therapy is working
- I don’t like my therapist
- I don’t have time to attend sessions
- I think I have gotten better and am ready to go it alone
- The things we talk about in session are too emotional/intense
- I don’t think my therapist likes me
- I am too much of a burden on my therapist
- I will never get better no matter what I do
- I believe my therapist is incompetent
- I don’t feel motivated to engage in the therapy
- I don’t have enough money to pay for sessions
Before You Quit Therapy: Talking to Your Therapist
Now that you have a list of your reasons for wanting to quit therapy, put a star next to the reasons that you have already discussed with your therapist. Chances are, there are reasons you have for wanting to quit therapy that you have never talked to your therapist about. Perhaps you are embarrassed to discuss dropping out with your therapist because you don’t want to disappoint or offend him. Or maybe you don’t trust her enough to discuss it with her.
Whatever the reason, it is always the best policy to try to discuss any issues you are having with your therapist. Of course, it is hard to bring up these issues. But, in the best case scenario, you will be able to think through these issues with the help of your therapist and come to a conclusion that is well thought-out.
Another reason to discuss this with your therapist is that there are some reasons that they may be able to address. For example, if you do not have time to attend appointments, perhaps your therapist would agree to see you every other week instead of weekly. Or, if you can’t pay for sessions, your therapist may be able to lower your fee or work out another financial arrangement.
Before You Quit Therapy: Is it the Disorder Talking?
One reason that it is a good idea to talk to your therapist about quitting therapy is that, in many cases, the symptoms of the very disorder you are battling may be “talking you out of” therapy. For example, people with BPD often experience splitting, which causes them to think someone is wonderful one moment and evil the next. Sometimes people with BPD split with their therapists, causing premature treatment drop out.
People with depression can have periods of hopelessness and extremely low motivation, which can in turn make them want to drop out of therapy.
In both of these cases, a therapist can help you think through what is in your best interest versus what your disorder is “telling you” to do.
Evaluate Dropping Out of Therapy: What Are the Pros and Cons?
Another technique that can help you decide whether to drop out of therapy is called the “Pros and Cons Tool.” This is a tool that is taught in Dialectical Behavior Therapy, and can be a great way of thinking through many different kinds of decisions.
To learn how to use the Pros and Cons Tool, see the article below:
Once you complete the pros and cons tool, think more about what direction you want to head in. Does quitting therapy still seem like a good idea? Or, is it becoming clearer that another path might make more sense? If quitting therapy still seems like the right choice, does this mean quitting therapy outright, or just changing therapists or the type of therapy you are receiving?
Dropping Out of Therapy: The Bottom Line
The bottom line is that there are many reasons that people drop out of therapy, and sometimes these are unavoidable. But sometimes people drop out of therapy prematurely without thinking it through and talking to their therapist about it. If you are thinking about dropping out of therapy, make sure that you have given therapy a fair chance. If you are sure that you need to drop out, consider other avenues of treatment.
Bados A, Balaguer G, Saldana C. “The Efficacy of Cognitive Behavioral Therapy and the Problem of Drop-Out.” Journal of Clinical Psychology, 63:585-592, 2007.
Linehan MM. Skills Manual for Treating Borderline Personality Disorder. New York: Guilford, 1993.
Wierzbicki M, Pekarik G. “A Meta-Analysis of Psychotherapy Dropout.” Professional Psychology: Research and Practice, 24:190-195, 1993.