Section 3: Bringing the Counselling Relationship to an End

Submitted by sylvia.wong@up… on Sun, 01/01/2023 - 19:20

In this section, you will learn to:

  • Assess the appropriateness of ending the current counselling relationship.
  • Appropriately plan for and structure endings.
  • Identify any unresolved issues, discuss further work if appropriate, and inform clients about any opportunities for further support.
  • Support clients’ sense of autonomy during the ending process.

Supplementary materials relevant to this section:

  • Reading G: Endings
  • Reading H: When Should Counselling End?

Ending the counselling process requires preparation and planning. This module section introduces the elements involved in successfully concluding counselling with a client.

Sub Topics

The counselling relationship is not designed to be a never-ending process. But how do counsellors and clients know it is time to bring the counselling relationship to a close? Ultimately, counselling aims to help the client achieve the goals established in the counselling plan, and the counselling relationship can be brought to a close when these goals have been achieved. When a client’s goals are clearly defined, and a clear counselling plan has been established and used, bringing the counselling relationship to a close can be a relatively straightforward process. However, closure can be more complicated when counselling goals are not clearly defined or based on ongoing client self-improvement. For example, how does the counsellor assess when a client’s “self-esteem” has increased enough or when a client has achieved the optimal level of assertiveness? This example illustrates the importance of developing tangible goals in the first place. Without clear goals and monitoring and review processes, knowing when counselling has been successful and when ending/termination is appropriate can be difficult.

How to End Therapy with Your Clients

In this video Mark Tyrrell talks you through 3 ways to signal the end of therapy with your clients, and the importance of doing so.

Watch

The following extract outlines some sources of information that counsellors and clients can use to explore goal attainment and assess the appropriateness of ending the counselling relationship.

The boundaries for ending counselling are imprecise. In a sense, lifeskills counselling has its ending built into its beginning. To look at it another way, the ending of formal counselling is the beginning of independent self-helping. Counsellors and trainers should start termination discussions before the final sessions and aim for convergence either then or by the final session. Throughout counselling, you and clients collect information relevant to termination decisions. Below are sources of and kinds of relevant information.

  • Client self-report. Clients may perceive themselves as better able to cope with problems. They may think they have attained their mind skills and communication/action skills goals. They may feel more confident and less prone to negative emotions. They perceive they no longer require your support and can maintain skills.
  • Counsellor observation. Over a series of sessions, you may notice improvements in how well clients use targeted mind skills and communication/action skills. These observations come from various sources: the counselling conversation, role-plays and other structured activities, and from probes about how well clients use skills outside counselling. You may observe clients feeling happier and more relaxed. They no longer have symptoms that brought them to counselling, for instance, excessive anxiety. Problems that previously seemed insurmountable now seem manageable in that clients now can use better skills in responding to such problems. In addition, they seem to understand the targeted skills well enough to maintain them.
  • Feedback from significant others. Significant others in clients’ lives give clients feedback that they are different or have changed or make comments such as “You seem much happier these days.” Sometimes the feedback may come direct to you: for instance, from counsellor’s aides, spouses, bosses or parents.
  • Attainment of measurable goals. Clients can have easily measurable goals. For example, they may pass an examination or driving test. Other examples include: losing a stipulated amount of weight and maintaining the loss over a given period; cutting down on smoking and maintaining the reduction; keeping off alcohol; or only spending a certain amount of money each week. Clients’ goals can be both objective and subjective: for instance, making a given number of friends in a set period of time. The given number and set period are objective, whereas the definition of friends is subjective.

(Nelson-Jones, 2014, pp. 376-377)

Counsellors should plan for the end of the counselling relationship from the very first session (Meier & Davis, 2011). At the start of the counselling relationship, both client and counsellor should understand how long the counselling process is predicted to be and when and how counselling will end. For example, the counsellor may consider the extent of the client’s issues and goals and contract counselling for a certain length of time. This helps to provide direction to the counselling process and ensure that ending/termination is worked towards from the initial session.

Ending counselling relationship

This video discusses what makes endings 'good' or 'bad' and how they can have a long-lasting effect on both the client and the counsellor.

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Read

Reading G & H - Endings & When does counselling end?

When and how to conclude a counselling process is one of the most commonly asked questions for counsellors in training. Reading G and H explore this aspect with suggestions on how counsellors can prepare clients, and themselves, for the end of a counselling process/relationship.

Ending/termination can be a challenging process for both clients and counsellors. It is the counsellor’s responsibility to try to ensure as smooth a transition as possible.

The counsellor and client build a strong therapeutic relationship throughout the counselling process. As the end of counselling draws closer, formalising its end can sometimes be difficult. Since endings are often associated with loss, they need to be handled sensitively, and it is the counsellor’s role to lead the relationship to a mutually agreed close. Counsellors use several techniques and processes to prepare clients for the end of counselling and assist in the ending process.

Firstly, it is important to regularly remind clients that the counselling relationship is structured and when it is planned to come to a close. This is best done well before the final session. Indeed, mentioning ending/termination as a regular part of the review process is quite effective. For example, counsellors might use language like: “As you are aware, our last counselling session will be in the last week of August. So far, we have achieved….” This sort of discussion also provides an opportunity for clients to identify if there are any other concerns that they would like to discuss. For example, the counsellor may say, "We have three more sessions together. What would you like to focus on in our remaining time together?” or “How would you feel if this was our last session? Is there anything that you would regret not having discussed?” These types of prompts remind the client that the counselling process will come to an end and help to identify if there are any other issues that the client wants to address – these should be discovered earlier rather than in the final session.

As the planned end date approaches, it is also important for the counsellor to take appropriate steps to help the client feel ‘ready’ for counselling to come to a close. Ending counselling can create feelings of loss in some clients that may need to be addressed before the counselling relationship ends. Allowing clients to talk about their feelings regarding termination helps them process their emotions and express how they feel about it. For example, a counsellor may prompt this discussion by saying, “As you know, this is our second last session together. How do you feel about bringing the counselling relationship to a close?” The counsellor will then work with the client to address any emotional issues that arise.

It is also helpful for the counsellor to remind the client how far they have come. This may involve reviewing the client's progress during counselling, discussing their achievements, reviewing the skills they have learned, and reflecting upon their hard work and personal growth. For example, counsellors may ask questions like: “How are you feeling now compared to when we started?” and “Do you feel like you have achieved the goals you set for yourself?” The goal is for clients to adequately reflect on the counselling process, including what has changed for them, what has not changed, the impact that counselling has had, and whether they can continue to work towards/maintain their goals outside of the counselling relationship. This can help the client feel more prepared and empowered for the end of counselling. When clients can identify the progress that they have made and have confidence that they will be able to continue to function effectively after the counselling relationship, they are more likely to embrace termination.

Last Session overview and demonstration

This role-play demonstration provides an overview of what a last session -- with referral -- could look like.

Watch the video and then answer the questions that follow. 

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Let’s look at another example of how a counsellor can discuss closing the counselling relationship.

Case Study

Trisha has met her client, Samuel, every week for two and a half months. Samuel was originally contracted for six sessions, but initial counselling revealed more in-depth issues, and together Trisha and Samuel decided to re-contract for an additional six sessions. During the last three sessions, Trisha has observed a marked improvement in Samuel’s behaviour and believes that he will be ready to end counselling in two weeks at the end of the re-contracted period. However, Trisha wants to ensure Samuel is happy with his progress and is prepared for the counselling relationship to come to a close so she discusses termination towards the beginning of the current session.

Trisha: Samuel, how do you feel now compared to when we started?
Samuel: I feel so much lighter and feel like a burden has been lifted off my shoulders. I guess I was much more anxious when I first came, but it is better now.
Trisha: Yes, I do agree with you there, Samuel. You have stayed committed to your goals, and we both have seen so much change in you. You look happier and more relaxed, and you have also avoided alcohol for two months. Do you feel like you have achieved the goals that you set for yourself?”
Samuel: Yes. I think so. I wanted to get my stress, anxiety, and drinking under control, and I really have. I’m proud of that.
Trisha: That’s great! You should be proud. I’m proud of the hard work you have put in. What do you think was most helpful for you?
Samuel: I think it really helped me to talk about my relationship with my mother and how her treatment of me as a child had affected my personality negatively. Opening my eyes to the truth and having a new understanding of myself, with your help, has really helped me immensely. I now feel free of all the ‘baggage’.
Trisha: Wonderful! Now, as you know, we have two more sessions together after today. How do you feel about our time together coming to an end?
Samuel: Wow! I haven’t really thought about our last session. Well, I suppose it would be a bit hard as I have got used to coming to see you and our chats, but at the same time, I do feel as though I have come a long way, and I think I might be able to continue with all of this myself.
Trisha: That’s great. You have learned so much and shown that you can apply it to your life. So, what would you like to focus on in our remaining time together?
Samuel: Maybe just reviewing what I have learnt so far and how I can continue working on it?
Trisha: That sounds like a great idea.

In this scenario, Trisha leads Samuel to reflect on his progress which helps him to gain further clarity relating to his achievements and personal growth. Trisha commends him and highlights his achievements. This helps ensure that Samuel is more comfortable with the counselling process coming to an end.

Reflect

If you were Trisha, what would you do with Samuel in your remaining sessions to help facilitate the ending process?

It is important to support the client’s sense of autonomy during the ending process. When clients first enter the counselling relationship, they seek to partner with a counsellor to help find solutions to their particular concerns. Ideally, through the counselling process, clients learn to rely on their own strengths and resources to make the required changes in their life. Clients move from being or feeling dependent initially to being strengthened in their self-view and autonomy. As the counselling relationship comes to a close, counsellors should focus on highlighting this autonomy and empowering the client to believe that they can function independently. Of course, fostering autonomy does not mean the client must be completely independent as soon as the initially contracted counselling sessions end. Many clients require additional support or additional counselling beyond the initially contracted sessions. Ultimately, if the client does not feel able to function autonomously outside of counselling, the counsellor should work with the client to explore opportunities for further support.

Everything A Therapist Wants You To Know: When Should You End Therapy

The presenter in this video provides an insight to potential users of therapists about when it’s time to end therapy,  that different therapists may be better equipped to help  navigate specific life changes, how its not uncommon to stop seeing one therapist but eventually begin seeing another. His explanation provides sound advice on things you could say to your client about the ending process of counselling. 

watch
Check your understanding of the content so far!

Clients might not achieve all of their goals within the initially contracted counselling sessions. In some cases, there may be a few minor issues that the counsellor can assist the client to develop resources for to continue their self-development independently, whereas, in other cases, the client might require some form of additional or ongoing support. Some common approaches that counsellors can explore when additional support may be required include:

  • Discussing options for self-support. In cases in which the client has made solid progress towards their goals and developed skills that will enable them to continue working towards their goals outside of the counselling relationship, the counsellor might simply discuss resources that the client can use to support themselves. This could involve continuing the use of techniques practiced throughout the counselling relationship or the discussion of self-support resources such as self-help books or other media.
  • Discussing options for future contact with the counsellor. In some cases, the counsellor might identify that the client could benefit from ‘booster’ sessions or follow-up sessions at a later date. This can help clients maintain improvements in their patterns of behaviour.
  • Referring the client to alternative supports. In cases where the client has made solid progress but could benefit from a different type of support, the counsellor might discuss alternative options such as support groups or other group programs that will allow the client to continue their progress in a different context.
  • Recontracting for further support. When the client has not made their expected progress on their goals or when additional issues have arisen that the client would like to address, the client and counsellor may agree to extend the counselling relationship to also work on these issues. In such cases, the counselling contract needs to be renegotiated.
  • Referring the client to another professional. This is useful in cases where the client’s new issues are unsuitable for counselling or would benefit from the services of another professional. In such cases, the counsellor should discuss the need for referral with the client, obtain the client’s consent, and make that referral.

The counsellor must ensure that any support options discussed comply with their organisation’s policies and procedures.

Organizational contexts can impact on how the client experiences therapy: A series of counselling sessions in a GP's surgery may not provide the client with the same experience as open-ended sessions in a voluntary service which is established explicitly to support individuals with specific trauma. The therapist needs to be aware of how the organizational context may impact on their client and, as necessary, address this with the client.

Many agencies will operate time-limited therapeutic services. This can often prove a challenge to the therapist, who is committed to doing the best for their client. Furthermore, the client may find it difficult to do the work they need to do in a limited time frame. In the original contracting process, the limitations of therapy, including duration and frequency of therapy, need to be made explicit. Both parties can then address progress collaboratively. It may be possible to negotiate a further term of therapy, referral to another agency, or to address ways in which the client may work through issues that they are still experiencing in other ways in their everyday lives. It is, therefore, the responsibility of the therapist from the outset to ensure that both parties remain aware of the time limits of therapy as the sessions progress.

(Paul & Charura, 2015, p. 194)

Ultimately, the counsellor should clearly discuss appropriate options with the client and facilitate the client’s decision-making. In cases where further supports are decided upon, counsellors should clearly document this in their session notes. In cases in which the counselling process is brought to an end, counsellors should document this ending. Remember, in all cases, counsellors are responsible for taking appropriate notes of their work with clients and storing these in compliance with all organisational and legal requirements.

Ending the counselling relationship can be a challenging process, but when counselling has been appropriately planned and monitored, this process can be an effective and rewarding experience for both the client and the counsellor – after all, the ultimate goal of counselling is for the client to feel capable and empowered enough not to require it anymore.

Check your understanding of the content so far!

In this section of the module you learned about the techniques and processes counsellors use to facilitate the successful ending of the counselling relationship and process.

Ultimately, successfully ending counselling involves empowering the client to be able to continue with the strengths and abilities they have worked on during counselling.

  1. Meier, S. T., & Davis, S. R. (2011). The elements of counselling (7th ed.). Belmont, CA: Brooks/Cole.
  2. Nelson-Jones, R. (2014). Practical counselling and helping skills (6th ed.). London, UK: Sage Publications.
  3. Paul, S., & Charura, D. (2015). An introduction to the therapeutic relationship in counselling and psychotherapy. London, UK: Sage Publications.
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