For Mental Health Professionals - The Practice Resource Section of GoodTherapy, How to Navigate the Termination of Therapy with a Client, Practice Management Software for Therapists, Rules and Ethics of Online Therapy for Therapists, How to Send Appointment Reminders that Work, For Therapists: What to Do When a Client No-Shows, Ending Therapy Right: Why Saying Goodbye Matters, This Is Goodbye: Ending Therapy with Intention and Meaning. The end of counseling, just like the end of a symphony, is not simply the end. Reach out empathically when clients no-show or cancel. For each of the statements below, circle the option (I disagree, Im not sure if it helped, It helped a little, or It helped a lot) that is closest to how you feel. A therapist may also need to terminate therapy with a client who makes unreasonable demands, whose insurance will not pay for therapy, or who otherwise presents practical or logistical concerns. Ideally, this adjustment period would include a space for self-supervision, with counselors objectively evaluating their performance and efficacy with the client. Working with a therapist can be extremely beneficial for a couple experiencing infidelity, if they can find a therapist who makes them both feel supported. Counselors can provide a letter template with certain blanks to be filled in, or they can simply provide a blank piece of paper on which clients can write their own letter. But cut and run is never the best termination strategy; it both denies the client the opportunity to process any feelings associated with ending the relationship and may leave the therapist unsure why a client left and whether they plan to return. Counselors also experience many emotions when forced-termination occurs. Forced-termination, by its very definition, means that the counseling relationship is ending prematurely. Encourage the child to share their feelings. If done ethically and competently, termination can help solidify counseling gains, empowering clients to integrate their experiences and bravely face their next chapter in life. Never blame the client, even if you must terminate therapy because the client is difficult or you are not a good fit. These strategies can help ease the transition: Laurie Leinwand, MA, a licensed professional counselor in Florham Park, New Jersey, shares how she helps foster a sense ofclosure at the end of therapy. Helping When terminating with a client who has a history of threatening to file licensing board complaints. Termination is often an ideal time to incorporate active, engaging and creative interventions that encourage clients to engage in active learning and reflection upon the counseling process as a whole. The counseling process is a planned and structured dialogue between client and counselor. A.11.c. 128 0 obj <>/Filter/FlateDecode/ID[<1D7D2AECFA9B1C233E1253F324377AAB>]/Index[88 93]/Info 87 0 R/Length 162/Prev 459343/Root 89 0 R/Size 181/Type/XRef/W[1 3 1]>>stream But for most people, there will come a time when therapy no longer feels necessary or progress has stalled. With practice, you can replace them with more functional habits. When a client repeatedly no-shows, a therapist loses time they could spend with other clients. Results. These tools will be critical in helping clients be self-sufficient in handling problems that might have previously brought them to counseling. When terminating with a client who has difficulty processing rejection. Men have long been silent and stoic about their inner lives, but theres every reason for them to open up emotionallyand their partners are helping. Syracuse University School of Education |, Engaged BIPOC Scholar-Practitioner Program, Office of Professional Research and Development, Instructional Design, Development and Evaluation, Center for Academic Achievement and Student Development, Center for Experiential Pedagogy and Practice, Types of Termination & Anticipating Reactions, Positive Endings to the Counseling Relationship, Remind clients of the approaching ending of the sessions with you. Counselor-initiated termination is also your ethical duty as a counselor if you determine an inability to provide professional service to your client. During the final session, counselors can bring a number of building blocks, Legos, Jenga blocks, or other toy blocks to session. Unresolved issues surrounding past relationships can be played out in the termination process, but if you handle the process ethically, sensitively, and honestly, you are in a wonderful position to provide your client with a healthy end to a productive relationship that they can look back on positively and feel comfortable with. Below are descriptions of two creative ways to provide closure during a final group counseling session: One fantastic method I have seen used to conclude a group has been the use of notecards passed around the room and filled out by group participants. and either rip them up, color over them, or simply fold them neatly. Clients then In such cases, counselors often feel a sense of insecurity in their ability to effectively connect with and counsel clients, guilt about losing a client, and possibly relief at being rid of a relationship that they were uncomfortable with. Practice Improves the Potential for Future Plasticity. Walking alongside clients as they grieve the loss of the counseling relationship allows them to experience the conclusion of a relationship in a nurturing and empathetic environment and helps them develop so that they can better manage future losses and transitions. Assisting participants in processing their feelings about termination and helping them resolve any unfinished business. Counseling is a collaborative relationship in which counselors work with clients to find solutions and achieve life goals the client's goals. When forced to terminate a session due to a time constraint, it may not be therapeutic. 3. On the other hand, it is normal to feel a sense of impotence, or the feeling that the relationship was not at all helpful to the client and that the client will be helped more effectively by a different therapist. Clients can be encouraged to include various objects in the box that they find important and valuable to the counseling process (e.g., a grounding stone, a worksheet with coping skills, a journal). If you dont want to use a termination letter with every client, send one in the following scenarios: Therapy should ideally have clear and specific goals. Making a case for counseling: With this activity, clients are invited to create a case and fill it with various objects to help them summarize and conceptualize their experience in counseling. Even when counselors introduce the discussion of termination in the initial stages of the counseling relationship, it is natural for many clients to experience some anxiety and disillusionment with the idea. Once termination has been introduced, members may pull back, or disengage themselves slightly from the process in an effort to protect themselves from the emotions surrounding termination. Ending a therapeutic relationship requires a great deal of thought. Counselors can identify potential growth areas and reflect on their professional strengths as part of this process. Discuss termination with the parents. National strategy to address the mental health crisis, Expanding the conversation on international perspectives and practice in counseling, Voice of Experience: Building a career path, Building rapport with clients experiencing psychosis, Fast-food frenzy: Treating emotional eating. Ideally, termination occurs when the goals that are mutually agreed upon by the counselor and client have been achieved, or the problem for which a client has entered into counseling has become more manageable or is resolved. For example, a Life Saver candy could represent the people for the client has been a life saver in the past. They can be either simple or complex, depending on the clients developmental abilities. July/August 2009. In these situations, transition may not always be possible. When a patient terminates with the therapist or counselor, the manner of termination and the circumstances extant will often not require the practitioner to do anything further to confirm or acknowledge the termination, other than to document the termination (and the reasons) in the patient's records. . One-way trip for trauma: This activity can be used with clients who have worked on trauma issues or those who have worked to let go of something while in counseling. Clients can terminate therapy whenever they want, for any reason or for no reason at all. Avoid initiating termination when the client is in a crisis. Retrieved from https://societyforpsychotherapy.org/say-goodbye-research-psychotherapy-termination. Allow clients to discuss their feelings of loss surrounding termination and the counselor must process your own feelings surrounding the process as well. While therapist-instigated termination can feel painful or confusing for clients, its important to remember that the vast majority of therapists who terminate therapy do so out of the clients best interest. If there is a positive prognosis for the client, the termination process may catalyze feelings in the counselor of fulfillment, competency and even confidence. Effective termination provides clients with an opportunity for continued personal growth, whereas ineffective termination can actually harm clients. All Rights Reserved. These feelings may be further complicated by countertransference. Clients can even draw pictures, along with using the stickers, to illustrate a story of their time in counseling. Regardless of the specific intervention used, termination is an ideal time to incorporate an optimistic, empowering and future-oriented approach. When successful, termination is an opportunity for closure. Once termination has ended, clients may want to return a few months or years later to refocus or to check-in. This is often one of the most difficult stages of training for students who are struggling to feel competent while feeling completely overwhelmed. Termination as a therapeutic intervention when treating children who have experienced multiple losses. Some therapists send a brief termination letter to every client who leaves. Termination can be difficult for children, especially when the child does not have many stable adults in their life or when the child has experienced numerous losses. It is also important for you to discuss your experiences surrounding termination with your peers. Be aware of your own feelings surrounding the termination process. Respect your clients desire to terminate if it is client-initiated, but be confident in expressing concerns if you feel termination may be premature. Marissa Marie is a licensed professional counselor working at Youth Intensive Services in Youngstown, Ohio. Termination can be an awkward, emotional, or even painful process, even when a client is satisfied with the progress theyve made and is making a conscious choice to move on. (Updated October 2012) In the January/February 2009 issue of The Therapist, hypothetical situations involving the termination of clients were represented in four vignettes. Your email address will not be published. Explain to the client that your job is to ensure they get excellent care and that you do not feel you can meet their needs. They will have the tools to help themselves. Retention of records can also help to assist the counsellor should there be an ethical complaint Termination may even be a bridge to resolving some of these issues. Discuss the therapeutic processboth what went well in therapy and what could have been better. Client autonomy can be reinforced by allowing clients creative license in decorating and designing their cases. Is there anything you dont like so much about coming to talk to (your name here)? Termination should be among the first topics that you and your client discuss. Steven Stosny, Ph.D. on February 20, 2023 in Anger in the Age of Entitlement. Some clients may struggle to negotiate healthy boundaries and the termination of relationships. Counselors should monitor these reactions, discuss them in supervision, consult with peers, and seek personal counseling if necessary to ensure that even as they adjust to the loss of a therapeutic relationship with a client, the quality of the services they provide to their remaining clients remains top-notch. Adding prompts or sentence stems for clients to complete can add a degree of structure to the letter. Counselors may also resist the process. Initiate discussion of how you view your progress in achieving . Can you think of other keepsakes that would be appropriate for you to give to your clients? When terminating with a client because of a poor fit. Once everyone has spoken, you will see that a huge web has been created that symbolizes the connection that group members make with one another through the group counseling process. When terminating with a client because of a poor fit. An evangelical Christian pastoral counselor may not be able to help a committed atheist, for example. This is an excellent way to show how everyone is connected, affects one another, and how the things that each member brought to the experience have sustained the group. Client follow-up should be conducted by a HUD certified housing counselor. **In some cases, the end of counseling is not always the end, and follow-up is deemed appropriate by the counselor and client to serve as a check to see if change has been maintained and to allow for clients to revisit old issues or work on new issues at a later date.
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