Coping with a Break in Therapy (A Parent's Perspective)

A planned break in therapy is an agreed-upon interruption of ongoing psychotherapy. The therapist, the child, and the parents jointly decide that no sessions will take place for a few weeks or months. What’s important is the plan behind it: there is a reason, an approximate timeframe, and an idea of when and how therapy will resume.

This distinguishes a break from discontinuing therapy, in which treatment ends without prior agreement. During a break, the therapy slot is usually retained, and the relationship with the therapist continues. Outpatient psychotherapy is typically approved in blocks anyway, such as short-term therapy consisting of up to 24 therapy hours. Shorter interruptions are common within this framework.

The reasons for taking a deliberate break vary:

• Putting it to the test in everyday life: The child has learned something in therapy and should try it out at home and at school, without weekly appointments.
• Assessing effectiveness: Professional associations recommend evaluating the success of treatment after about eight to twelve weeks. A break can be part of this assessment.
• Vacations or external circumstances: A vacation, a move, or a change in therapy practice.
• A gradual phase-out: Before therapy ends, the intervals between appointments are lengthened to help the child feel more secure.

In any case, the decision is a joint one. If an agreed-upon goal is not met, the specialist and the family discuss the causes and adjust the approach.

For many parents, time without scheduled appointments feels unsettling. A few concrete steps can provide some stability:

• Mark the return date or the time of the next meeting firmly in your calendar.
• Before the break, clarify how and who to contact if things start to fall apart.
• Write down the progress your child has already made so you can look back on it during difficult moments.

Parents shoulder a lot of the burden on their own during this phase. Anyone who remains on high alert for weeks on end will soon become exhausted themselves. Taking time to recharge is therefore part of the job. You’ll find suggestions for this under “Self-Care.” Feelings of guilt about not doing enough during the break are common—and rarely justified.

The break is not wasted time. What the child has learned in therapy is practiced at home. This doesn’t require therapeutic expertise, but rather reliable support.

• Stick to routines: Set times for sleep, meals, and school provide structure.
• Stay in touch: Have short, calm conversations without grilling the child.
• Observe and take notes: mood, sleep, appetite, withdrawal. These notes help the therapist during the next session.

In child and adolescent psychotherapy, the immediate environment of family and friends is deliberately included, and working with parents and caregivers has become increasingly important. So you are not a substitute therapist, but an important part of the process. When the child returns to the therapist’s care, you hand things back over to the professional; the article “Handoff to Professionals” is relevant here.

A break doesn't always end as planned. Contact the doctor's office sooner if you notice any of these signs:

• A clear recurrence or worsening of the symptoms that led to the start of treatment.
• Severe or persistent withdrawal, refusal to go to school, or breaking off friendships.
• Significant weight loss, barely any sleep, and persistent low mood lasting more than two weeks.
• Comments about self-harm or the desire to end one’s life.

With the last point, every hour counts. The on-call medical service can be reached at 116 117; in case of immediate danger, call 112; and the telephone counseling service at 116 123. Having a crisis plan in place helps you act calmly in such moments.

When deciding whether to continue the break or resume treatment, the treating specialist is the first point of contact. Many practices offer short office hours or telephone consultations. If you’re still unsure, contact your pediatrician, a psychosocial counseling center, or the social psychiatric service. Looking back, many families say they wish they’d sought support sooner.

Rückenwind We’re here to support you as parents through this time with coaching and guidance. A diagnosis, the assessment of symptoms, and decisions regarding the course of treatment should be left to a child and adolescent psychiatrist (KJP) or a medical or psychotherapeutic specialist.