Ending a session on time and doing so gracefully can be tricky. There are a plethora of ideas out there of how to end a session on time, such as setting a timer or providing a nonverbal cue, and many of those suggestions may be effective in ending a session on time.

However, very few, if any, address implementation of those techniques fluidly and in a manner that is natural and least disruptive to the client’s process. Why does this matter?

One reason the way in which a therapist ends a session matters is because it could help in facilitating a sense of support for the client, augmenting the support already given during the meat of the therapy session. It could contribute to the client’s sense of feeling valued which in turn contributes to the therapeutic alliance.

The therapeutic alliance has been correlated with improved treatment outcomes across individuals with varying mental health issues [1] and has been found to be a better predictor of treatment outcome than the type of intervention [2].

Ending the session smoothly could be analogous to landing an airplane. The pilot needs to see the passengers through to the end of the flight, which may have been turbulent or smooth, and instill a sense of safety and trust from boarding to the moment the last passenger has deplaned.

Similarly, ending a session gracefully may nonverbally communicate to the client that you can and are going to be there to support his growth whether the emergent therapeutic material is pleasant or unpleasant, thereby building trust and openness – part of the framework for growth.

What follows are some suggestions that may be helpful in facilitating graceful endings to sessions and in contributing to the strengthening of the therapeutic relationship, providing the opportunity for growth and healing.

Please note that these suggestions are oriented toward non-crisis situations and are suggestions based on mine and my colleagues’ professional and personal experiences, having had our own therapy and having worked in diverse settings and with populations ranging from young children to the geriatric population. Please consider if these are appropriate for you and your client, and seek consultation.

1. Consider the ending as therapeutic.

Conceptualizing the end of the session as a therapeutic interaction that could contribute to your client’s growth may encourage and inspire you to end the session in a timely and thoughtful manner.

For instance, the way in which you end a session could demonstrate healthy boundaries and time-management skills, model compassionate and effective communication skills, or even possibly provide a corrective experience for the client.

Communicating with the client that ending the session on time is a step toward one of the client’s treatment plan goals or an interaction you see worth working on may invite the client to also be thoughtful about ending the session (or at least have a little bit of understanding if you have to interrupt him or her). This could reduce awkwardness and the potential for hurt feelings, and in a way gives you some permission to interrupt the client at the end of the session.

For example, when I worked in a forensic setting, one goal that many clients worked on was respecting boundaries. Ending the session on time was modeling for the client respecting boundaries, which in this case were each other’s time, the following client’s time, or the client’s next appointment’s time. Because I had discussed with the client the importance and purpose of being able to end the session on time, the client was understanding of whenever I interrupted him to end the session.

2. Orient and collaborate.

Orient the client to the general logistics of the therapy session and invite collaboration during the initial meeting or at the start of any meeting periodically throughout as needed. As you review confidentiality with the client, familiarize the client with the general course of the session.

For example, I have informed clients that I prefer to set a timer so that I can fully focus on them without being distracted by monitoring time. The alarm will sound to indicate there are a certain number of minutes remaining and I will summarize the highlights of the session and discuss assignments or things to practice during the week.

Please be mindful of the type of alarm sound – loud obnoxious beeping is usually not preferred. You can also adjust the timing of the alarm and the alarm sound for each client. You may find that two minutes works effectively for some clients and five minutes works well for others.

I have also asked clients if they would prefer a hand gesture or some other notification to signal that there are a certain number of minutes remaining and it is time to wrap up the session.

Figure out a game plan with each client so you both know what to expect. This helps to set the end of the session up for success and reduces anxiety from both ends.

3. Reflect and summarize.

Another way to end a session gracefully is to reflect and summarize. Reflect the important message in the client’s last statement, tie that back into the overall theme(s) of the session or relevant takeaways, and then translate that into a practical action step or question to ponder for the week.

This technique has the potential for nicely wrapping up the whole session into a neat package. However, it also has fumbling potential. For one, you may have to interrupt the client as he or she is speaking in order to reflect and summarize, which could feel as though you are telling her when her last statement is as opposed to the client naturally stopping on her own. Attunement, authenticity, and finesse facilitate this type of ending, which also requires good communication.

4. Use verbal and nonverbal communication.

Colleagues of mine have shared that they utilize nonverbal cues to help communicate to the client that the session is over. These cues could include closing their notebook or placing the cap back on their pen.

Some therapists begin to stand or gradually shift their seat if they are in a swiveling chair. Another therapist stated that she energetically begins to withdraw from the conversation by reflecting less profoundly and providing less complex responses.

An example of this might be guiding the conversation back to small talk as what may have taken place at the very beginning of the session or redirecting the client to the assignment and next session-oriented messages (e.g., “That is a great example of what to write in your journal” or “That is exactly the kind of thought to document in your daily log we just discussed. I’m looking forward to what new insights this assignment could evoke for you”).

Good old direct communication is always an option, especially if the client is not responsive to ending the session as agreed upon or as communicated in less direct ways (e.g., “I have another appointment now. Let’s talk about this next session”).

5. Be flexible.

There will be times when the session is just not going to end on time and you may have to go over a few minutes. Once in a while, this may be necessary to provide sufficient support to the client, but note that I said “once in a while.”

If the session is going over time regularly, that is unlikely to be therapeutic and may actually be unhelpful to the relationship and to the client’s growth (e.g., enabling ignorance of boundaries). It may be helpful to introspect and process underlying factors within yourself that may be contributing to this with your supervisor, therapist, or colleagues, and in select cases, may be something to discuss with the client.

Also consider that some clients may respond better to one style or technique of ending a session versus another (e.g., direct communication versus nonverbal cues) or perhaps a combination of two or more.

You might have a client who prefers a routine or ritual (non-obsessive-compulsive) ending that consists of a timer, summary, and then sitting in meditative silence for a minute. You could find that you have been ending sessions one way and then the client wants to modify that after a few months. You may also find that there are clients with no preference.

The point is to be flexible and consider what works best and most effectively not only for the client but also for you as the clinician. Consider what is authentic and natural for you. For example, if meditation makes you cringe, it may be ill-advised to end the session in this manner even if it is your client’s favorite past-time.

6. Practice and try, try again.

Play with different methods, phrases, words, and even role play. Get comfortable with it. Notice your own experience.

Perhaps you notice that you feel uncomfortable or do not like the way the word “end” feels (or the memories it evokes), which could translate into the session. It is absolutely okay to try something else that is natural to you, such as “pause for now,” “session coming to a close,” or “transition out of the session,” or whatever other words or phrases feel most authentic and accurate for what you would like to convey.

It is also okay to check in with the client if you think it is necessary for the client’s benefit (not solely to allay your own discomfort, which would be better addressed by consulting with a supervisor, therapist, or colleagues).

Gracefully ending a session can be done with a little thoughtfulness, authenticity, and attunement.

The method of ending the session on time likely accomplishes the goal (like looking at the time and telling the client it is the end of the session) but the graceful part is facilitated by mindfulness. The way a clinician can bring herself/himself into connection in therapy contributes significantly to the client’s positive response to the clinician’s therapeutic efforts [3].

There is, after all, a human being, and likely one who feels a little (or a lot) vulnerable, sitting across from you, not an appointment.

I invite and encourage you to play mindfully with the aforementioned suggestions aloud to yourself, with a colleague, or with a client, as appropriate. Notice your experience, get explicit feedback from colleagues, or notice your client’s response, and make modifications accordingly to what is natural for you and what is effective in conveying your support to the client and ending on time.

What are some other methods you have tried or have considered for ending a session gracefully on time?

 

References

[1] Cronin, E., Brand, B.L., & Mattanah, J.F. (2014). The impact of the therapeutic alliance on treatment outcome in patients with dissociative disorders. European Journal of Psychotraumatology, (5), 10.[2] Ardito, R.B., & Rabellino, D. (2011). Therapeutic alliance and outcome of psychotherapy: Historical excursus, measurements, and prospects for research. Frontiers in Psychology, (2), 270.[3] Siegel, D. (2010). The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration [Audiobook].

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Reina Remigio, PhD

Reina Remigio, PhD

Reina Remigio, Ph.D. is an early career licensed psychologist with a whole-being approach to psychology utilizing evidenced-based interventions. She is currently working at various skilled nursing and rehabilitation facilities providing cognitive testing, skills training, and supportive counseling to the middle adult to geriatric populations, in addition to her small private practice. Her background includes working and training in forensic and community mental health settings with a diverse population ranging from young children to adults. She also has experience providing mentorship, supervision, and program coordination/development and training to pre- and post-doctoral students and a team of clinicians. She enjoys playing with and learning from her spirited toddler, practicing mindfulness, and frolicking in nature solo or with loved ones.
Reina Remigio, PhD

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