Collaboration has been recognized as an important relationship variable in psychotherapy that is linked to client treatment outcomes. Although many therapists seek to build a collaborative working relationship with their clients when making treatment decisions, collaboration is also an important technique that can be used to help clients plan for a successful termination. Collaborative termination strategies can first be used in the initial session in order to address clients' termination expectations. Strategies can also be used throughout treatment to help clients focus on their treatment goals. Last, collaborative termination strategies should be used in the final session to help clients take ownership of their gains and to equalize the therapeutic relationship. In this article, we provide specific recommendations for collaborating with clients in preparing for psychotherapy termination. Case examples demonstrating these strategies are also provided. (PsycINFO Database Record
Establishing a collaborative therapeutic relationship is an important research-supported goal for the initial sessions of psychotherapy. Fostering a collaborative relationship can occur through strategies such as recognizing the client's expertise in treatment, involving the client in the treatment decision-making process, and discussing the possibility of therapist mistakes. In this article, we present theoretical and research support for establishing a collaborative relationship. We then provide a case example that illustrates different collaboration-building strategies. The article concludes with several clinical recommendations for how therapists can increase client collaboration in the initial sessions of treatment.
Clinical Impact StatementQuestion: Given the high rates of psychotherapy dropout, therapists and researchers alike may wonder how best to fully engage their clients in treatment. Findings: This article describes several strategies that therapists can use in the initial sessions of psychotherapy to build a collaborative relationship with their clients. Meaning: Building a collaborative relationship can lead to reduced premature termination and improved treatment engagement. Next Steps: Further research empirically testing brief pan-theoretical strategies for engaging clients in the initial sessions is needed.
Clinical errors occur in the psychotherapy decision-making process whenever a less-than-optimal treatment or approach is chosen when working with clients. A less-than-optimal approach may be one that a client is unwilling to try or fully invest in based on his/her expectations and preferences, or one that may have little chance of success based on contraindications and/or limited research support. The and the models are two decision-making models that are frequently used within psychology, but both are associated with an increased likelihood of errors in the treatment decision-making process. In particular, these models fail to integrate all three components of the definition of evidence-based practice in psychology (American Psychological Association, 2006). In this article we describe both models and provide examples of clinical errors that can occur in each. We then introduce the shared decision-making model as an alternative that is less prone to clinical errors.
Premature termination appears to be a consistent problem in psychotherapy, showing up across client, treatment, and therapist types. As psychotherapy researchers and practitioners, it is important that we gain a better understanding of this negative psychotherapy event and identify methods for reducing its occurrence. This article introduces a special section on premature termination in psychotherapy. In addition to briefly introducing the articles contained in the special section, this article offers suggestions for future research on the topic of premature termination.
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