Ending psychotherapy
Psychotherapy is not complete simply because the final appointment arrives. Ending creates time to understand what has changed, what remains difficult and what it means to lose a regular relationship and place in the week.
An ending is part of the treatment
For children who are sensitive to change, rejection, separation, uncertainty or failure, an abrupt ending can repeat the very experience the work has been trying to make more thinkable. A planned ending lets those feelings enter the treatment rather than being acted out through disappearance.
When an ending may be considered
Ending dates are decided collaboratively with parent(s) and child, and termly psychotherapy reviews are when we consider this. Endings are usually most appropriate when:
the agreed aims have changed or been met sufficiently;
the young person has more internal and external support;
psychotherapy is no longer adding enough benefit;
another service or form of help should lead;
the child can no longer use the treatment meaningfully;
practical circumstances make continuing impossible;
the family chooses to end the rolling arrangement.
Four weeks’ written notice
Consent to psychotherapy can be withdrawn at any time. Ending the reserved treatment arrangement requires at least four weeks’ written notice, and the monthly fee remains payable up to and including the agreed end date. Where the young person wishes to attend, appointments during the notice period can help prepare for the ending.
If the agreed end date falls part-way through a billing month, the final fee covers only the days up to and including that date. If you have already paid for the full month, I will refund the prepaid days after the agreed end date.
The refund is calculated by dividing the monthly fee by the number of calendar days in that month and multiplying it by the number of days after the agreed end date. Refunds are issued within five working days after the agreed end date.
Appointments during the notice period should ordinarily be used. They help the young person:
understand the decision;
reflect on the work and the relationship;
reflect on feelings around separation and transition;
identify what has changed for the better;
identify where there is room for further development;
prepare for the final session (e.g. deciding on how to say goodbye, how to spend the final session, and which items of your materials/toy box you might like to take home to keep).
A longer ending may sometimes be clinically recommended, after longer-term or particularly intensive work, but this does not affect a family’s right to only attend or pay for the contractual notice period minimum of 4 weeks.
What is carried forward
The aim is not to leave with a flawless account or proof that every symptom has gone. The young person may carry:
a clearer language for their emotional life;
greater confidence in recognising needs and limits;
greater freedom to seek help from others, earlier and more openly;
greater ability to articulate their needs honestly;
greater freedom to experiment with their identity, personality and interests;
greater ability to name feelings and emotions;
greater awareness of their own emotional responses;
an experience of separation that can be thought about rather than simply endured.
How this fits i-THRIVE
The THRIVE Framework asks services to be explicit about goals, limits and what happens when an intervention is not working or is no longer needed. i-THRIVE also treats confidence in “letting go” and managing endings as part of good care, rather than equating a longer intervention with a better one.
My use of these principles remains clinically individual. Ending is not driven by a fixed number of sessions, and “better” is not reduced to symptom disappearance.
i-THRIVE: Building confidence in letting go and managing difficult endings.
THRIVE Framework for system change: outcome-informed care and explicit endings.
Written and clinically reviewed by Sagal Hassan, ACP-registered Child and Adolescent Psychotherapist. Last reviewed 31 August 2026.
Frequently asked questions
Not always. The number depends on the published treatment calendar and the agreed end date. The notice period is a minimum period of time, not a guaranteed count of sessions.
I would think with parents about what the refusal may communicate and whether another form of acknowledgement is possible. The fee remains governed by the notice period even when appointments are not attended.
Immediate safety takes priority. If a different level of care is required, urgent or statutory services may need to lead. The practical and financial handling of the existing arrangement would then be discussed in light of the circumstances and the signed agreement.
A future place cannot be guaranteed once the regular appointment is released. A new consultation or assessment may be needed because the child’s situation and the suitability of treatment may have changed.
No. Children may end with ongoing vulnerability, illness, neurodivergence or periods of anxiety. The relevant question is whether the work has increased understanding, agency and capacity, and whether weekly treatment remains the most useful form of help.
Parent Consultation
A 40-minute online appointment for parents, offering specialist guidance without an obligation to continue.