Therapy 101: Terminations & Ending Therapy
Why Ending Therapy & Termination Sessions Are Important
Endings are a way for client to metabolize their learnings with us
Some clients fear endings and this can be a corrective experience (if they are open to it and willing) to say goodbye
Helps us understand what we did well and what we didn’t do so well with the client
Ultimately, the goal is for to learn and practice self-management skills, seek out healthy relationships, take relational risks, be okay with discomfort, and ultimately stop seeing us one day
Endings Depend An A Variety Of Factors Including
Who initiated the ending: clinician, client, or mutual decision
Rationale: Why ending was suggested/encouraged. This can include: finances, insurance, availability and schedule changes, retirement, changing jobs, death, sabbatical.
Length of treatment so far
Focus of therapy and presenting issues/concerns
And more
Core Themes To Consider With Ending Therapy & Termination Sessions
Attachment issues such as those who have a history of being abandoned or rejected by others
Some clients may not show up and “ghost” you
Some clients may bring you gift(s)
Receiving negative feedback
Receiving positive feedback
Receiving neutral feedback or no feedback
Your policy or your agency’s policy on client returning to treatment after ending
Understanding what you did well with the client and what you didn’t do so well (growth edges, strengths, etc.)
And more
Things To Try Out In A Last Session
Reviewing their initial intake/assessment form
Reviewing areas of growth and changes
Reviewing areas of continued barriers and challenges
Exploring the therapeutic relationship and underlying feelings of saying goodbye
Exploring the therapeutic relationship and underlying feelings of connection and mutuality
Self disclosing something of clinical value
Self disclosing your feelings about the client, saying goodbye, and therapy ending
Saying goodbye to one another
Giving space for the client to voice their thoughts and feelings about course of treatment (silence, pausing, ample time)
And more
Statements And Questions You Can Try Out
Given that therapy is important to you, how will you carve out space for yourself during the time we would be meeting?
Now that therapy is coming to an end, I wonder what your thoughts are about not coming to
see me any longer. What were you thinking just before coming to today’s session?
Some people experience the end of therapy as a “loss. Does ending therapy feel like a loss to you?
Do you have any concerns now that you won’t be in therapy any longer?
How do you feel toward yourself for doing the hard work of growing and healing?
What do you think that says about you that you can heal and grow?
What did you learn about yourself during our work together?
What has been the biggest impact on your life from our sessions?
What were some of your most memorable moments during our time together?
What are continued areas of challenges for you?
How will you ask for help and support when life changes, challenges, and difficulties arise? How do you see yourself handling problems as they come up?
Questions To Reflect On
What is my relationship to ending and saying goodbye? Are endings difficult or easy? Do I have unresolved issues/concerns with endings and saying goodbye?
In my life, who leaves whom first? How do relationships end for me?
How do I like to say goodbye? Verbally? Expressive arts? Client led?
We are changed in relationships. The client grows and changes, and so do we. What have I learned as a result of working with this client?
Clients impact our lives, some more than others. Do I let the client matter to me? If so, how do I express this? Do I?