Terminating Therapy: A Professional Guide to Ending on a Positive Note

Terminating Therapy provides a thoughtful and comprehensive discussion of the many issues involved in termination. It addresses underlying principles and concrete actions in a way that will be consistently helpful to practicing clinicians. This is the single best source I have seen on the subject of termination."
—Steven D. Hollon, PhD, Professor of Psychology, Vanderbilt University
"The simplicity and clarity of her style belie the subtle clinical wisdom that anyone—seasoned therapist/provider or client new to the process—might profitably access. This text, heavily punctuated with ′how to?′ and ′what should?′ queries throughout, provides guidance and raises issues garnered only from broad clinical experience from which anyone in the practice of psychotherapy might benefit. This work is a must–read clinical treasure that offers gems in sample vignettes and pragmatic applications throughout."
—James L. Rebeta, PhD, President, Manhattan Psychological Association, and Assistant Professor of Psychology, Weill Medical College of Cornell University
The first book of its kind to provide an in–depth and practical approach to termination in the current era of time–limited therapy
A successful termination is a vital phase of any kind of psychotherapy, yet often taken for granted or not considered when therapy is initiated. This text presents a much–needed guide to wrapping up treatment with your clients, covering:
The practical challenges faced by practitioners and possible solutions
How to conceptualize termination as a task of the therapeutic alliance
Setting termination goals and linking them to the treatment plan
Communicating effectively about termination
Recognizing appropriate reasons for termination
The six essential steps to ensure that the practitioner is doing "enough" to achieve a clinically and ethically appropriate processWritten for a wide range of practitioners at all levels of experience, this unique book includes numerous case studies illustrating both typical and difficult situations and provides practical and straightforward advice on ending therapy on a positive note.

Spis treści:
Chapter One. Termination Strategy: A Pragmatic Approach In Contemporary Practice.
A. The Importance Of Termination.
1. How Does Theoretical Orientation Impact Termination?
2. How Is Termination Managed In Today′s Practice Environment?
3. What Makes Termination Difficult To Plan Even In Brief Therapy?
4. What Circumstances Elevate The Risks Of Adverse Events At Termination?
B. Strategies For Effective Termination.
1. What Are The Main Objectives Of A Pragmatic Termination Strategy?
2. How Can I Distinguish Good Termination From Bad Termination?
C. Summary Points For Applied Practice
Chapter Two. Professional Skills And Termination.
A. Building A Base Of Collaboration.
1. What Is A Collaborative Stance Toward Termination?
2. Is It Useful To Distinguish Types Of Termination?
B. Applying Reasonable Professional Standards.
1. What Are The Standards For Ethically Responsible Termination?
2. What Is Client Abandonment And How Can It Be Avoided?
3. Can Termination Be Broken Down Into Specific Applied Skills?
C. Summary Points For Applied Practice.
Chapter Three. Positive Closure From The Start: Groundwork For Termination.
A. Optimize The Match.
1. How Does A Practice Profile Help To Manage Terminations?
2. Can A Provider Ethically Screen Referrals?
B. Set Policy And Shape Expectations.
1. Should Termination Be Included In Informed Consent?
2. How Can I Estimate The Length Of Therapy At The Outset?
C. Formulate A Termination Plan And Discharge Criteria.
1. What Is A Termination Plan And How Is It Linked To The Treatment Goals?
2. How Can I Assess Client Motivation And Use It In The Termination Plan?
3. How Do I Know If The Client Is Benefiting Or Likely To Benefit From Therapy?
D. Summary points for applied practice
Chapter Four. Talking About Termination: A Closer Look At Communications.
A. Orientation To The Topic Of Termination.
1. What Makes Termination Difficult To Discuss?
2. What Is The “Culture Of Expectations” And How Does It Impact Termination Discussions?
3. Are there beliefs that affect the provider’s approach to termination?
B. Making The Decision To Terminate.
1. What Are Clinical, Practical And Ethical Reasons For Termination?
2. Are There Any Conversational Targets To Help Structure Termination?
C. Creating A Record.
1. What Documentation Is Necessary?
D. Summary Points For Applied Practice.
Chapter Five. Achieving Closure: Assuring Professional Action.
A. Directing The Termination Process.
1. Are We Ending Sessions Or Ending The Relationship?
2. How Do I Know That I′ve Done Enough For An Appropriate Termination Process?
B. Managing Risks.
1. When Should I Insist On Termination?
2. What If The Client Refuses Termination Or Becomes Hostile?
3. What Should I Do About My Personal Needs And Limits?
C. Summary Points For Applied Practice.
Chapter Six. Adapting Termination To Client Needs – A Consumer Oriented Perspective.
A. Sociocultural Context.
1. Does The Client′s Cultural Background Or Social Environment Impact Termination?
B. Clinical Needs.
1. How Do Axis II Personality Disorders Affect Termination Strategy?
2. What About Termination When The Client Has A Chronic Or Recurrent Axis I Disorder?
B. Developmental And Health Related Needs.
1. Does life stage or health status affect termination needs?
C. Practical Concerns.
1. How Can I Handle Practical Concerns About Time, Convenience And Money?
D. Summary Points For Applied Practice.
Chapter Seven. Provide r Challenges.
A. Termination Dissonance.
1. I Am Not Sure That We Are Talking Enough About Termination.
2. I Am Worried That This Client Will Never Be Able Terminate Therapy.
3. I Can′t Seem To Satisfy This Client.
B. Sudden Or Crisis Terminations.
1. My Client Has Disappeared And Does Not Return My Call.
2. I′ve Just Been Fired.
3. My Client Has Suddenly Died.
C. Self–Management Challenges.
1. I Can Not Seem To Let Go.
2. I Think I Mishandled Termination.
3. I Have Lost Control Of The Therapy Relationship And Don′t Know How To Terminate.
4. I′m Feeling Burned Out. How Can I Get My Enthusiasm Back?
D. Summary Points For Applied Practice.
Chapter Eight. Termination With Couples, Families And Groups.
A. Attending To Multiple Interests.
1. How Does Termination Differ When Therapy Involves More Than One Person?
2. When Should I Recommend Termination With Couples?
3. If One Member Of A Couple Or Family Terminates Therapy, Does That Mean The Other Participants Must Terminate As Well?
4. Are There Risks Of Abandonment In Couples Or Family Therapy?
5. What Should I Do If I Think Couples Therapy Should Be Terminated In Favor Pursuing Individual Therapy?
5. How Can I Respond When A Parent Abruptly Terminates The Therapy Of A Child Or Teen?
6. What About Handling The Opposite Situation, When A Parent Essentially Remands The Child Or Teen To Treatment?
B. Termination And Group Therapy.
1. How Can I Minimize The Disruption Of Early Termination From A Group?
2. Is There A Best Way To End A Group?
C. Summary Points For Applied Practice.
Chapter Nine. Supervisory Termination.
A. The Supervisory Relationship.
1. Should Termination Be Included In The Supervisory Contract?
2. Is There A Clinically And Ethically Appropriate Process Of Supervision Termination?
3. When Is Supervisory Termination Complete?
4. Should Required Ongoing Supervisio