Termination of Therapy

“Termination” is a scary word that one would not typically associate with a relationship, let alone the therapeutic process. It makes sense to therapists because we have been trained in it. For our clients, especially the ones who have never been in counseling before, the process may be unclear.

This is where I think a lot of the abandonment, anxiety, and sadness comes up – to them, especially the younger ones, we are up and leaving them.

Termination should be an ongoing discussion between client and therapist that addresses goals, achievements, and future directions. Source: http://laurenmford.blogspot.in/2011/03/breakup-termination-in-therapy.html

(You have to completely enter the internal world of the child, while being firmly rooted on yours. )

Sexually abused children suffer a wide variety of symptoms and changes within the home and their environment. Therefore the criterion for termination is different and subjective for each child and differs from one child to another.

General points to check before termination:

1. To begin the process of termination, the child should be in a position where she/he is able to talk about a range of feelings both in therapy and to friends.

2. Children who are sexually abused have great difficulty in feeling safe. Many children hide their emotions to avoid feeling vulnerable or being teased. But this avoidance of feelings serves to isolate the child from developing close friendships which are important to promote healing. If children are withdrawn, they miss out on an essential part of their childhood.

3. You must ensure that the abused child must have at least one trusted adult caretaker to whom the child can talk when he/she is upset about the abuse or any other matters.

4. Check if the child is doing as well in school and with friends as she/he was prior to the abuse. The child should be at about the same level of functioning as she/he was prior to the abuse.

5. The child should not be symptomatic e.g. child should be free of panic attacks, intrusions, bedwetting, sleep problems and other symptoms related to abuse.

6. Family conflict, if any, should be resolved.

7. There is always a power dynamic between the counselor and the child and here, the child needs to be given precedence. It is important that the child needs to know that she/he is in control of the process.

8. Respect your client’s desire to terminate if it is client-initiated. But be confident in expressing concerns if you feel termination may be premature.

9. If client-initiated, the important thing is to make sure that the child is not leaving therapy because it became unpleasant or difficult. Initially therapy is more about helping the children understand themselves than making them feel better. This process can take time and the initial perception of the child towards this approach can be varied.

10. Discuss termination with your clients early on in the counseling process. This way they are prepared for what is to come when it does and does not come off as a shock. Pick a final session date so the client is prepared well in advance and so are you when the day comes.

11. The way the child handles and ends therapy can be a way of examining how they say goodbye to people and the feelings involved in leaving and loss.

12. It can be empowering for the child to know what the therapist thinks of their experience together. Knowing that the therapist or the counselor has learnt something from the child as well, as they saw them grow and get better, always leads to a happy and positive ending.

13. How you close your counseling relationship can have a significant impact on your client’s view of his or her experience in counseling and the likelihood of their practicing what has been learned after sessions have concluded.

14. Temporary termination: Children often reach a plateau in their work with the counselor and need some time to integrate what they have accomplished. Termination, temporary or permanent depends on the child and their further progress.

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