MOVING TOWARD TERMINATION OF THERAPY

 
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. However, as Masters students, you will learn during your Practicum experience that it is relatively unlikely that you will have been able to work through all of the stages of counseling with your clients during the span of one semester, especially when you may only be at your site one or two days a week. Oftentimes, it can take the majority of your time at the site to establish a trusting connection with clients so that they are willing to open up to you about their issues. You may have resistant clients who are mandated to see you, or clients who volunteer to engage in the process with you but who bring so many concerns with them that it is difficult to decipher what needs to take precedence. Getting them to a point at which they are comfortable with you might bring you close to the end of the semester, at which point you are already thinking about having to end the relationship you have worked so hard to establish.
 
Termination is the final stage of the counseling process but is not something that should be broached during your last (or next to last) session with a client. Doing so does not allow for the proper amount of time for counselor and client to process what termination means, how the client will handle the conclusion of the counseling relationship, and what follow-up contact or transitioning needs to happen for the client. Termination should be among the first topics that you and your client discuss. Kramer (1990) clearly articulates this when he writes: “The therapist must be clear from the first contact, unless there are mitigating circumstances, that the intent of treatment is to help the (client) function without the therapist.” As a counselor, you are ethically bound to communicate to your client how long you will be available to counsel them, to discuss openly the timeline of your relationship, and to make appropriate referrals or recommendations at the conclusion of your relationship. It is a stage of counseling that clients need to be prepared for and counselors need to address early on in the counseling process to avoid abandonment.

Here are some helpful guidelines for effectively moving your clients toward termination:
  • Remind clients of the approaching ending of the sessions with you. This should be done at least 2-3 sessions prior to the final one. This provides you an opportunity to ask clients to talk about relationships that have ended in their past, how they have ended, and how that might affect the end of this counseling relationship. You can also ask clients what they would like to focus on during their remaining time with you. A question to ask prior to the final one, which may help to prepare clients for the reality of the end, is "If this were our last meeting, how would that be for you?"
  • If you and your client are not limited to a certain number of sessions, you have the option of spacing out your last few meetings. This is a good way to wean your client of the relationship and foster in them a sense of confidence in their ability to handle things without seeing you on a weekly basis before the relationship abruptly ends.
  • Review the progress that you and the client have made during your sessions. Very often, clients will forget the advances they have made, or neglect to give themselves credit for their accomplishments. Doing this with them can instill confidence and provide them with a positive perspective on what counseling helped them to do. Ask your clients what they learned, what they intend to do with what they have learned, what they found helpful about their sessions and how they felt about their participation in the process.
  • Allow clients to talk about their feelings surrounding termination. They will likely have many emotions to work through and time should be spent acknowledging and processing them.
  • Be aware of your own feelings surrounding the termination process. It is normal to feel many emotions when ending a relationship with your clients. Acknowledge your feelings, your ambivalence about termination, etc. Always keep in mind that your ultimate goal as a counselor is to "put yourself out of business." If you are good at what you do, people will not need to continue to see you for help. They will have the tools to help themselves.
  • If possible, have an open-door policy. Once termination has ended, clients may want to return a few months or years later to refocus or to "check-in". This is often impossible in the training setting, but something to keep in mind for your professional career.
  • Review the tools and skills that clients have acquired through the counseling process. These tools will be critical in helping clients be self-sufficient in handling problems that might have previously brought them to counseling. If there are additional resources that you feel your client would benefit from for continued personal growth, make appropriate referrals and make your client aware of them.