Endings in therapeutic relationships

I recently completed a research topic entitled ‘How do counsellors work toward and experience endings with clients?’ This arose out of an interest in the significance of therapeutic endings, a matter I’d given little thought to early in my training but which, as I began to see (and stop seeing) clients started to assume greater importance.

At first sight, it may seem that, as long as work has been accomplished, the end of therapy is wholly a good thing, much as would be the case when a course of medical treatment is concluded. I quickly found, both from my own experience and from reading the literature, that counselling is not like this.

Its success depends on the establishment of a relationship between therapist and client which, when it ends, can evoke feelings of abandonment, anger, grief - especially in individuals who have suffered painful losses in their past, whether of persons, opportunities or roles.

The longer therapy continues, the more probable such responses become, but they may occur to a degree within short-term work, even the two – six sessions that are usual for workplace counselling; and for individuals vulnerable to feelings of loss, maybe powerfully disruptive triggers of sadness or anxiety.

The dilemma for the counsellor is how, within a few sessions, to create a relationship close enough for trust and confidence to develop, but to end that relationship without the risk of emotional damage to the client.

Awareness that therapeutic endings should never be presumed unproblematic is the first requirement. Lendrum (2004) offers a second: counsellors should carefully examine and remain conscious of their own management of significant endings, in order to maintain a clear understanding of the separateness of clients’ experience. Failure to do so can result in endings that are rushed, avoided, dismissed; or where therapist insecurity leaves clients unsure of their capacity to cope.

Murdin (2000) considers difficulties with ending to be inherent in the counselling process, and Mander (2002) advocates that in time-limited situations the ‘relationship’ should be more of a functional working alliance; the implication is that closeness must be sacrificed in very brief therapy. My own belief is that the ‘working alliance’ is accurately descriptive of coaching (and perhaps other workplace interventions), but not of counselling.

In the short time that I have been practising, I have found that, in addition to being clear from the outset how many sessions are available and whether this is negotiable or not, a reminder to the client every week about the time remaining is helpful. Also that the ending stage should be carefully planned to highlight ‘consolidation and maintenance of what has been achieved, and the generalisation of learning into new situations’ (McLeod; 1993 p335).

With all this to think of, reflecting on the relationship which has facilitated and directed the work through its unique qualities may seem a poor use of precious counselling time, or simply too much to accommodate: ending overload. My experience to date has been that, on the contrary, this has provided a valuable coda for both to our shared enterprise.