Ending With Options

Frank, Kenneth A.

doi:10.1080/07351690802274843

Cited by 10 publications

(4 citation statements)

References 63 publications

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“…Even though these terminations pose different sorts of challenges, it is important for therapists to strive and provide a climate of comfort that fosters an open discussion about the termination itself. In such cases, specifically, therapists should actively initiate open, respectful engagement in the resolution process (Craige, 2009; Frank, 2009; Gabbard, 2009), and go beyond the mere discussion of the decision to terminate. Otherwise, therapy is more likely to end abruptly with conflict and disagreement as the lingering feeling (e.g., Olivera, Challú, Gómez Penedo, & Roussos, 2017).…”

Section: The Cmra Modelmentioning

confidence: 99%

“…117–128) and be open to discussing their feelings of fear and pain regarding ending the relationship. Often, therapist’s self-disclosure regarding their own feelings facing termination, may enable patients to engage in this intimate discussion (Frank, 2009; Shafran et al, 2015).…”

Section: The Cmra Modelmentioning

confidence: 99%

“…It may also alleviate some of the patient’s mourning regarding termination. Often, mourning stems from the loss of the relationship, rather than the discontinuation of sessions (Quintana, 1993); an open-door policy disentangles the two, and helps clarify that the relationship itself is not entirely over (Craige, 2009; Frank, 2009). This can help patients and therapists focus on what is, in fact, over—namely, this particular chapter in their relationship and in their lives.…”

Section: The Cmra Modelmentioning

confidence: 99%

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Teach them how to say goodbye: The CMRA model for treatment endings.

Saidon

Shafran

Rafaeli

2018

Journal of Psychotherapy Integration

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The ending of treatment brings with it unique challenges. Traditionally, different therapeutic approaches have emphasized distinct aspects of the termination process. Insight-focused approaches emphasized the therapeutic relationship and retrospection, whereas symptom-focused approaches emphasized therapy goals and prospection. In this paper, we present an integrative model for treatment endings, which unites the different approaches' emphases and identifies four main challenges for the end phase. Specifically, we argue that as termination nears, therapists need to actively assess and address (a) the progress and consolidation of gains achieved in therapy, (b) the maintenance and generalization of those gains in the future;, (c) the celebration of the meaningful relationship alongside resolution of ruptures that may have occurred in it, and (d) the acceptance of the impending separation between therapist and patient. We argue that these four challenges map onto two axes. One axis is temporal, and helps distinguish tasks focused on reviewing or reflecting on the past from ones devoted to planning and anticipating the future. The other axis is substantive, and helps distinguish tasks focused on the therapy's goals from ones centered on the therapeutic relationship. We conclude the paper with a discussion of the model's implications for clinical practice, training, and research.

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Section: The Cmra Modelmentioning

confidence: 99%

Section: The Cmra Modelmentioning

confidence: 99%

Section: The Cmra Modelmentioning

confidence: 99%

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Teach them how to say goodbye: The CMRA model for treatment endings.

Saidon

Shafran

Rafaeli

2018

Journal of Psychotherapy Integration

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“…Novick and Novick (2006), for instance, provide guidance on the topic, "Knowing how to end". The theme of ending has been explored in special issues of the Journal of Psychotherapy Integration (e.g., Curtis, 2002;Goldfried, 2002;Greenberg, 2002;Martin, 2002;Wachtel, 2002) and of Psychoanalytic Inquiry (e.g., Craige, 2009;Fosshage & Hershberg, 2009;Frank, 2009;Harrison, 2009;Shane, 2009). According to Wachtel (2002), who focused on the importance of ending in a way that safeguards the client's self-respect -especially in cases in which the client ends therapy prematurely -recommendations as to how to end therapy do not differ considerably across the different theoretical affiliations; this can best be done by summing up what has been achieved and trying to lead the client to realise his or her own contribution to these achievements.…”

Section: Introductionmentioning

confidence: 99%

Negotiating ending: A qualitative study of the process of ending psychotherapy

Råbu

Binder

Haavind

2013

European Journal of Psychotherapy & Counselling

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Objectives: When psychotherapy is open-ended, the question of termination is a matter for negotiation. A model based on both content and the process of ending may explain how "good enough" psychotherapies can be brought to "good enough" endings. Design: Twelve processes of ending were explored through a combination of audiorecordings made during therapy sessions and post-therapy interviews with clients and therapists. Therapies had been tailored to the needs of the clients and were based on a broad spectrum of theoretical affiliations. Methods: A procedure for systematic text condensation was used on a case-by-case basis. Issues surrounding the initiation and negotiation of ending were pointed out in each case and were then compared across cases. Results: The initiation of ending and exchanges concerned with when and how to end therapy unfolded as a concerted process because both parties seemed to be aware that the theme of ending contained a potential challenge to the alliance. Dual affect regulation, implicit communication and a future-oriented perspective were important features. Structural elements such as schedule changes and temporary breaks served several psychological functions. Therapies seemed to reach "good enough" endings when the client and therapist joined in their efforts to resolve basic ambivalences embedded in the decision to terminate contact with the affirmation of a continuing emotional bond. Negotiating ending 3 Negotiating ending: A qualitative study of the process of ending psychotherapy

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The Analyst's Idealization of the Patient: On Not Seeing the Dark Side

Schaffer¹

2016

Contemporary Psychoanalysis

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Ending With Options

Cited by 10 publications

References 63 publications

Teach them how to say goodbye: The CMRA model for treatment endings.

Teach them how to say goodbye: The CMRA model for treatment endings.

Negotiating ending: A qualitative study of the process of ending psychotherapy

The Analyst's Idealization of the Patient: On Not Seeing the Dark Side

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