By Noah MP Spector and Shaofan Bu When is it over Determining when to end therapy Clients should have reasonable warning about when therapy will end Endings can be an opportunity to review accomplishments ID: 741832
Download Presentation The PPT/PDF document "Chapter 15 Endings and Beginnings" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Chapter 15
Endings and Beginnings
By: Noah M.P. Spector and Shaofan BuSlide2
When is it over? Determining when to end therapy
Clients should have reasonable warning about when therapy will end. Endings can be an opportunity to review accomplishments.
Endings can also take place gradually over time by for example initially increasing time between sessions (“fading”). Slide3
Ending with clients
When to end? A function of preferred outcomes establishedYou and I have been reflecting on a number of significant changes you
’
ve made; I
’
m wondering if you might be thinking it
’s getting to the time to take a break from this process and put those changes to work?
3Slide4
Ending with clients
Possible sense of loss for client and counsellorClient concern about
“
flying solo
”
Can
“fade” frequency or schedule future “check in”Counsellor: sign of failure?Counsellor; is the client ready?
Marks accomplishment on part of client
Rite of passage
A new beginning
Chance to celebrate & review learningsOpportunity to anticipate backslides (relapses)
4Slide5
The ending of therapy as a rite of passage
Rites of passage (Van Gennep, 1960) is a useful metaphor to understand the end of therapy. Slide6
“Termination” as a rite of passage
Rite of passage metaphor (van Gennep
, 1960)—stages of change:
Separation– detached from familiar ways of being.
Liminal space—Betwixt and between.
Reincorporation- moving into a new phase of life
(
White &
Epston
, 1995) Slide7
Taking stock of learnings
With the changes you’ve been making, what would you say is one piece of yourself or way of being that you
’
re leaving behind you as you go forward?
What is it about this
“
part” that no longer fits for you?
What are tips you
’
d share with others going through similar challenges?
7Slide8
Taking stock of learnings
How would you describe what’
s different about your relationship with yourself now?
Which priorities have risen to the surface?
What skills and abilities have you uncovered that were dormant or at least not very visible to you before?
8Slide9
Celebrating, documenting and soliciting witnesses to change
The ending of therapy, like other significant rites of passage warrants celebration.
Examples of documents:
Letters
Certificates
Therapeutic gains may also be formally recognized by others Slide10
<Your Organization Name Here>
honors
<Client Name>
We Admire Your Hard Work &
Dedication. You are Inspiration.
You are a Winner
and It Shows.
Congratulations on
Your Success.
00 / 00 / 00
Date
Therapist signature
Psychotherapist Typed Name Here
<Name created together>
Sample Document Slide11
Celebrating, documenting and soliciting witnesses to change
Friends and loved ones may also bear witness to changes at the end of therapy.Sometimes these loved ones are remembered or imagined as being present…other times they may be invited to attend a session.
Slide12
Spreading the word
Who do you know who’
d be most likely to predict the changes you've been making? What would they tell me about what they know about you that would help me understand the accuracy of their predictions?
Who would be most interested to hear about these developments? What would s/he find interesting about it? How could you catch her/him up?
Who will be most affected by the changes you
’
ve made? Are they aware of them or do you plan to talk to them about what
’
s been going on?
12Slide13
Preparing for setbacks
The end of therapy will not mark an end to struggles. It is important to prepare for setbacks— also known as “relapse prevention”. Slide14
Preparing for setbacks
-How will you know that X is creeping back into the picture next time?
-What
are the situations (contexts, people, times of day, etc.) in which X is most likely to reappear?
-How
will you respond differently next time your boss pushes your buttons again?
-How will you remember to re-connect with your breath next time that feeling comes on?-What have you learned about your ability to deal with X that will help you if X does reappear
? Slide15
Changing the Social Context
-Are there certain circles of friends who are most likely to encourage the Drinking’s return?
-What
situations are most likely to tempt you to start using again?
-Who
do you figure stands against Trouble in your life, and who stands with it?
-Who do you most associate with your old lifestyle and who fits with your new lifestyle?Slide16
Reflecting on your own learnings
What preferred developments have occurred in your own practice as you’ve engaged in this course?Who would be most likely to predict your successes? On what basis?
What potential setbacks lie ahead (opportunities for backslides) and what have you learned about how to anticipate and respond to them?
How will you acknowledge and commemorate your
successful completion of
this course?