Tuesday, December 6, 2011

Why your last therapy session may be the best one of all

As you know if you've read this blog for any period of time, I work at a college counseling center. At this time of year, most students are bracing for finals, and for that trip home that some love, and some loathe. For some of my clients, though, it's time to graduate.

Graduation is a positive event for nearly everyone. All those years of attending classes, writing papers, taking tests... finally, it's time for a break. But as my clients get closer to the big day, they start to see the truth in one of the things I often say to the people with whom I work. For every loss, there are gains. And, for every gain, there are inevitably some losses. If we've been working together for a while, it can be hard for my client to accept that their graduation means that they'll have to stop seeing me for therapy.

In the therapy biz, this is called "termination." I've always disliked that term, as it conjures up images of Arnold Schwarzenegger dressed in black leather and smoking a rogue robot with a giant gun. Therapy termination is not as dramatic as that, but it can certainly feel just as final.

Termination happens in just about every therapy relationship, not just those at counseling centers. Eventually, therapy ends, whether through artificial means such as a graduation or someone moving out of town, or through organic means like the natural end of a successful therapy. And, for the client and the therapist, there are some ways to make sure that termination is a meaningful, mindful experience that can bring lasting benefits to both people.

Here are six ways that you and your therapist can make termination a positive, healthy experience.

1. Have a plan. A good therapist will pace the overall course of your therapy, just as he or she paces each individual session. Coming to the end of therapy is something that should be planned by you and your therapist. It's a good time to take a look at how your therapy has gone, what you've learned, and where you'd like to go from there. The last 2-3 sessions of therapy should look as though you are heading toward some kind of conclusion.

2. Stick to it. if you avoid things like this, tell your therapist so they can keep you on track. Therapists avoid goodbyes, too... they're human. Make sure they do their job, too. There should be an explicit conversation about how to tell when you (or your therapist) is avoiding doing the termination work, and about what to do if that happens.

3. Resist the urge to drop the bomb. Every therapist has a story or two about clients who save the last session for something earth-shattering. If there are things unresolved in your therapy, then maybe it's not time to terminate. If you're in an artificial termination (like graduation, or moving out of town), work with your therapist to set up the next step. Your therapist can offer a referral. Work with your therapist to plan your next step.

4. Let the emotions come. Work at acknowledging that this relationship is important, and give it the attention and emotion it deserves. Learning how to look someone in the eye and truly say goodbye is a lesson that many people never learn. It might help you as you say other goodbyes, which leads to number five...

5. Generalize your gains. Apply the lessons you've learned in mindful therapy termination to your other relationships. You will nearly always need to be the "grownup" out there in the real world, and take on the hard (but so satisfying) work of not letting yourself or others avoid goodbyes.

6. Remember that it's truly over. When a therapy relationship is over, it's OVER. While we can take the sting out of some endings with a "see you around," your therapist won't be in contact with you again. It's not ethical for your therapist to start a friendship with you after therapy is done, no matter how comfortable or natural that might seem. So, at the end of therapy, it's important to realize that the two of you won't be seeing each other again. This is the case in many goodbyes, but with this one, there's no question.

As a therapist, I think that learning how to terminate with clients is one of the lessons I've learned that has the most application to my "outside" life. It's just not something that anyone shows us how to do. It's also one of the places that some therapists bumble, and let their clients down. By being aware of how the process works, and willing to work with your therapist to do it right, you can use your therapy termination to make important gains right up until the very last moment.

1 comment:

  1. Thank you for posting this! I'm an MSW intern therapist and about to have my last session with a client because he is moving. I'm confident I can make "artificial termination" a positive experience for him.