Taking a Break From Therapy: A Pause or an Escape?

Thinking of taking a break from therapy for financial or time reasons? Learn how to tell a healthy pause from an escape and how to plan the break with care.

When your landlord announces the rent increase, one of the first sums that runs through your head is the money you set aside for your session every week. Or perhaps your shifts have changed in your new job and Tuesday evenings are never free any more. Maybe your baby has just been born and you don't have a single hour left for yourself. In situations like these, taking a break from therapy looks like an unavoidable and sensible option. Often it is. But sometimes the same decision becomes a polite way of quietly closing the door on a process that is starting to get difficult. In this article I look at how you can tell a healthy pause from an escape, what is worth paying attention to before taking a break and how to make returning afterwards easier.

What Does Taking a Break From Therapy Mean?

Taking a break from therapy means stopping sessions for a set or open-ended period at a point when the process has not yet been completed. What distinguishes it from ending therapy is that the goals have not yet been reached and the person intends to continue at some point.

Breaks can be roughly divided into two kinds:

• Planned breaks: Pauses that have been discussed in advance, with a clear length and reason, and with a return date or condition agreed. For example, a two-month break for a teacher who will spend the summer in their hometown, or a pause taken for the first weeks after giving birth.
• Unplanned breaks: A new appointment that never follows a cancellation, a "Let's leave it for now" message, or contact that simply stops without explanation. These breaks tend to stretch out, and returning becomes harder.

Both kinds can have valid reasons. But a planned break offers a much stronger foundation for protecting what has been gained in therapy.

Common Reasons for Taking a Break From Therapy

Behind clients' decisions to take a break, the following reasons are usually found.

Financial difficulties

At times when the rising cost of living is felt, therapy can be one of the first items in the budget to be questioned. The question "What with the bills, school costs and rent this month, where am I going to fit in the session?" is real and legitimate. We look in more detail at how economic pressure affects mental health in the article on the cost of living and mental health.

Changes in time and routine

A new job, changing shifts, caring for a relative, exam periods or a house move may leave no room for a weekly session. Sometimes the problem is not the session itself but the time spent getting there and back.

Feeling good

When symptoms ease, the thought "It seems I don't need it any more" is natural. Sometimes this really is the right timing; sometimes it is an early stage at which the gains have not yet settled enough.

Tiredness and saturation

Someone who has been doing intensive work for a long time may want to "be on their own" for a while, try out what they have learned in their life and have a period independent of therapy. This wish can be a natural stage of the process.

Others questioning it

"Are you still going? Haven't you got better yet?", "What on earth do you talk about for all that money?", "We've had our troubles too, and we never went to anyone." Comments like these from a partner, a mother or colleagues can lead a person to doubt their own decision. Especially in circles where going to therapy is still seen as a weakness or an "overreaction", a long process brings the pressure to explain oneself. Break decisions made under this pressure often reflect the expectations of those around the person more than their own needs. Noticing how much a voice like this is influencing your decision is the first step towards understanding whether the decision is really yours.

Entering a difficult period

When a subject that has long been avoided in therapy is approached, the wish to take a break can rise suddenly. In this case, even if the external reasons (money, time) are real, the timing of the decision is worth thinking about separately.

Taking a Break From Therapy: A Pause or an Escape?

The answer to this question is not always clear, because in most decisions a real external reason and an emotional wish to escape can exist side by side. Asking yourself the following questions can help you tell them apart:

1. When did I start thinking about this decision? After a financial or practical change, or after a challenging session?
2. Am I planning to discuss the break with my therapist, or does ending things with a message feel easier?
3. What do I plan to do differently during the break? Do I have a plan?
4. Do I have a time or condition in mind for returning?
5. If the financial or practical obstacle disappeared, would I want to continue?

The last question is particularly important. If your answer is "Yes, I'd continue straight away," you are most likely facing a real obstacle, and it is worth looking for a solution. If your answer is "Actually, I'd feel a bit relieved," there may be something within the wish to take a break that needs to be talked about. This does not mean your decision is wrong; it simply shows that bringing it into the session would be useful.

Let's say a client who has just graduated from university says they will be moving to another city to find work and will have to take a break from therapy. The move is real; but it is also true that a difficult subject about their relationship with their father has come up in recent sessions. In this case, the thing to do is not to question the move but to use the final sessions deliberately so that the difficult subject does not leave a sense of being "left half-finished", and, if needed, to discuss the option of continuing online.

A healthy pause is not closing the door but leaving it ajar, knowing what you are leaving behind and when you will come back.

What Can Be Done Before Taking a Break?

Before deciding to take a break, it is useful to consider whether the same need could be met with a different arrangement.

• Reducing session frequency: Meeting every two weeks or once a month instead of weekly can ease both the financial and the time burden. This arrangement can work especially well in the consolidation stage of the process.
• Switching to online sessions: Once travel time and transport costs disappear, a session often fits into the day more easily.
• Narrowing the focus: A shorter work plan can be made that focuses on a single, concrete goal for a set period.
• Looking into public and low-cost options: Psychiatry and psychology units in state and university hospitals, practice centres attached to some universities' psychology departments, and psychological counselling services offered by some municipalities are among the options. Waiting times and the scope of these services can vary. You can read how psychological support works in public hospitals in the article on seeing a psychologist at a state hospital.
• Talking openly about fees: Some therapists can make different arrangements in certain circumstances; even if they can't, talking openly about the situation is far healthier than quietly disappearing.

If none of these options is suitable, taking a break is an entirely legitimate decision. What matters is that the decision is made in a planned way and after discussion.

How Do You Take a Planned Break?

If you have decided to take a break, doing so not by message but, where possible, by talking it through in a session is the most effective way of protecting your gains. In this "break session" the following areas can be covered:

1. What has changed so far? List together the changes you have noticed since you started therapy. This list helps you keep your motivation during the break.
2. Which skills have helped? Breathing exercises, thought records, boundary-setting sentences, things you can say to yourself in hard moments... Put the tools that work for you in writing.
3. What is left unfinished? Note down the subjects that have not yet been worked on or that were opened and not closed. These become a starting point for your return.
4. What are the warning signs? Identify the early signs that might show you are slipping back into old patterns: disrupted sleep, social withdrawal, rising irritability, avoidance returning and so on.
5. What is the condition or date for returning? Set a concrete yardstick such as "I'll start again in September" or "If two of these signs last more than two weeks, I'll get in touch."

This work allows the break to be experienced not as a rupture but as part of the process.

How Can You Support Yourself During the Break?

A few habits can help keep what you have learned alive while you are taking a break from therapy:

• Hold your own weekly session. At the time you used to go to therapy, set aside half an hour to review your week: What was hard, what helped, which skill did I use?
• Reread your notes. Glance once a month at the list you prepared in the break session.
• Keep your support network alive. Regular contact with a few people you trust is an important anchor during the break.
• Don't neglect basic needs. Sleep routines, movement and nutrition play a bigger role than expected in keeping your mood steady.
• Don't blame yourself. Struggling during the break does not mean that therapy didn't work or that you have failed.
• Keep up small experiments. Repeat now and again during the break a step you started in therapy, such as speaking up in meetings or setting a boundary with your mother on the phone. Skills that go unused gradually get rusty; those that are used become your own.

When Should You Not Take a Break, or Come Back Early?

In some situations, taking a break from therapy can be risky, or the break may need to end early:

• If there are intense depressive symptoms, hopelessness or a marked drop in functioning,
• If there has recently been a loss, a separation, a job loss or a traumatic event,
• If there is an increase in alcohol or substance use,
• If there are thoughts of harming yourself or ending your life.

In these situations, even if the financial or practical obstacles are real, it is important at least to keep in contact through less frequent meetings or to be referred to public services. If one of these signs appears during the break, don't wait for the return date you planned. If thoughts of harming yourself are involved, in an emergency call 112 (emergency services) or go to the nearest emergency department.

How Is the Decision to Take a Break Handled in Therapy?

When the wish to take a break is brought into the session, the therapist's aim is not to talk you out of it but to understand your decision together and help it be carried out in the healthiest way.

In cognitive behavioural therapy, the break period is often prepared for with "relapse prevention" work. The person plans in advance which situations are risky, which thoughts might trigger a return of difficulties and what steps they will take in those situations. This plan aims to enable the person to act as their own therapist in the therapist's absence.

From a schema-focused perspective, the relational side of the decision to take a break can also be discussed. Someone with an abandonment schema may try to control the risk of "being left" by leaving the therapist first. Someone with a subjugation schema may struggle to voice the wish to take a break out of fear that the therapist will be disappointed. Noticing these dynamics allows the decision to be made more freely.

Returning after the break is also a process worth talking about. In the return session, what happened during the break, which skills were used, where things were difficult and the goals for the new period are reviewed. Some people come back after a break with much clearer goals, because the break helped them see what really matters. When you want to start again, or to seek support for the first time, you can look at how the individual therapy process works.

Frequently Asked Questions

If I take a break, will my therapist take me back?

Most therapists treat a client's return after a planned or unplanned break as perfectly normal. However, the therapist's diary may be full at that point, so it is useful to discuss the conditions for returning in the break session. When coming back after a long break, a short message letting them know is enough.

Can I contact my therapist during the break?

This depends on your therapist's way of working and should be clarified in the break session. Contact is usually possible for booking appointments or planning your return, but therapy is not carried out by messaging. In an emergency, you should go to emergency services without waiting for your therapist.

How long a break is too long?

There is no fixed limit. A break of a few weeks often has no noticeable effect on the process, whereas after breaks lasting months some restructuring may be needed on return. What matters is less the length itself than whether the break was planned and how well your gains were maintained during it.

After a break, should I go back to the same therapist or start with someone new?

If your relationship with your therapist is safe and the process productive, continuing with the same person usually saves time, because you don't have to tell your story from the beginning. However, starting with someone new for reasons such as moving or a change of approach is also a healthy choice. In that case it helps to share with your new therapist what did and didn't work in your previous therapy.

• #therapy process
• #pausing therapy
• #cost of therapy
• #returning to therapy

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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