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Partners in Aftercare

[This guest post is one of several guest posts that will be appearing on our Partners and Wellness blog during the upcoming weeks.]

After therapy, there will be surprises, challenges, and new problems that will test your resolve and your ability to apply your newfound emotional skills to new situations. One of the most important tasks that should take place before you leave therapy, and ideally, as early as possible, is the development of your personal support network, which should include individual family members, friends, advisors, organizations, or other individuals or groups that can be supportive of you during recovery and beyond.

In many cases, a spouse or other family members (or close friends) may need to be taught to be understanding and supportive of you during and after therapy. They may have joined you for some psychoeducation. If so, they’ll be able to see you through a new lens; rather than see you in terms of themselves, they’ll learn to understand that you are dealing with a set of struggles and are working to overcome them.

Generally, family members of those with mental illness or addiction problems are themselves suffering. They find the stress of coping with a mentally ill or addicted family member to be overwhelming. They themselves may be struggling with mental illness or addiction. Studies show that the probability for continuing therapeutic success goes up dramatically with the development of a healthy, strong, and compassionate support network. After therapy, caring partners in your support network can give you tips and pointers about how to solve problems that come up. They can remind you to use techniques you learned during therapy. This can make an enormous impact on your continued wellness.

Therapeutic success doesn’t happen in a vacuum. I know from keeping track of my own case outcomes: those patients with very supportive family members tend to do better over the long term than those patients without. Sometimes (and perhaps more often than not), in the real world, family members’ own issues may impair their ability to help you.

Even if your family is not so supportive, you can still do very well as long as you develop another kind of support network. One of the benefits of joining a 12-step program or other support group is the chance to make friends who really understand what you are going through and can help you continue to achieve your goals. Recently a friend of C.R.’s who is trying to cope with family-of-origin abuse, created her own path to treatment.

While raising her own family, she faced many triggers which she found hard to cope with. She decided she benefited more from attending Al-anon (a 12-step program for family members of alcoholics) than therapy, even though alcohol abuse was not an issue for her parents. The care and support she received in Al-anon is exactly what she feels she needs to resolve some painful issues.

Everybody needs a friend, companion, or mentor who can help them face life’s challenges. Your therapist shouldn’t become that type of support forever. The kind of intense support your therapist gives you must end in a reasonable time-frame, otherwise, your therapist becomes part of the problem. In ancient China, the upper classes paid doctors to keep them well. If they became sick, the doctor wasn’t paid until he cured them! The more a patient saw his doctor, the less the doctor was paid.

Though we operate somewhat differently today, we can borrow the general idea. Your therapist’s job is to help you get to the point where you can function in an emotionally healthy way — without the need to see him. Sure, occasionally you may want to call your therapist to ask a question or two. But healthy, non-therapy relationships with family and friends with whom you can bare your soul and get—and give—feedback are essential to living a normal, healthy life.

There is an American cultural phenomenon where people’s relationships with their therapists are taking the place of relationships with family and friends. I know it exists in big cities on both coasts; I am willing to bet that it exists to some extent in other places in the country. Remember, unless you have a specific diagnosis that requires it, you should not be in therapy year after year after year.

I strongly question the agenda of a therapist who would keep a patient in therapy for so long. Without knowing the particulars, it is hard to say definitively, but it would be a reasonable guess to say that some therapists view their patients as “paychecks.” If you haven’t developed the ability to end therapy and live independently after a reasonable treatment time frame, ask yourself: Why not? Why hasn’t my therapist helped me develop the kind of skills I need to help me find and sustain interpersonal relationships?

Skill building of all kinds must be a part of good therapy. A therapist must help you make a life for yourself—a real life, without therapy. Also, the existence of a reasonable time frame for ending therapy, along with a comprehensive discharge plan that clearly outlines your support network, shows that your therapist wants you to succeed without him.

Joined hands photo available from Shutterstock.

Partners in Aftercare

Kate Thieda

Kate Thieda, MS, LPCA, NCC, is a patient advocate for Women's and Children's Services at Duke University Hospital in Durham, North Carolina. She is a licensed professional counselor associate and a National Certified Counselor who specializes in cognitive-behavioral and dialectical behavior therapies. Her book, Loving Someone With Anxiety, will be published by New Harbinger in the spring of 2013.

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APA Reference
Thieda, K. (2012). Partners in Aftercare. Psych Central. Retrieved on November 18, 2019, from


Last updated: 18 Aug 2012
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