How to Break Up With Your Therapist

They say breaking up is hard to do, but breaking up with a therapist can be especially challenging. It’s a unique relationship, rooted in trust and vulnerability, and it’s also transactional, time limited, and inherently lopsided: The therapist may know almost everything about their client; the client likely knows very little about their therapist.

When therapy works, it can be life-changing, even lifesaving. But what if it doesn’t work?

Studies have shown that about one in five patients quits therapy before treatment is complete. Cost, scheduling difficulties, and other logistical hurdles partly explain why so many people step away, but the connection — or lack thereof — between client and therapist is a major variable.

And for good reason. Research suggests that the relationship between a therapist and client — often described as the therapeutic alliance — is at least as impactful as the interventions or techniques that the therapist incorporates.

“The relationship is the single most important predictor of outcome. It’s the medium and the message,” says Linda Michaels, PsyD, MBA, a psychologist in private practice and cofounder of the Psychotherapy Action Network, a nonprofit that advocates for quality therapy.

Here are some thoughts on how to navigate this tricky but important dynamic.

Finding the Right Fit

Sometimes a bad match reveals itself early on.

Nadine (who asked to go by a pseudonym to protect her privacy) has worked with her fair share of ineffective therapists. One provider was too hands-off: “She didn’t recognize that I was suffering from what I later learned was PTSD and seemed to think I could just talk my way out of what I was feeling.”

Another ended services abruptly, despite Nadine being in the midst of a crisis.

A third seemed downright unprofessional: “Not only was she late to our first session, she called in from her car and didn’t take any notes, so when we met a second time she didn’t remember anything I told her, and I had to repeat my entire story.”

None of these breakups quite prepared Nadine for her work with Dr. Jones (also a pseudonym), who would ultimately reveal just how seriously a misconnection can mar therapy’s effectiveness.

Nadine was in a difficult place when she started working with Jones. Not only had she struck out with her previous therapists but she was also reeling from the recent death of her mother. “I felt utterly paralyzed.”

Jones was helpful at first. She validated Nadine’s suspected PTSD and offered tools for managing the symptoms. But it wasn’t long before their relationship took a turn.

“I got the sense that she didn’t believe I was working hard enough,” Nadine recalls. “She’d say things like, ‘You’re just stuck’ and ‘You’re not trying’ only two months after my mom died. It seemed like she wanted to rush to a solution rather than give me space to grieve.”

The discrepancy between Nadine’s expectations and those of her therapist illustrates a key component of the therapeutic alliance: mutual agreement on goals.

“You and your therapist should discuss your goals in the beginning of treatment and check in throughout the process,” says Michaels.

Nadine and Jones seemed misaligned on expectations. “I assumed I’d be given time to feel my feelings rather than pressured to move forward,” Nadine says. But their relationship also felt unequal.

“The power balance seemed really off,” she adds. “She would push back if I tried to assert myself, and I began to feel unsafe and minimized.”

It’s no wonder Nadine felt unsettled. Studies suggest that a healthy therapeutic alliance requires an atmosphere of humility, openness, and mutuality; a sense that therapist and client have an equal say in the process. Without this, the relationship lacks a crucial sense of safety.

“For therapy to work, clients need to have trust with their therapist and feel that they can be honest and vulnerable without feeling judged,” says Michaels.

Room for Repair?

Sometimes, a therapist with whom you feel connected might do or say something that doesn’t sit well. Depending on the depth of the relationship and the significance of the misstep, it may be tempting to cut and run. Yet there’s a strong case for sticking it out in some situations.

Being a therapist means being willing to point out things a client may not want to hear. This is a delicate art, and even the best therapists get their words, tone, or timing wrong. Before throwing in the towel, it’s worth considering whether your reaction represents a mistake on the part of the therapist — or your own discomfort with a difficult truth.

What’s more, addressing and repairing the rupture can be healing. “Therapy is exactly the place to practice addressing miscommunication or hurt feelings,” Michaels says. There’s a chance you deprive yourself of a valuable learning opportunity if you choose not to raise the issue.

An honest conversation between client and therapist can strengthen the alliance — one of the most effective ways to reestablish equal footing is to acknowledge that we all make mistakes.

It may even help you get more out of therapy, notes Michaels. “Those kinds of conversations should teach you that your thoughts and feelings matter.”

Still, some therapeutic relationships lend themselves to repair more than others.

For example, it may not be worth the effort if you’ve only seen your therapist for a session or two. And if previous efforts to provide feedback have left a bad taste in your mouth, it’s reasonable to terminate therapy without attempting repair.

How to Cut Ties

If you decide that you need to end your relationship with your therapist, the next question may be how to do it. The means you use might depend on the stage of your relationship as well as the reason for discontinuing services.

If you’re either just starting to work together or you’re winding down, communication via email may be appropriate. Similarly, if the choice to end services is a financial one, email is OK.

In these cases, your therapist might like to hear some context on why you have decided to end services, even if it’s as simple as, “I just don’t think we’re a good fit.” It’s helpful for therapists to know why a client is choosing to end treatment, and providing an explanation gives them an opportunity to offer a referral, if appropriate.

Ideally, though, therapist and client get a chance to process the breakup during a session. This allows for the possibility of closure as well as collaboration around next steps. Most therapists recognize they won’t be a good fit for every client and will gladly offer referrals when a client opts to end services.

You might wonder whether it’s OK to simply stop making appointments or ghost your therapist if you feel there were boundary breaches or elements of disrespect. On one hand, it could be seen as disrespectful toward the therapist; on the other hand, you may feel this is your only solution. Ghosting could also be seen as perpetuating avoidance, which is basically the opposite of what you should be working toward in therapy. Whether it’s with your therapist or anyone else in life, it’s much healthier to speak up if something isn’t working.

But sometimes the relationship is too far gone for a formal, in-person goodbye. A few months into her work with Jones, Nadine found herself with more than just a bad taste. Disturbing dreams featuring the therapist, unexplainable physical pain, and expressions of concern from friends and family finally convinced Nadine she needed to call it quits. She ended things by email.

“Funnily enough, her response was kind and understanding,” Nadine says. “I wish that would have happened in therapy.”

Worth the Wait

Nadine’s experience illustrates how hard it can be to find the right therapist — and how distressing it can be to stay with the wrong one.

Thankfully, her story has a happy ending. She took a chance on another therapist. It was a little scary to start the process yet again, but this time things felt different.

“My new therapist explained her philosophy from the beginning,” Nadine says. “She encouraged me to offer feedback, and even told me she’d help me find another therapist if things weren’t working between us.”

With this early foundation of trust and candor established, Nadine finally felt safe to open up. The new therapist wanted to know her story and understand her as a person, not a diagnosis. And while previous therapists had been either too hands-off or too confrontational, this one was like Goldilocks — just right.

“She held up a mirror,” Nadine says. “I could see my authentic self in the reflection.”

This is exactly what therapy should be. “Good therapy means better understanding yourself so you can get to the root of your issues,” says Michaels. “It takes time, but it’s worth it.”

5 Signs That It’s Time to Break Up With Your Therapist

Consider the following red flags if you’re on the fence about whether to stick it out with your therapist.

1. You don’t seem to be a priority. The therapy hour should feel sacred. If your therapist is chronically late, seems distracted during sessions, or doesn’t recall important details you’ve shared, consider looking elsewhere.
2. You’re not sure what you’re working on. An effective therapist will explain their approach, work with you to develop goals, and regularly check in to ensure you’re meeting them. Frequently wondering what you’re doing and why — or not getting clarity when you ask — can provide grounds for taking a step back from the relationship.
3. You feel more like a diagnosis than a human. Formal diagnoses can be helpful, especially if they lead to effective treatments. But you are a human, not a collection of symptoms, so think twice if your therapist seems more focused on treating a disorder than understanding a real person.
4. You feel minimized, judged, or belittled. These are obvious red flags: Therapy must feel safe to be effective. Still, therapists are human. They make mistakes, miss cues, and put their foot in their mouth from time to time … which is why the final sign is so important.
5. You don’t feel comfortable offering feedback. You can and should be able to bring up missteps or misunderstandings without fear of getting a defensive reaction. Any therapist who isn’t willing to hear your concerns is not the right therapist for you.

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