Friday, January 22, 2010

What is Termination and How to Discuss it With your Therapist

The end of therapy is one of the important aspects of the therapeutic relationship. However, knowing when and how to say goodbye to your therapist can be a daunting task. Clients are often unsure as to what the end of therapy should entail. To make matter worse, the end of therapy is known in ‘therapist-speak’ as “termination”.

Termination is a rather obtuse term, one that for most of use doesn’t have positive connotations (it’s the same word we use for getting fired from our jobs). Plus most people, myself included, find it difficult to say goodbye, even when we are ready to leave. Although, it can be frightening since it involves change, termination really is ' like the light at the end of the tunnel'. When you do say goodbye to your therapist, although you will be ending one chapter in your life, you will be opening the door on a new chapter, one where you feel strong and function just fine on your own thank-you-very-much, without the weekly or biweekly check-ins with your therapist. The end of therapy is just as important as the beginning.

Some clients enter therapy knowing exactly what they want. They desire a brief solution focused approach and definitely know how long they expect reaching their goals to take. Other people are more process oriented and prefer to develop a long term (several months to a year) therapeutic relationship. With both of these approaches to therapy, however termination is eventually inevitable.

Clinical literature on the therapeutic relationship defines termination as an ethical and clinically appropriate end to a professional relationship (Youngren and Gottlieb in Davis, 2008). A good therapist should discuss with you at the very beginning of therapy what your expectations are regarding this important aspect to your work together.

After all, the therapeutic relationship is one of the few relationships where do you have more control as to how, when and for how long the relationship lasts. The frequency, duration and amount of time you expect to work with your therapist in order to reach your goals should be discussed as an element of designing your treatment plan (therapist-speak for what you want to get out therapy and the manner in which you will do so). A well defined treatment plan helps your therapist select interventions that are the most appropriately suited to your needs and goals as well as the amount of time you have together. When you feel in control and understand the expected framework or boundaries in therapy, trust develops and you can be more open with your therapist.

So, no matter which phase of the therapeutic relationship you are in now with your therapist, or if you are just considering entering into therapy, talk with your therapist about what your expectations are regarding the duration of your work together. If you don’t know, that’s okay. Your therapist should be able to openly and honestly discuss termination and answer any questions you might have about the process, including feelings that might accompany saying goodbye, what happens to your clinical record, and how your relationship with your therapist changes after you are no longer formally participating in therapy. This way when it is time for your relationship to come to an end, you can do so consciously, and feel you have reached a positive conclusion to all of the challenging emotional work you have been doing.

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