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?