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Preparing for the end of therapy

September 14, 2020

CBT is a short-term therapy which aims to help you become your own therapist. For most people treatment lasts a few months, with the number of sessions tailored to their individual needs. This means that, unlike some other talking therapies, there’s a definite end point to the treatment which will be determined based on the progress you make.

The idea is that the skills you learn will equip you to manage your mental health in the future. A few years down the line you should be able to call on them if you’re experiencing similar problems – and also hopefully apply them in other situations, too.

This is why your therapist will spend one or two sessions helping you to prepare for the end of your treatment, and looking to the future, so you’re ready to continue developing your CBT skills independently. You may be asked to take more of a leading role in these sessions to build your confidence.

You might discuss things like:

  • What led to the difficulties you were having when you started CBT?
  • What situations might lead to these resurfacing, or being triggered, in the future?
  • Which techniques and tools might help you manage this?

During your final session you’ll complete a relapse prevention plan; also called a ‘therapy blueprint’. This will summarise everything you’ve learnt, and help you prepare to cope with any setbacks after therapy has ended.

While your treatment might be complete, the CBT could actually just be getting started. You’ll need to practice the techniques you’ve learned to embed them, so don’t put your workbook away in a drawer! Keep revising your notes and your plan, and put the skills into action whenever you get the chance. In other words, give yourself homework! It’s also a good idea to check in with yourself regularly by filling in the questionnaires.

One advantage of online CBT is the ability to look back at every conversation and interaction you’ve had with your therapist. While you’ll no longer be able to message them, you can log into the therapy website for as long as you like. This allows you to access all of your appointments, messages and goals to remind yourself what you’ve learned. If you find yourself facing similar difficulties in future you can look back to a relevant session, in effect ‘reliving’ the appointment, and apply the same tools.

How you feel as you come to the end of your treatment will probably depend on how the sessions have gone for you, and the difficulties you came to CBT with. You might feel a bit cast adrift. Some people feel relieved at getting their time back! More often than not, patients are apprehensive, and wonder whether they’ll be able to manage as well on their own. If this is you, you could challenge yourself with an experiment – leaving longer between appointments to test how you cope. This should help boost your confidence, or highlight any areas you need to work on to feel more prepared for ‘going solo’.

Some people are afraid they might have a setback, or will relapse altogether. First of all, it’s worth making a distinction between those terms.

Setbacks are minor blips that feel like you’ve taken a couple of steps backwards in your progress. We all have bad days; if you keep applying what you’ve learned you ’ll get back on track.

A lapse is when you’ve fallen back into the ‘vicious cycle’, and it’s been like that for a couple of weeks or more. The best thing to do is take out your workbook and notes, review the sessions that are relevant, and consciously make a change to your behaviour.

A relapse is when you go back to the very beginning – and it’s important to emphasise that this is very rare. The simple fact is that you can’t unlearn something you’ve learned, so you will never be back at square one!

If you find you’re really struggling, however, you will be able to return to therapy.

Read more about what to expect from the online CBT process here.

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