Unlike diamonds, therapy is not forever. Managing termination for clients and clinicians can be equally difficult. Although the therapeutic relationship may be strong and one may feel that they get much out of the process, no therapy is meant to last a lifetime. Termination, the therapeutic term used to signify the end of therapy, is an important and often bittersweet milestone that is much enhanced by thoughtful planning and consideration and often comes with a myriad of emotions from both the therapist and client’s perspectives. Today, we will explore our understanding of the termination process, what that may look like emotionally, and some helpful suggestions for making the end of therapy a positive experience.
Understanding Termination and Graduation: As mentioned, termination is the formal conclusion of the therapeutic relationship between a therapist and a client. Under the best of circumstances, many clinicians choose to call the end of therapy graduation, which signifies that the client has achieved their therapy goals, acquired the necessary tools to manage their challenges independently, or has reached a point where further therapy is no longer needed. Termination may also come about suddenly, due to the therapist or client moving, changes in insurance, becoming significantly ill, a safety concern or simply because the client's needs do not fit the therapist’s training and ability. It is not uncommon for clients to leave their therapist for various personal issues that are never explored. No matter the reason, the end of therapy will likely cause a range of emotions for both the client and the therapist.
For the client, graduation may bring feelings of accomplishment, gratitude, and a newfound sense of self-confidence. However, it can also trigger anxiety, sadness, or a sense of loss. Clients may develop a strong attachment to their therapist, making the idea of ending the therapeutic relationship emotionally challenging. In cases of sudden termination particularly, clients may even feel a sense of abandonment.
For therapists, termination can also be emotionally complex. They may experience a sense of fulfillment in witnessing their client's growth and progress. However, they may also feel a sense of loss as they say goodbye to someone they have formed a deep connection with. Alternatively, if the client ends therapy abruptly, therapists may feel professionally inadequate, confused, and harbor deep concern for the future of that person.
Navigating The End of Therapy: The following are some ways in which the therapist and client can ensure their journey ends on a positive and ultimately therapeutic note.
Open and Transparent Communication: Depending on the therapy intervention, the therapist might know exactly how long therapy will last. In other kinds of therapy, the therapist may at some point use their best judgment to determine whether or not the client is ready for termination. In others still, the client may want to end therapy for fit or other reasons. In all cases, it is important for the therapist and client to discuss termination openly as soon as possible. This includes addressing the goals of therapy, assessing progress, and exploring the client's thoughts and feelings about the therapeutic fit and general end of therapy. By initiating this dialogue, therapists can help manage the emotional impact of termination and clients have a space to express their concerns or reservations. Although therapists generally initiate this conversation, it is vital for clients to be honest about their therapeutic expectations and intentions as well.
Acknowledging and Addressing Emotional Responses: Both clients and therapists may experience a range of emotions during the termination process and throughout therapy in general. It is vital for therapists to acknowledge and validate these emotions, and to open up the conversation for clients and themselves to express any grief, loss, or anxiety they may be experiencing. As they might already do in therapy, therapists can offer support by normalizing these feelings, discussing healthy coping mechanisms to manage the emotional impact of termination, and share their own emotional reactions to the client.
Reviewing Progress and Identifying Future Strategies: Throughout treatment and during the termination process, it is important to review the progress made during therapy. Here, therapists can help clients recognize their achievements, reinforce coping strategies, and identify areas that may still require attention. By collaboratively setting future goals or providing resources for ongoing support, therapists can help clients maintain the progress they have achieved and continue their personal growth beyond therapy.
Gradual Transition: More often than not, therapy does not end with an abrupt event. Instead, therapists might work with their clients to establish a gradual transition, allowing for a smooth adjustment to the end of therapy. This may involve reducing session length or lengthening the intervals between sessions. Gradual transitions can provide clients with a sense of closure and foster confidence in their ability to manage life's challenges without the help of therapy.
As Shakespeare once wrote, “parting is such sweet sorrow.” While termination can be accompanied by a mix of emotions for both clients and therapists, proper navigation of this process can ensure a positive and empowering experience. By fostering open communication, planning a gradual transition, reviewing progress, and attending to emotions, therapists can guide their clients through this delicate phase, helping them embrace the growth achieved and confidently move forward on their personal path.