When it’s time for goodbye
BACP Children, Young People and Families, December 2025

Much of the psychoanalytic literature on endings in child psychotherapy contains themes such as how endings enable emotional growth and highlight the anxiety and grieving entailed in ending therapy, while many behavioural studies focus on premature endings.¹ More recently, empirical psychoanalytic studies have begun to also focus on premature endings and dropping out of therapy.²

While many experienced therapists come to establish their own guidelines for endings, those in training or new to child work often find endings challenging, even in treatments that have gone well. There are few published overviews, and this article aims to fill that void by providing basic guidelines. I also include a description of my treatment model and the approach from which the guidelines developed.

Integrated child psychotherapy model

Like many contemporary child therapists, I integrate various perspectives. As a psychologist, I have found the most relevant are techniques from psychoanalytic, behavioural and parent/family therapy orientations. By psychoanalytic, I mean relational-developmental theory, which places the relationship between child and therapist as the primary catalyst for enabling a developmental process towards symptom reduction and better relationships. Change comes about through play, talking, emotional expression and insight. Not unlike mentalisation (understanding our own and others’ mental states),³ the therapist provides empathic attunement (accurately interpreting psychological content with compassion)⁴ and strives to develop this capacity in the child and parents. 

The behavioral component includes elements of classical learning theory and contemporary cognitive behavioural therapy (CBT). Accordingly, while the model facilitates emotional expression and insight through play and talking, it also allows for skill building. For example, when children are struggling to cope with sleep, calming behavioural strategies may be incorporated. Further, while the model centres on the child, it allows for generous add-ons of parent involvement with parent-only sessions, and/or parents and child together. In this way, I can work individually with parents to develop beneficial insights, and/or work directly with child and parents together in family meetings to resolve specific conflicts. With this background and model in mind, I suggest the following 10 guidelines for desirable child therapy endings: 

1. Consider whether the child and family are ready to end 

This is perhaps the most important consideration, and ideally set into motion based on the child’s resolution of the emotional and/or behavioural issues that led them to seek therapy in the first place. This is often accompanied by a sincere desire to use the time for other age-appropriate activities.⁵ It’s especially notable when these are activities in which the child was not previously able to participate because of the emotional or behavioural issues that brought them to therapy. 

2. Include a reflective dialogue 

Reflective dialogue is fundamental to psychoanalytic technique, and aims to facilitate expression of feelings and improved insight and self-awareness. It allows the therapist to be empathically attuned, and helps the child gain healthy, self-affirming perspectives. Research on termination of therapy with young adults finds that reviewing the therapy experience and goals, and focusing on feelings specifically about saying goodbye, are much appreciated by clients.⁶ I also find this to be the case with children and families. Assuming that therapist, child and parents have decided the goals of therapy have been met, the therapist may, with the child and parents individually and/or together as a family, set aside time to reflect on: 

• how things have improved
• how you have spent your time together – including games, pretend play and the issues discussed
• the sad feelings that can accompany endings, such as missing seeing each other
• the positive, happy feelings, like the joy of seeing progress and change. 

3. Include an explicit statement that the child may return 

Stating clearly to the child and parents that you will be available at a future time should the need arise is standard practice for healthcare professionals, and a common recommendation in child play therapy.⁷ It also reflects more recent perspectives on endings which are not framed in terms of cures. With this in mind, we might say something like: ‘I am not going away. You will just not be coming here anymore. But I will still be here. And if you would like my help again, you can tell your parents and they will let me know.’ In training situations, clients will be informed that training is on a schedule that may not coincide with the end of treatment. Thus, in beginning and ending training cases, it’s important to let the client know that they can continue in the clinic with another well-supervised and matched therapist. Or if they wish to stop, to make sure they know they can return and a good match will be provided. 

4. Decide what schedule to follow including the last session 

While it may be possible to maintain a consistent weekly schedule until the last session (often the case in psychoanalytic treatments) or have a set number of prescribed sessions from the beginning (as in behavioural treatments), I generally find that meeting less frequently and tapering off is preferable. This approach derives from guidelines⁸ which emphasise client preference rather than strict adherence to theoretical models. For example, in my experience, it has been beneficial to go from weekly individual therapy to fortnightly sessions and then monthly sessions prior to ending. 

5. Prepare to be flexible and resourceful 

In classical psychoanalysis, termination is often a distinct lengthy phase, which theoretically ensures that the treatment is complete and that the child is ready. At the other extreme are shorter treatments which resolve pragmatically. For example, consider working with a divorced dad and his eight-year-old child for about seven months. They return from holiday and the dad conveys that the child is doing well, having fewer temper outbursts and has made some friends. She is adjusting to dad’s new partner and step siblings – the primary goals of the treatment. You decide to take a break to ensure that goals are consolidated and, upon resuming, all seems well. Despite much encouragement for the child to participate, the final session is just with the dad. However, it contains many of the elements discussed here. 

6. The last session may be a graduation 

The notion of termination as a graduation is endorsed in literature on child CBT endings⁹ and termination of adult treatment.¹⁰ It helps frame the ending in positive terms associated with feelings of accomplishment, health and wellbeing – a framework also endorsed in the adult literature.¹⁰ Thus, the last session with children and parents may include a card and/or a small gift exchange. A framed drawing that the child made in therapy is often well received and card with a note is always appreciated. I might write something like: 

Dear Nancy, You have been strong and brave in overcoming many fears. Your persistence and hard work are awesome. I will remember your beautiful drawings. Best wishes, Dr Sonya 

7. Consider developmental issues 

While individual differences can account for a great deal of variability, younger children generally won’t want to dwell on saying goodbye. They usually have less capacity for tolerating affect than older children, teens or adults. 

However, components of the goodbye process may appear in the young child’s imaginative play. For example, consider a pretend play scenario like this one, at the end of treatment: The setting is medieval times. Woodsmen and knights are in battle. Many are wounded. A genie appears and says, ‘I can help.’ She stops the battle and heals all the hurt people. They all get better. Everyone is very grateful and thanks the genie. This may be interpreted as the child saying things are better for everyone in the family due to the treatment and that all are thankful for the help they received. 

8. Consider the child’s previous experiences with separation and loss 

Another important therapeutic consideration is that many children in therapy have not had good experiences with endings. They may have experienced abrupt or traumatic separations and losses – like losing a loved one in an accident or through a contentious break-up in the family. Ending therapy may remind them of these experiences, even though it may seem that these were worked through in the treatment. You may need to revisit some aspects to help them gain better mastery. Ending gradually, and on the child’s terms, is especially important in these cases. It can also be reassuring to remind them that things are different and better now, they have new strategies for coping and they may return if needed. 

9. Recognise the value of what is being modeled 

While ending, like much of what goes on in therapy with psychoanalytic elements, is co-created and allows for a range of emotions, most children and parents will want your guidance. Modelling, in keeping with social learning theory, a thoughtful and calm paradigm for saying goodbye can be very therapeutic, and have lifelong benefits. 

10. Managing ‘Geppetto envy’ 

The concept of ‘Geppetto envy’ came to me at an early stage in my career, when a child I was treating became much better. This was accompanied by a wrenching sense of impending loss, as I knew we were nearing time to say goodbye. This did not feel like classical countertransference (feelings the therapist has about the patient stemming from the therapist’s personal history, which may suggest the need for further personal analysis to remain objective in the treatment). Rather, it was based in the here-and-now of our real attachment. Of course, clients may also struggle with losing their therapists, making endings even more bittersweet.

‘Geppetto envy’ originates from the story of Pinocchio,¹¹ the wooden puppet carved by the craftsman Geppetto. Pinocchio does not fare well among rough and tumble real live boys. He gets picked on and bullied. He gets lost. He has nightmarish experiences. But he overcomes hardships, lessons are learned and his ‘strings dissolve’. 

Creator and boy are rewarded with Pinocchio becoming a real live boy himself, and Geppetto remains with the boy he laboured to create and care for through the ups and downs of a difficult childhood. At the end of the popular 1940 Disney film version, Pinocchio and Geppetto go happily heel-clicking off into the horizon. 

When child therapists complete a treatment, they do not remain in relationship with their clients. When children in therapy begin to ‘lose their strings’, it’s just about time to think about saying goodbye. Geppetto envy refers to the experience of child therapists, upon ending therapy, in which they envy the craftsman Geppetto because he and Pinocchio remain happily in relationship. Although it will not be a primary guidepost in navigating the goodbye process, at the end of some treatments that have gone well, therapists may find themselves feeling Geppetto envy. If this is the case, I offer some advice: Embrace it. It probably signals a job well done.