Concealment, an act of intentionally withholding information for some purposes, is considered to be often employed by caregivers to veil the terminal status of the patients. This paper therefore investigates the pragmatics of concealment in interactions between terminally-ill patients and their caregivers as it relates to psychotherapeutic process; thereby complementing existing studies which have largely captured attitudes, strategies and structures of such discourses. Seven interactions, capturing cancer, heart disease and kidney failure, were collected through tape-recording and participants’ observation at University College Hospital, Ibadan, between February and August, 2016. These were transcribed and analysed using convergence aspect of Gile’s Communication Accommodation Theory. Findings show that concealment in this discourse pragmatically configures psychotherapeutic context which bifurcates into palliative psychotherapy and cognitive-behavioural therapy. Palliative psychotherapy, through shared situational knowledge and mutual contextual belief, raises hope of recovery and dislodges fear of death. Cognitive-behavioural therapy, through shared cultural knowledge, facilitates compliance and support in the healing process. The aforementioned findings resonate that the use of concealment in therapeutic discourse psychologically changes the underlying thoughts that contribute to mental depression and modifies the problematic behaviours that result from these thoughts