Termination in short-term counseling: Comparison of successful and unsuccessful cases.

Abstract

Counselors (N = 85) rated the level of outcome for 2 recent short-term counseling cases of equivalent lengths and reported the termination activity that occurred for each case using the Termination Behavior Checklist-Therapist. It was predicted and found that, in comparison with their report of successful cases, counselors reported in unsuccessful cases less frequent discussion of the end of counseling, less review of the course of counseling, less activity bringing closure to the client-counselor relationship, and less discussion of clients' affective reactions to termination. Furthermore, results of this study, which was based on counselor report, paralleled important findings of Marx and Gelso (1987), which was based on client report. Counselors were encouraged to end counseling in a more complete manner with unsuccessful cases.

Correlates of Clients’ emotional and Behavioral Responses to Treatment Termination

“…The findings of the negative responses to abrupt termination are consistent with findings that planned, and presumably gradual, termination leaves clients with fewer negative feelings than abrupt or forced terminations (Siebold, 1991;Ward, 1984). The findings that the perceived failure of the intervention makes for a more negative termination experience, less positive self-feelings, and more self-doubt/sorrow are consistent with findings by Quintana and Holahan (1992). The findings that centrality of the therapeutic relationship increases clients' hurt and anger and the resistance behaviors that express these feelings is consistent with the theoretical claims made in the literature (Hepworth, Rooney, & Larsen, 1997;Levinson, 1977;Webb, 1985).…”

“…With respect to the emotional responses, the findings show that clients whose treatment was terminated abruptly, who perceived little choice in the termination, and who felt that the therapy had been a failure or that its goals had not been achieved responded with feelings of self-doubt and sorrow. In contrast, clients who desired to end the treatment, felt they had control in the process, and believed that goals of the therapy had been achieved and that the therapy was successful were inclined to experience positive self-feelings (Quintana & Holahan, 1992). Clients for whom the therapeutic relationship was central responded with both hurt and anger and more positive self-feelings, reflecting the ambivalence many people feel in ending important relationships (Marx & Gelso, 1987).…”

Therapists’ Responses to Treatment Termination: An Inquiry into the Variables that Contribute to Therapists’ Experiences

“…The finding that goal achievement makes for a better termination experience, more positive self-feelings, less hurt/anger, and less self-doubt/sorrow are consistent with findings by Fortune (1987), andFortune et al (1992). The finding that the perceived failure of the intervention makes for a more negative termination experience, less positive self-feelings, and more self-doubt/sorrow are consistent with findings by Quintana and Holahan (1992). Of particular note is that goal achievement and failure together contributed very substantially (45%) to the therapists' feelings about themselves at the treatment termination.…”

“…As for treatment outcome, findings indicate that the more successful practitioners felt the intervention to have been, the more inclined they were to feel pride at the termination and the less doubt in their therapeutic skill they reported, the less their relief and the difficulty they experienced in the termination (Fortune, 1987;Fortune et al, 1992). Quintana and Holahan (1992) found that counselors had more problematic termination reactions with unsuccessful than successful cases of similar duration. These studies are relatively few, reflecting the much greater concern in the literature with clients' feelings and well-being than with those of practitioners-a weighting which stems from and is entirely justified by the obligations of the profession.…”

‘What are you taking away with you?’ Closing radio counselling encounters by reviewing progress

“…Remarkably, reports of experienced psychotherapists revealed commonality in termination behaviour across theoretical orientations and individual practitioners (Norcross et al, 2017). Activities aimed at reviewing the course of treatment and discussing the client's affective reactions to termination were also found to be an essential component of successful short-term psychological counselling (Quintana and Holahan, 1992).…”