The Process of Termination
Using the social work literature, talk about the concept of the termination process.
•Why is termination such an important part of social work? Why can’t we just say, “so long” and move on? Discuss the process of termination as it relates to your current field placement and the clients you serve (Royal Care (https://www.royalcare.nyc) patents from the Social Work perspective).
•How will termination at your field placement and with your clients affect you? How do you relate to ending/termination in other areas of your life? Apply this to the social work knowledge related to conscious use of self and self-awareness.
•Select a client/case from your current caseload (or one with whom you have already terminated). Remember, a case can be an individual, a family, a couple, a group, or a community. Keep in mind that a case can be an individual, a family, a couple, a group, or a community and need not be a client/case that you see weekly, but one with whom you have repeated contact.
•What are the factors that led up to this termination? Is/was this a planned or unplanned termination?
•How did you introduce termination to the client/case? Were the responses/reactions what you anticipated? Discuss both yours and the client’s response to termination. What concerns do you have for the client regarding termination?
•How do you think issues of intersectionality, ie. gender, culture, and socioeconomic status, sexual orientation, age, and religion affect the termination process? How would you appraise your client’s access to and use of needed services?
•What specific social work skills are necessary for a successful termination? What are some of the common pitfalls social workers often fall into around termination?
•Include a part of a process recording where you talk to a client about saying goodbye and ending your working relationship. What skills are evident in this process recording? What is your self-assessment of your work in this particular area of termination? What could you have done differently?
Termination is a concept used to end the psychotherapy relationship between a patient and a psychotherapist (Compton & Galaway, 2004). It occurs after articulation of well-planned treatment process or by a surprise. Primarily, it should occur when the goals mutually agreed upon by the client and the counselors have been achieved. It is the final stage of counseling (Hepworth, Rooney, Rooney, Strom-Gottfried & Ja, 2017). It is not something to be breached during the last session with the client. The process of termination and the manner of its execution is very important. Termination helps to model healthy boundaries and appreciate the end of the relationship between the client and the counselor. Besides, it provides clients with a chance of continued personal growth. The client, after termination, has the opportunity to start afresh knowing that he or she has undergone a successful process that has had a significant impact on the manner they move forward.
In the perspective of social work, the process of termination begins when it becomes clear that the client no longer needs the counselor’s services (Turner, 2011). Thus, it is sometimes likely to make the client experience grief and loss. Therefore, space should be given to the client to experience instead of avoiding such feelings. Clients should be encouraged to use copying and emotional regulations they gained during the counseling period to help manage the emotions associated with terminations (Turner, 2011). The actions help reinforce what the client learned during the process of counseling. The councilors should walk alongside clients as they grieve the loss of relationship with their councilors. It helps them to develop and manage future losses in their lives ahead.
In social work, it is normal to form a strong bond with the client during the counseling therapy sessions. Councilors become the best friend of clients. Termination affects that relationship and the counselor has to feel as if he or she has lost a friend. Primarily, it is essential to experience a feeling of loss (Saleebey, 2012). Nonetheless, the process triggers intense feeling of sadness among therapists. The counselor’s experiences unresolved conflictual feeling towards loss. The same scenario happens when you have to bid goodbye to a friend or a family member when they are leaving for a long journey that may see them take long before meeting again. For instance, I was handling a case of an individual who had been coming for bi-weekly therapy sessions. The therapy period had been running for three months and I had to conduct a termination because the client was showing significant improvement (Saleebey, 2012). Besides, she had learned most of the copying strategies that were intended for the program. Thus, it was proper for the sessions to be terminated. This was a planned termination since I had informed the client that everything was rolling out well and there was need to terminate the process. However, the client did not know the exact day that the termination would occur.
I introduced the termination by explaining to the client the description of my job and the need to terminate the process ones the objectives are achieved. Thus, it was time to execute the termination. I gave the client time to process her feelings. Since the therapy was a success, I reflected on the major milestones on the client’s growth and the manner she planned to continue experiencing positive experience. We discussed the therapeutic process, all that went wrong and that which we got right. Nonetheless, we discussed any feeling of grief or anxiety concerning the termination. I talked about personal growth as an ongoing process and gave the client guidelines on when it is most appropriate to return for therapy. The client was surprised and expressed a gloomy feeling since she did not know it would end exactly the day it did. I was feeling dull as well since, it was difficult for me to execute termination. However, it was something I had to do. I had concerns that the termination would affect the client in a short while before she could be okay. However, I was confident since the patient had learned various copying skills that would help her through the period.
Therapists should understand that clients they serve are intersectional beings. Thus, they should be aware of identities of the clients. The concept helped me in exploring all the factors exerting influence on our daily relationship with the client. Intersectionality gave me a broader perspective on how to change the oppressive impact of sexism and oppressions based on culture and other client’s characteristics (Shulman, 2016). I would say that my client would have ease in using other support systems or services that would improve her copying. I was able to provide acceptable and flexible etiology of the client’s distress. Besides, I ensured that the treatment plan I developed was congruent with the etiological information given by the client. The therapy sessions did not avoid difficult content, but I was considerate to appreciate the client’s intersectionality and the manner it affects the feelings of the client and the outcome of the therapy process. I was aware of the client’s demographics, contexts as well as her own internal processes. Having an intersectional stance foster my attitude and characteristics consistent with what is considered a standard practice in therapy, especially during the termination process (Norcross, Zimmerman, Greenberg & Swift, 2017).
Social skills that I used during the termination process were essential in reinforcing a successful termination process. Effective communication was essential, especially when I broke the news of termination. I ensured that I maintained eye contact to realize changes created in the client by the information. I had to keep a smiling face to help the client take the information positively. I was empathetic with the client, I wanted her to know that I was equally not happy terminating the process, but I had to make it happen. Stress management and emotional understanding was important in managing the reactions of the client. For instance, the councilor should take time to calm his or her mind to think about what to say since it will prevent emotions affecting the delivery process.
Speaking in a calm and prepared manner demonstrates the professionalism required during such an important psychological process. The counselor should explore possible outcome of the process and prepare for the reaction of the client, especially the difficult questions that may be asked. In fact, it is important to consider undertaking role-play to prepare for the delivery of the termination news. Stress management skills such as taking a deep breath helps in calming the body and the mind. The composer of the counselor during termination determines how calm the client would be during the termination process. The counselor should predict possible reactions from the client and develop solutions to such challenges before the termination process. This makes it easy to deal with the outcomes of the process. It is important to have ideas on how the client will adopt to the changes using various copying strategies discussed during the therapy sessions.
However, Social workers often fall in social pitfalls while delivering termination news to their clients. For instance, they fail to realize and manage the reactions of the client to the news. The therapists must understand that their relationship with the client is short-lived (Hepworth, Rooney, Rooney, Strom-Gottfried & Ja, 2017). This will help them manage the termination process without experiencing loss or anxiety. Nonetheless, therapists make mistakes of conveying a none epithetical attitude while delivering termination message. Clients take long to establish trust and relationship with the counselors. Sometimes they share personal information with the counselors and consider them friend. Thus, the news for termination affects clients deeply. Showing empathy during termination helps clients to understand the obligation of the counselor of ending the sessions when the objectives are met.
Furthermore, therapists fail to express optimism during termination. The sessions are ended and the client needs to be hopeful that the copying strategies learned during the process would be helpful (Olivera, Challú, Gómez Penedo & Roussos, 2017). Thus, it is important to inform the client that the therapy sessions were crucial to realizing change, and all will he or she will be well. Nonetheless, therapists should not fail to inform the client of possible return to therapy whenever things do not work as expected. The feeling of shame and built about things that happened during the therapy is a major pitfall around termination. Most therapists are not willing to make consultations concerning the cases they hand, and this results to the violation of the sovereign principle of risk management. The principle requires councilors not to worry alone concerning the challenges they experience during therapy. The fear of reporting the consequences may derail a successful termination exercise. Failure to maintain termination also affects the process. It is good to sustain necessary and indicated termination. For instance, some patients may attempt to put pressure on subsequent therapy, especially when they refuse to see subsequent therapists (Olivera, Challú, Gómez Penedo & Roussos, 2017). While this is their rights, it is crucial to undertake consultation to strengthen the resolve of the client.
I would consider the process of termination a success since I was able to follow almost all the standards of practice in therapy, especially concerning motivation. Firstly, I laid ground for termination right from the beginning of the sessions. I informed the client that therapy is a time bound process and will need to end when the objectives for the process is achieved. Thus, it set the expectations from the start that termination is a positive goal. Nonetheless, I set a rough timeline for the therapy reinforcing the idea that the treatment is time limited and would have to end at some point. It is not possible to tell how long a client will take in therapy. However, estimates can be made on therapeutic experience. Nonetheless, suggestions from treatments made manually can also be used to make the estimations. I had set my therapeutic goals to make a finish line for the process. The plans were important in guiding the client’s therapy by highlighting the goals and therapy of the client. Before termination, I observed sign that showed the client was ready for termination such as reduction of the symptoms. The remaining minor symptoms could better be treated by other means. I was open with the client and encouraged her to request for termination if she feels that she has had sufficient sessions and no longer experiences the symptoms. Since it was a planned termination, I informed the client of the intention to conduct the termination as she had shown improvement, and could manage the rest of the practices herself.
However, there are practices I would have done better to prepare the client for the termination process. For instance, I would have had a timed reminder between the sessions on the termination date or approximation of the same. For instance, I should have invited the client to discuss the termination after the first three sessions. The purpose regular reminder is to keep in mind the time left to fast track on goal achievements. I feel I did not handle the patient’s frustrations in a supportive manner. I did not have enough time with the patient after termination. I think I would have taken more time to address the outcome of the termination and observe the influence it had on the patient.
Psychological therapy is a very important process for those experiencing various copying challenges. The process of termination is one of the most important stages of therapy. The client and therapist form a relationship that can be hard to let go during termination. Thus, it is important to understand various aspects of termination to ensure that the process does not affect the client. Having effective communication strategy, stress and frustration management helps to make the client understand the implication of the process. It is important to appreciate intersectionality and it influence on the wellbeing of the client.
Compton, B. & Galaway, B. (2004). Social work processes, 7th edition. Pacific Grove, California: Brooks/Cole Publishing Company. ISBN: 9780534365592
Hepworth, D.H., Rooney, R.H., Rooney, D.R., Strom-Gottfried, K. & J.A. (2017). Direct social work practice: Theory and skills, 10th edition. Cengage Learning/Brooks Cole. ISBN: 978-1305633803
Marmarosh, C. L. (2017). Fostering engagement during termination: Applying attachment theory and research. Psychotherapy, 54(1), 4.
Norcross, J. C., Zimmerman, B. E., Greenberg, R. P., & Swift, J. K. (2017). Do all therapists do that when saying goodbye? A study of commonalities in termination behaviors. Psychotherapy, 54(1), 66.
Olivera, J., Challú, L., Gómez Penedo, J. M., & Roussos, A. (2017). Client–therapist agreement in the termination process and its association with therapeutic relationship. Psychotherapy, 54(1), 88.
Shulman, L. (2016). The skills of helping individuals, families, groups and communities, 8th edition. Cengage Learning/Brooks Cole. ISBN: 978-1-305-49793-1