Termination of Counseling Flashcards
1
Q
Endings
- intentional process that occurs when client has achieved most of the goals
- “how will we know when our work is done”
A
Endings
- intentional process that occurs when client has achieved most of the goals
- “how will we know when our work is done”
2
Q
Why is termination an important part of counselling?
A
- opportunity to experience closure
- motivator for work during counselling
- opportunity to generalize new learning & skills
- acknowledgement of growth or maturation
- ending/loss that can be hard
3
Q
Types of termination
A
- client initiated
- counsellor initiated
- planned (ideal)
- premature (30-60% of clients)
4
Q
What is Client Initiated Termination,
and why does it happen
A
- when the client determines end of therapy
1. extenuating circumstances
2. articulate readiness to end (met goals)
3. ask to be referred (not going well)
4. stops coming
5
Q
What is counsellor initiated terminations?
Why does it happen
A
- counsellor initiates therapy termination
1. time limited
2. client met their goals for therapy
3. goals are beyond competency
4. not effective or helpful
5. extenuating circumstances - need to be clear, and be sure to examine motives before bringing it up with client
6
Q
What is planned termination?
How does this happen?
A
- both decide together to terminate
1. engage in an intentional process to bring work to a close
2. review goals/progress and end work
(ideal)
3. facilitated by discussing it early & throughout process by having clearly defined goals
4. clients are aware more so “how much” counselling they’ll need - ask about this early on (can help facilitate planned ending)
7
Q
What is premature termination?
A
- client ends therapy prior to the achievement of the established goals
- usually abrupt
- by how well client has achieved their goals/level of functioning
- tendency is to blame client
- happens for a variety of reasons
- counsel. should track patterns of premature termination in their work
- know clients history of PT & address this directly
- higher involvement decreases premature
-30-60% dropping out prematurely
- 65-80% end before 10th session
10% more than 20 sessions
8
Q
When to terminate counselling?
A
- initial problems been reduced?
- achieved goals?
- consistent progress?
- counsel. relationship helpful?
- stress-producing feelings eliminated?
- better coping abilities
- relate better to others
- able to love and be loved
- more productive
- better enjoy life
- environmental variables (session limits, service costs, therapist schedule)
9
Q
what does “Pre-terminating counselling” entail
*** maintenance phase (most common termination) -
A
- negotiate end date with client (both agree)
- review treatment gains
- acknowledge and process clients/your thoughts/feelings about T
- relapse prevention planning - reasure routh they’ve taken, and positives; look back @ past experiences/session
- address future challenges/resources
- referrals
- determine details for short/long term follow up if possible
10
Q
Goals of termination phase
A
- consolidation, maintenance & generalization of clients gains
- enhance clients ability to carry on their psych work outside treatment
- progress & change review & acknowledgement
- Validation of client’s progress, growth, resilience & strengths
- plans for addressing future challenges
- Explore the meaning of the loss of the therapist
- Obtaining feedback from client (most/least helpufl)
- Celebration of the work/relationship & saying goodbye – cultivating closure
- share (if appropriate) their hopes for the client (let them know they matter, value, impact)
11
Q
Client resistance to termination
A
- Client asks for more time @ end
- Askfor more appts after goals been reached
- Development of new symptoms
- result of a fear of change
- clients with attachment, abandonment or grief issues - can be very challenging but presents opportunity for them to have a healthy experience of saying goodbye…
- Client responses: sadness, anger, fear, excitement, pride
- x number of sessions, fading, Relapse prevention planning, & providing additional resources can help ease the transition - “cheat sheet” for troubleshooting
12
Q
Counsellor resistance to termination
A
- End of a significant relationship
- anxious about client’s ability to function – fragility
- Guilt for not being more effective
- professional self-concept is threatened
- End of a learning experience
- End of living vicariously
- Reminder of other goodbyes
- can have a parallel process in their own reactions to terminating counselling
- SELF REFLECTION: essential skill, understand own thoughts feelings and behaviors in terminating
13
Q
Follow up care
A
- Often a neglected step – encourages client growth & shows counsellor’s care and concern
- Short-term (6 months)
- Ask to have another session, telephone, e-mail, mail
- Some clients but will likely need the support of other nonprofessionals/para-professionals
- In these cases, counsellors need to connect clients to appropriate support groups or programs upon termination or simultaneously with counselling
14
Q
Why has addressing termination been avoided?
A
- associates with loss, taboo subject in all parts of society
- not directly related to microskills that facilitate counselling relationships
15
Q
What are the functions of termination?
A
- signals something has finished
- Maintaining changes already achieved
- reminder that the client has matured
