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Chapter 12 Summary

Chapter 12 Summary

Chapter Review

According to Prout et al. (2022), termination is the end of psychotherapy. The term comprises not only the actual end point of the therapeutic relationship, but also the latter stage of the process. This is the time when the client and therapist consolidate gains and review the therapeutic process.

The decision to end psychotherapy is attained by mutual agreement between the therapist and the client. Clients must demonstrate a significant reduction in signs and symptoms. Besides, clients should accomplish a significant number of goals they established at the beginning. While 100% attainment or perfection is not the ultimate objective, a client must make considerable progress. Further, reduction in signs and symptoms should be continual, and clients should report minimal functional impairment. According to Prout et al. (2022), a client is thought to have achieved recovery when there is an improvement in occupational and social functioning, as well as a reduction in symptoms. In ideal termination, recovery will be achieved alongside mastery – the ability of the client to resolve day-to-day issues independently.

In certain situations, the client or therapist may initiate unilateral termination. Premature termination or client-initiated termination occurs when the client decides to end therapy. This can be attributed to external factors, such as relocation, financial burdens, dissatisfaction with treatment, etc. On the other hand, forced termination or therapist-initiated termination happens when the therapist decides to end therapy. This often occurs when the therapist relocates, retires, or closes their practice for any reason. Forced termination can be very challenging for therapists and clients alike.

 

Termination

Termination is the end of psychotherapy. Simply put, it is the ending of the therapeutic relationship. The decision to end the relationship will be made mutually based on the client’s progress. Still, the client may initiate termination – a process known as client-initiated termination. Therapists may also initiate termination – a process known as therapist-initiated termination. 

Termination Issues

There are various reasons for ending a therapeutic relationship and, hence, different types of termination. According to Prout et al. (2022), a client or therapist (or both) may initiate the end of therapy or the decision could be brought by external forces, such as finances. The integral challenges of termination entail embracing independence and ending a helpful relationship. These are a test of the therapy – a way to determine the steadiness of the achievements made. 

Therapist-Initiated Premature Termination

Prout et al. (2022) argue that therapists, especially those undergoing training, are normally forced to terminate therapy when clients have not attained their treatment goals. This process is known as forced termination or therapist-initiated premature termination. One primary reason for this termination is the end of clinical rotation, signifying that the therapist must leave the hospital or clinic. On a few occasions, therapists will be forced to terminate therapy prematurely due to institutional pressures. The clinic may close the service entirely due to economic realities, or they could shift to a time-limited psychotherapy. Therapists may also initiate premature termination due to relocation, retirement, or health reasons, like pregnancy or chronic illness.

Interpersonal Psychotherapy

Interpersonal psychotherapy is a form of psychotherapy that helps improve symptoms of mental health illness, including depression. Earlier, most mental health professionals viewed depression as a person-based problem. This is not the case with interpersonal psychotherapy, as it recognizes that external factors in an individual’s life, particularly their relationships, can significantly affect their mental well-being. 

As the name suggests, interpersonal psychotherapy focuses on personal relationships, as well as social interactions. This entails how much support a person receives from other people and the extent to which these relationships impact their mental health. Unlike other types of psychotherapy, interpersonal psychotherapy does not focus on inner conflicts that may originate from developmental or childhood issues. Instead, it focuses on current relationships, how they could affect mental health, and how one can enhance their interactions and mental well-being. When addressing depression, for instance, interpersonal psychotherapy focuses on current relationships and how they could be affecting depression symptoms. It recognizes that depression is not always a person-based problem, but it can be linked to relationship problems.

Interpersonal psychotherapy can be used in the initial phase of depression, but it can also be used as a maintenance therapy to prevent the recurrence of illness or relapse. Besides depression, interpersonal therapy can help address anxiety, chronic fatigue, mood disorders, and bulimia nervosa.

References

Prout, T. A., Wadkins, M. J., & Tatianna Kufferath-Lin, P. (2022).  Essential interviewing and counseling skills: An integrated approach to practice (2nd ed.). Springer Publishing Company.