Psychotherapy can often feel like a stabilizing force keeping your life together. But there may come a time when you may not need to go for a while. Or something can happen ― say, your finances take a nosedive or you have to go out of town for an extended period ― making it unfeasible to keep a standing appointment.
“It’s very common for people to take a break from therapy, even if they aren’t ready to,” said Anna Kress, a New Jersey-based clinical psychologist. “The most common reasons for taking a break include finances, scheduling difficulties, moving or travel.”
As tough as it can be to bring up the subject, the best remedy is to discuss it with your therapist as openly and as early as possible. No matter why you need to cut back or pause therapy, information and lead time gives your therapist ample opportunity to help you transition.
Curious how else you can adjust based on your situation, or how to take a pause altogether and maintain your mental health? Experts break down some options below.
If the break is a financial decision, talk about adjusting the cost.
Many therapists are open to temporarily lowering the cost of sessions for patients who are struggling financially, “especially if I feel that a patient would have significant difficulty supporting themselves during a break from therapy,” said Katie Krimer, a therapist based in New York. The sooner you broach the subject with your therapist, the sooner you can alleviate at least one of your financial worries.
Explore other budget-friendly options.
If your therapist is unable to lower the price of sessions (or the lower price still won’t fit your budget), another option is to have your therapist point you in the direction of budget-friendly options you can turn to until you’re back on your feet.
“This could include free and low-cost support or therapy groups, spiritual and religious support when appropriate, and other events that offer you a community to lean on,” Krimer said. (Here’s a comprehensive list of affordable therapy options if you need them.)
Consider doing some sessions over the phone or online.
Some circumstances can make physical trips to your therapist’s office a challenge, in which case your provider may be open to temporarily having sessions over the phone or online, known as teletherapy.
“Although teletherapy appointments are similar to in-person appointments, therapists are obligated to make sure they’re practicing within ethical and legal guidelines,” Kress said. That means taking precautions to ensure that the communication platform is secure and protects your privacy, as well as making sure they’re allowed to practice therapy with you if you’re outside state lines (some states allow therapists to continue providing therapy in their state for a short duration, while others don’t unless the therapist is licensed in that state).
If you’ve permanently relocated, it’s usually best to be referred to a therapist who’s licensed in your new state, Kress said. Teletherapy apps, like Talkspace and BetterHelp, can offer an alternative to traditional therapy and streamline the process of finding a therapist based in your new location. (Before signing up, Kress recommends reading the terms and conditions carefully and making sure the therapist you ultimately choose is qualified and licensed in your state.)
Your therapist can refer you to someone with better hours.
Circumstances like an uptick in work hours or surges in personal obligations can make your schedule chaotic and unpredictable, which is not a great recipe for maintaining therapy appointments. If your therapist’s hours don’t align with your schedule, maybe there’s someone else who does.
“Therapists often have colleagues they can refer you to who have flexible schedules, evening availability, or weekend appointments,” Kress said. (This tends to result in a permanent change rather than a temporary fix, however, since it’s usually better to have one consistent therapist for individual therapy.)
You may be able to reduce the number of sessions.
“Often, patients will feel like they need to come into therapy every week as a rule, and it helps them to be reminded that lessening sessions could lighten the financial burden,” Krimer said. That can help with time restraints, too.
Book one session at a time.
If your financial situation or schedule is particularly rocky, another option could be to book one session at a time, instead of trying to set them weeks in advance.
“Unless there’s a court mandate or other compelling reason why you’re supposed to attend regular sessions over a period of time, therapy is usually done on an appointment by appointment basis,” said Tina B. Tessina, a California-based licensed psychotherapist author of It Ends With You.
If you’re unsure by the end of your current session when you’re able to schedule your next one, let your therapist know that you’ll get in touch to confirm as soon as you can.
Do ‘homework’ between sessions.
If you do end up doing fewer appointments, your therapist may encourage you to work through a particular workbook or read a self-help title that’s based on the specific topics or issues you’ve been addressing in therapy. This can help maintain your mental health and offset the reduction in sessions.
“Typically, I’ll have already had someone start on a workbook or set of activities, and will encourage them to continue coming back to these tools between sessions,” Krimer said.
Make the most of the sessions you attend.
Just because you have fewer sessions doesn’t mean you can’t make them count. Keep a journal of your thoughts and feelings between appointments, like issues that are bothering you, questions you’d like to ask, successes and breakthroughs you have and moments when you feel out of control, Tessina said. When you come in for your next session, bring your journal with you and go through it with your therapist, point by point, to maximize your time together.
Plan ahead if you’re taking a full pause.
If you have to take a break from therapy for a longer stretch of time, planning ahead is paramount. Start by identifying coping skills you’ll utilize when a particular struggle or trigger occurs.
“It’s likely that we’ve already addressed particular behavior, thought and physical stress that someone goes through when they’re working to improve their mental health,” Krimer said. Going over the coping skills you’ve learned together and compiling a cheat sheet of sorts can help you feel more confident and in control while you’re away from your therapist.
Process your feelings about taking a break.
“It’s common to have feelings of loss during a therapy break, and it can be helpful to discuss these feelings ahead of time,” Kress said.
Sometimes we need to take breaks from therapy, which can both enlightening and worrisome, but it’s OK that they happen. And when it is time to hit pause, your therapist will be there to help you prepare and feel confident in your ability to maintain your mental health during the off period.