Ending a Counselling Relationship

“Not every end is the goal. The end of a melody is not its goal, and yet if a melody has not reached its end, it has not reached its goal. A parable.” ~ Friedrich Nietzsche

It’s almost a paradox, but the goal of a successful counselling relationship is to, eventually, come to an end! Sometimes therapists and clients build a rewarding relationship and it may be difficult for both to formalise the end of that bond; but nevertheless, it is a vital step to effectively mark the success of the process and move forward.

In this article, we will overview the formal ending of the client-worker relationship. This formal ending usually falls into two categories: planned or unplanned.

1. Unplanned terminations

Either client or worker may initiate unplanned terminations. Client-initiated terminations may occur as a result of:

• the client dropping out of treatment,
• an adverse event that has rendered the client unavailable for service, or
• the client behaving in a manner that is incompatible with service requirements and is thus withdrawn from the program.

Client-initiated terminations can leave both worker and client with residual feelings of rejection, relief, anger and/or shame due to lack of opportunity for discussion and defusing.

Unplanned worker-initiated terminations can occur as a result of:

• an adverse event that has rendered the worker unavailable for service,
• the worker being dismissed, or
• the worker being laid-off or transferred.

Similar emotional reactions to those that may occur from client-initiated unplanned endings can also occur in response to worker-initiated endings, particularly if the ending is immediate. Some worker-initiated endings, however, whilst unplanned, can accommodate a final session for discussion and handover and this, of course, is best practice.

2. Planned terminations

Planned terminations can occur with two outcomes:

• the unsuccessful achievement of service goals and
• the successful achievement of service goals.

Planned Terminations with Unsuccessful Outcomes

Planned terminations with unsuccessful outcomes may occur when:

• the worker or client is dissatisfied with the helping relationship,
• the client is not progressing, despite continual attempts,
• the worker is not competent in addressing the specific needs of the client or
• the client does not comply with the requirements of intervention.

Hepworth, Rooney, Rooney, Strom-Gottfried & Larsen (2006) suggest that in situations such as these, the worker should discuss with their client (1) what factors prevented a more favourable result from being achieved and (2) the client’s feelings about seeking help in the future.

Such discussion needs to occur in an environment where the client feels safe and does not feel judged. Additionally, the worker needs to ensure that they do not respond in defence of themselves or the service. This will only serve to distance the client and may initiate a missed opportunity for genuine feedback.

Planned Terminations with Successful Outcomes

The aim of case management and other collaborative practice endeavours is to achieve the goals established with the client in the planning and contracting stage. The achievement of such goals, may not signal that the client won’t need the support of the worker in the future, but it does demonstrate that at this time the client can function sufficiently on his or her own.

It may therefore be beneficial in situations of planned terminations (with successful outcomes) that client and worker together discuss contingencies should future assistance be required. Additionally, successful outcomes may mark the client’s readiness for further growth and development, thus a referral to an appropriate service that would foster such development may be appropriate.

Consolidating Gains

Part of an effective termination phase involves enabling and empowering clients to consolidate the changes they have made. There are several reasons why clients may find it difficult to sustain change over time, including such factors as one’s natural tendency to revert to habitual behaviour patterns and one’s inability to resist peer pressures.

To sustain change over time, clients need to be equipped with sufficient coping skills. Workers can assist clients in consolidating gains by:

Anticipating the factors that are likely to impact on the client’s consolidation of change and practise strategies for coping with associated events (for example, a client seeking to abstain from drinking alcohol could be encouraged to role-play being assertive with family members and peers in regard to declining an offer of alcohol).

Implementing a monitoring (or ‘weaning’) phase, whereby the frequency of sessions gradually decreases over time.
Informing clients that they are welcome to return for help, if it is required. Note however that there is a fine line to tread between conveying your continued interest and support and expressing a lack of confidence in the client’s ability to cope on their own.

Follow up

Follow up sessions are another component of effective termination. The purpose of follow up sessions is five-fold:

1. provide opportunity for the worker to acknowledge the changes and progress that the client has made since the final, formal session
2. allow the worker to offer assistance and guidance in response to any residual difficulties
3. can act to lessen the impact of termination
4. provide further opportunity for evaluation of service delivery
5. can initiate progress toward more formalised help (if this appears necessary)

References

• Hepworth, D. H., Rooney, R. H., Rooney, G. D., Strom-Gottfried, K., & Larsen, J. (2006). Direct social work practice: Theory and skills (7th ed., pp. 571 – 585). Belmont, CA: Thomson Higher Education.