Jan. 23, 2019 12:05 pm

How to break up with your therapist

Picking the right care environment for your needs in essential. Two people who have received mental health services and two health professionals advise on how to make the switch when it's not working out.
The decision to go to therapy in the first place can be a tough one. The decision to end a therapeutic relationship can be just as tough.

Picking the right mental health professional and care environment for your needs in essential, and when that relationship or environment aren’t feeling good for any reason, it’s perfectly acceptable to transition to new ones.

“People don’t have a consumer mindset when it comes to therapy,” said Becca, a former West Philadelphia resident who has received counseling services, but “you are making a choice about the care you receive.”

(Anyone with financial constraints should check out Generocity’s guide to finding mental health services on a sliding scale if they feel stuck with one therapist because of the costs.)

To help you figure out what’s best for you and how to approach what can be a delicate situation, here’s some advice from two folks who have transitioned from one therapist to another as well as from two local mental health professionals; last names have been omitted at sources’ request.

Look for these signs

Any decision about therapy is extremely personal. Sometimes it’s clear something isn’t working out. Other times … not so much.

Dana, a South Philadelphia resident, recognized that it was time to look at other options when she and her therapist uncovered a disorder that wasn’t evident at the beginning of their therapeutic relationship. The disorder wasn’t one that therapist specialized in, so Dana worked with her therapist to find someone else.

“Part of the therapeutic relationship is that there is some sort of agreed upon common goal that is being work for,” said Paul H., a therapist in Philadelphia. “The number one red flag I would see is if there’s not an agreement of what that goal is.”

It’s not always so evident, and even in Dana’s case it took time to come to that conclusion. Therapy involves a lot of checking in. Make sure you’re are making time to check in with yourself about how therapy is going.

Having a friendly or chatty therapist isn’t enough, Paul said: “You should feel challenged or like you’re doing work.”

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What you don’t want, according to Becca, is to feel like you’re avoiding your therapy session because your therapist isn’t helpful — though “there can be active avoidance because I don’t want to talk about my issues,” she said, which is different. If you’re experiencing those feelings of avoidance, take some time to figure out what is the source of those feelings.

Check in with the therapist or another healthcare provider

Each situation is so varied and personal, so it’s important to get another perspective.

“Perception creates reality,” Paul said. “There might be something that therapist may or may not be even aware that they’re doing.”

A client might get frustrated that their therapist is checking the time, for instance. However, the therapist might want to be conscientious of their next client instead of eager for the current session to end. Talking about it with your therapist can help address something you want to change before it leads to a professional split.

If you’re still not content, talking about it with another healthcare provider can also help provide insight. For Becca, the experience with other mental health professionals both previously and concurrently helped cement her decision to transition her care to someone else.

Recognize that it’s not a bad thing

“Ultimately, what I want is for people to be able to advocate for themselves,” said Sean P., a Philadelphia-based social worker who works in community behavioral health.

Similarly, Dana shared, “if you can talk through your issues with them, you’re showing them you’re actually applying the skills they are teaching you,” depending upon your personal goals with your therapist.

How to do it

Sean emphasized that part of the training to be in the mental health field is maintaining professional boundaries, despite the fact that therapy can be an emotionally intimate experience.

“We welcome hearing feedback directly,” Paul said.

You can bring it up directly with your therapist and explain that your needs aren’t being met, like Dana did. Her therapist agreed and helped transition Dana’s care to another professional.

You can also communicate it in other ways.

“I sent an email that said ‘I have decided to transition my care.’ I kept it short and formal,” Becca said. Ideally, it’s the final part of an ongoing conversation but that may not be the case for everyone and that’s OK.

Most importantly, Sean said, “don’t worry about upsetting your therapist.”


Full disclosure: Dana and Becca are both friends of the author. The interviewed mental health professionals’ workplaces declined to let their names be used in this article; none of their clients were interviewed in this article.


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