The first book of its kind to provide an in-depth approach to termination of therapy, Terminating Therapy guides you through the practical, ethical, legal, and emotional challenges of how and when to end therapy. Written for a wide range of practitioners at every level of experience, this book provides straightforward advice on ending therapy on a positive note.
Premature termination is a significant yet often neglected problem in psychotherapy with significant consequences for clients and therapists alike. According to some estimates, as many as 20% of adult clients terminate psychotherapy prematurely. Even experienced practitioners using the best evidence-based techniques cannot successfully promote positive, long-term change in clients who do not complete the full course of treatment. This book helps therapists and clinical researchers identify the common factors that lead to premature termination, and it presents eight strategies to address these factors and reduce client dropout rates. Such evidence-based techniques will help therapists establish proper roles and behaviors, work with client preferences, educate clients on patterns of change, and plan for appropriate termination within the first few sessions. Additional strategies can be used throughout therapy to help strengthen and reinforce clients' feelings of hope, enhance their motivation to create change, develop and maintain the therapeutic alliance, and continually evaluate overall treatment progress. Case examples demonstrate how these strategies can be employed in real-life scenarios.
With a focus on the termination of psychotherapy, this guide examines the pertinent additional training that will aid mental health professionals in providing the most financially sensible and clinically deep treatment for their clients. It covers a wide spectrum of therapy approaches, patient populations and termination strategies.
A successful termination phase is a critically important component of psychotherapy of any orientation. The authors synthesize and evaluate the clinical, theoretical, and empirical literature on termination. They then offer their own Termination Phase Model designed to help psychotherapists understand and address the full range of both patient and therapist responses that must be considered as therapy winds down and the patient prepares for life without treatment.
What sets off the termination of analysis and psychodynamic therapy from the variety of endings that enter into all human relationships? So asks Herbert J. Schlesinger in Endings and Beginnings: On Terminating Psychotherapy and Psychoanalysis, a work of remarkable clarity, conceptual rigor, and ingratiating readability. Schlesinger situates termination - which he understands, variously, as a phase of treatment, a treatment process, and a state of mind - within the family of "beginnings and endings" that permeate one another throughout the course of therapy. For Schlesinger, therapeutic endings cannot be aligned with the final phase of treatment; ending-phase phenomena are ongoing accompaniments of therapeutic work. They occur whenever patients achieve some portion of their treatment goals and supervene when therapy stagnates. Small wonder that an assessment of the patient's relationship to time and capacity to end therapy are key aspects of diagnostic evaluation. By linking beginning and ending phases not to the chronology of treatment but to the patient’s experience of it, Schlesinger brings revivifying insight to a host of psychodynamic concepts. Nor does he shy away from a trenchant critique of the instrumental “medical model” of psychiatric and psychotherapeutic training, which militates against the therapeutic exploration of treatment endings. Schlesinger's exemplification of how to begin treatment from the point of view of ending; his sensitive delineation of the mid-treatment "ending" crises characteristic of "vulnerable patients"; his richly woven case vignettes illustrating various "ending" contingencies and permutations - these inquiries are gems of pragmatic clinical wisdom. Endings and Beginnings distills lessons learned over the course of a half century of practicing, teaching, and supervising psychotherapy and psychoanalysis and is a gift to the profession.
Ending therapy in an appropriate and meaningful way is especially important in work with children and adolescents, yet the topic is often overlooked in clinical training. From leading child clinicians, this much-needed book examines the termination process/m-/both for brief and longer-term encounters/m-/and offers practical guidance illustrated with vivid case material. Tools are provided for helping children and families understand termination and work through associated feelings of loss and grief. Challenges in creating positive endings to therapy with children who have experienced trauma and adversity are given particular attention. Several reproducible forms can be downloaded and printed from the companion website in a convenient 8 1/2" x 11" size. This e-book edition features nine full-color figures. (Figures will appear in black and white on black-and-white e-readers).
(Choral Score)"The Waters of Prayer" for Female Chorus, a cappellaText by Vassar MillerMusic by Kentaro Sato (1981-)Voicing: SSAADuration: 12minLyrics: English1. Heritage2. Renewal3. Prayer upon Waking4. InvitationVisit: www.wisemanproject.com for more information.
Psychoanalysis can make a huge difference in the lives of patients, their families and others they encounter. Myths have developed, however, about how psychoanalysis should end – what patients experience and what analysts do. These expectations come primarily from accounts by analysts in the analytic literature which are often perpetuated in an oversimplified form in teaching. Patients' perspectives are rarely presented. I her book, Judy Leopold Kantrowitz seeks to address this omission. Exploring the accounts of 82 former analysands, she illustrates the rich diversity of psychoanalytic endings and ways of maintaining analytic benefits after ending; in presenting patients' experiences Kantrowitz provides correctives for some myths about termination. Myths of termination: What patients can teach psychoanalysts about endings is not a book that seeks to refute or support any specific idea about a best way of ending analysis, but rather to show that there are countless ways of having a satisfactory conclusion to the process. Nor is the author espousing any particular analytic theory. Kantrowitz sets out to show that an oversimplified view of psychoanalytic endings not only diminishes an appreciation of the diversity of psychoanalytic outcomes but may also interfere with the creativity of individual psychoanalysts. In this book, former analysands describe and illustrate how their analyses ended. They reflect on the effect of non-mutual endings due to external factors (moving, retirement, illness or death) or psychological factors (wishing to avoid facing some issue); the impact of post-analytic contact; and the ways in which they have held on to their analytic benefits after ending their analyses. Myths of termination confronts and refutes the myths about the termination phase of psychoanalysis that are passed from generation to generation. It is a refreshing and insightful study that will be welcomed by psychoanalysts, psychodynamic therapists, such as clinical psychologists, social workers, and others trained or in training to do clinical work.
Forced Endings in Psychotherapy and Psychoanalysis: Attachment and Loss in Retirement explores the ambivalence the therapist may feel about letting go of a professional role which has sustained them. Anne Power explores the process of closing a private practice, from the first ethical decision-making, through to the last day when the door of the therapy room shuts. She draws on the personal accounts of retired therapists and others who had to impose an ending on clients due to illness, in order to move house, to take maternity leave or a sabbatical. A forced ending is an intrusion of the clinician’s own needs into the therapeutic space. Anne Power shows how this might compromise the work but may also be an opportunity for deeper engagement. Drawing on attachment theory to understand how the therapeutic couple cope with an imposed separation, Power includes interviews with therapists who took a temporary break to demonstrate the commonality of challenges faced by those who need to impose an ending on clients. Forced Endings in Psychotherapy and Psychoanalysis opens up an area which has been considered taboo in the profession so that future cohorts can benefit from the reflections and insights of this earlier generation. It will support clinicians making this transition and aims to support ethical practice so that clients are not exposed to unnecessary risks of the sudden termination of a long treatment. This book will be essential reading for practicing psychotherapists and psychoanalysts, and to undergraduate and post-graduate students in clinical psychology, psychiatry and social work
