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

Abstract

The study investigates predictors of emotional responses to treatment termination in a sample of 48 professional social workers and 92 student social workers in Israel. The findings show that the respondents found treatment termination to be moderately difficult, and client initiated terminations to be especially difficult and to bring in its wake particularly negative emotions. They also show that the aftermath of the termination was related to the process. The less abrupt the termination, the more control the therapists had over the termination process, the more central the therapeutic relationship was to them, the more they attained the therapeutic goals, the less they believed that the therapy had failed, the more choice they had in the treatment termination, and the more they wanted the termination, the more positive self-feelings the therapist reported. The paper suggests that treatment termination is better viewed as a transition than a loss and discusses the clinical implications of the findings.

After you’d gone

“…For example, a reduction in the frequency of consultations or discharge from services altogether was viewed as a positive thing for some service users who had greater confi dence in their own capabilities and resources for coping. This is consistent with the fi ndings of Baum (2007), who concluded that 'treatment termination is better viewed as a transition than a loss', and follows the conceptualisation by Quintana (1993) of 'terminationas-transformation'.…”

“…Baum, 2005;Fortune, 1987;Fortune et al, 1992;Garcia-Lawson et al, 2000;Penn, 1990). This also mirrors what has been found from the therapists point of view, in that social worker therapists were found to view the end of therapy more positively the less abrupt the termination, and the more control the therapists had over the termination process (Baum, 2007).…”

Training Frontline Mental Health Staff to Deliver “Low Intensity” Psychological Therapy for Psychosis: A Qualitative Analysis of Therapist and Service User Views on the Therapy and its Future Implementation

“…This is likely to be especially difficult given the brief nature of the intervention, combined with the often complex needs of the client group. Future training should aim to normalize both staff and service user anxiety around ending (Baum, 2005(Baum, , 2006Martin and Schurtman, 1985) and provide techniques for managing these difficulties, including the possibility of referring the client on for continued input if appropriate.…”

Live Discharge from Hospice and the Grief Experience of Dementia Caregivers

“…However, literature suggests that forced or unexpected terminations of therapeutic relationships are more stressful than those determined by the individual (Gaugler et al, 2005). Baum (2007) asserts that an unplanned termination can impede the therapeutic process, resulting in a lack of control or involvement for the participants. Individuals in these situations tend to experience more anger, regression, and narcissistic injury (Siebold, 2007;Zilberstein, 2008).…”

“…It is not clear how a live discharge may impact post death grief, particularly if hospice services are not immediately connected as they are when enrolled. Baum (2007) suggested that a termination is better viewed as a transition than a loss and naming this specific transition may help reduce the complexity of the loss. This process can normalize feelings of loss including sadness, anxiety, and self-doubt.…”