Planned client termination may be one of the hardest aspects of clinical work.
Although planned termination is often a great opportunity for both the client and therapist to gain additional insights, it can lead to a variety of thoughts and emotions that can be unpleasant for all involved.
Why is Planned Termination so Difficult?
One of the reasons that planned termination can be so difficult is that it is the ending of a relationship.
Any time there is an end to a relationship, it can bring up emotions related to the current relationship as well as forgotten emotions related to the ending of previous relationships. Additionally, planned termination signifies the end of an important relationship and one which more than likely has pushed both the clinician and client to grow and learn.
More often than not, this therapeutic relationship is valued by both the clinician and the client, which creates an additional aspect to planning the termination.
Given these aspects it is not surprising that the ending of a therapeutic relationship is challenging, just as the ending of any relationship can be.
Preparing for a Planned Termination
Using a planned termination as an opportunity to pause and reflect on the work and progress you and your client have completed is a great way to see some of the benefits a planned termination has to offer. In addition, it can assist those involved to gain additional benefits from experiencing the planned termination.
It may be important to reframe some of our thoughts and emotions related to a planned termination in order to allow both the client and clinician to focus on the positives of the end of the relationship. Not only will this allow the planned termination to potentially be easier to process, it also allows both the client and clinician the ability to fully reap the benefits of this portion of the therapeutic process.
For some (both therapist and client), this may be one of the first opportunities to experience a healthy and positive ending of a relationship and can allow those involved to learn and practice important skills needed to engage in a successful and healthy termination of a relationship.
Below are a few suggestions and facets to focus on while planning a termination:
It is important to begin discussing the upcoming termination well in advance. In fact, some believe that discussing termination and discharge planning at the onset and throughout the therapeutic process is a valuable part of therapy.
Discussing and processing the point that the therapeutic relationship will come to an end, and doing this early, allows for all involved to have enough time to process and prepare for this event. For some, the processing and preparation may not be as thorough as it is for others, but it is significant nonetheless.
Review & Highlight Changes
A well-deserved and essential aspect of the termination process is to review and highlight changes, growth accomplishments, and progress of the client during the therapy process.
This can serve as reminder of all the client has done throughout their time in therapy with you.
Discuss & Plan the Next Step
Will the client be transferred to a new clinician? Is it time the client uses their skills on their own or has the client overcome a difficult time in their life?
Make sure to develop aftercare plans and reminders to assist the client in recalling information discovered, learned, and utilized within the therapy process. Help the client to identify resources and supports to lean on once therapy is completed.
If the client is transferring to another clinician, assist the client in identifying what they would like to carry over to their new therapist. Helping the client to identify what was helpful in current therapy sessions and what worked and didn’t work within this portion of their treatment is important. It can help the client to identify what type of therapist they work best with or are expecting.
If possible, allow for a transfer sessions/introduction between the client and their new therapist.
Use Your Support System
Discuss and reflect on your own feelings and thoughts of the termination stage within consultation and supervision sessions. Make sure to allow yourself time to review how the termination stage is having an impact on you.
Although it can be a very busy time in tying up loose ends, make sure you are pausing enough to allow yourself the opportunity for reflection.
During supervision and consultation sessions, review your own progress as a professional. Identify strengths and weaknesses within your own work. Additionally, set your own goals as a professional in order to assist your work in the future.
Remember the saying that practice makes perfect? This can apply to planned termination.
The more you practice, discuss, or even role play with colleagues and supervisors, the easier planned termination will be within sessions. It will also assist in relieving anxiety and allowing the clinician to identify any transference and emotions that are occurring for them regarding the upcoming termination.
Additionally, practicing within therapy sessions allows the client to get used to the idea of termination and gives them opportunities to discuss and process emotions or thoughts that may be occurring for them.
Practicing within sessions can come in a variety of forms. It may be practicing coping skills previously learned that the client will be relying on after termination, introducing and re-introducing the next therapist to the client, or even just further scheduling out therapy appointments to allow the client more time between sessions to rely on identified supports and resources within their daily life to assist with day to day stressors.
Planned termination with a client can be demanding, but by taking the time to plan ahead and using some of the tips discussed above, it can be a valuable opportunity for both the client and clinician to grow and learn.And remember – although it is the ending of a relationship, it is also the beginning of a new chapter for all involved.