Clinical I DB Challenging Endings. Week 14

P R O F E S S I O N A L I S S U E S

Challenging Endings: First Year MSW Interns’ Experiences with Forced Termination and Discussion Points for Supervisory Guidance

Caroline Rosenthal Gelman Æ Phyllis Fernandez Æ Nathalie Hausman Æ Sarah Miller Æ Michael Weiner

Published online: 10 March 2007

� Springer Science+Business Media, LLC 2007

Abstract Every year, students prematurely end their

work with some clients due to the completion of their

internship, rather than the client’s achievement of goals

and thus a more natural endpoint of treatment. It is

important to understand students’ experiences with forced

termination to provide them with the necessary knowledge,

skills, and support to optimally manage this complex

phenomenon. This paper reviews the social work literature

on forced termination arising from the ending of students’

internships and presents, in their own words, the experi-

ences of four first-year MSW interns with forced termi-

nation. Finally, based on the literature and as borne out by

these students’ experiences, some areas for discussion and

reflection between interns and their supervisors in handling

forced termination are offered.

Keywords Forced termination � Social work interns

Introduction

Every year, social work interns are forced to prematurely

end their work with some clients due to the completion of

their placement, rather than the client’s achievement of

goals, and thus a more natural endpoint of treatment. The

ending of a helping relationship is complicated under any

circumstance, but particularly so under such conditions.

First, the termination is determined by the intern’s aca-

demic calendar, which does not necessarily coincide with

the client’s needs. Second, interns are still learning how to

handle the technical and relational aspects of this stage.

Third, unlike many terminations, where the client often has

the opportunity to return to the worker if needed, the intern

is leaving the agency and this is not a possibility. Finally,

the intern is ending relationships with multiple clients, the

agency, and his or her field instructor, potentially further

compounding the intern’s sense of loss.

Despite the annual occurrence of this complex phe-

nomenon, relatively little is written on this subject, partic-

ularly from the students’ perspective. It is important for

field instructors, supervisors, and senior colleagues to

understand interns’ experiences with forced termination in

order to provide them with the necessary knowledge, skills

and support to manage this stage in an optimal way. This

Caroline Rosenthal Gelman, Ph.D., is an Assistant Professor at New York University’s School of Social Work. She received her M.S.W. in

1991 from the University of California, Berkeley, and her Ph.D. in

1998 from the Smith College School for Social Work. Phyllis

Fernandez, Nathalie Hausman, Sarah Miller and Michael Weiner

received their MSW in 2004 from New York University’s School of

Social Work.

C. R. Gelman (&) New York University School of Social Work, 1 Washington

Square North Room 311, New York, NY 10003, USA

e-mail: [email protected]

P. Fernandez

Calvary Hospital Hospice Program, 1740 Eastchester Rd.,

Bronx, NY 10461, USA

e-mail: [email protected]

N. Hausman

444 Atlantic Avenue, Brooklyn, NY 11217, USA

e-mail: [email protected]

S. Miller

Riverdale Mental Health Clinic, 5676 Riverdale Ave., Bronx,

NY 10471, USA

e-mail: [email protected]

M. Weiner

P. O. Box 8299, New York, NY 10150, USA

e-mail: [email protected]

123

Clin Soc Work J (2007) 35:79–90

DOI 10.1007/s10615-007-0076-6

paper reviews the social work literature on forced termi-

nation arising from the ending of the student’s internship.

We then present, in first-person narrative, the experiences of

four first-year MSW interns in handling forced termination

with a range of clients in multiple settings and under

varying degrees of supervisory guidance. Each intern pre-

sents the client (disguised for purposes of confidentiality),

an overview of the treatment, when and how termination

was introduced, the client’s and the intern’s reactions, and

the role of supervision in guiding the process. Finally, based

on the literature and these interns’ experiences, we present

some areas for discussion and reflection between students

and their field instructors in optimally managing these

premature terminations.

Literature Review

Premature Terminations

Social work textbooks unfailingly discuss termination as an

important phase of any intervention, and often devote en-

tire chapters to it. Rarely discussed, however, are the

special difficulties arising from terminating treatment be-

cause of the completion of the internship (Walsh, 2003).

Furthermore, over the past 35 years there have been rela-

tively few articles on termination in social work journals,

and these have decried the paucity of attention to this stage

of treatment in the literature (Fox, Nelson, & Bolman,

1969; Gould, 1978; Levinson, 1977; McRoy, Freeman, &

Logan, 1986; Siebold, 1991, 1992; Shapiro, 1980).

Of these existing articles, only some address premature

terminations, and an even smaller number discuss the

endings specifically experienced by students and their cli-

ents at the completion of internships. Several of these latter

articles are written by professors or field instructors who

note both the importance and challenge of termination for

their students and often include brief case examples and

recommendations for handling this stage (Fox et al., 1969;

Levinson, 1977; Rubin, 1968; Walsh, 2002). Their recom-

mendations will be further discussed and incorporated into

suggestions for interns and supervisors offered in this paper.

There are two case discussions in the literature focusing

on interns ending their work with clients due to the com-

pletion of placement. Barton and Marshall (1986), a

supervisor and intern, describe a child who discloses sexual

abuse in the face of the impending end of treatment with

Ms. Marshall, a first year social work student. The dis-

cussion centers on the need to shift therapeutic focus, ra-

ther than on the intern’s experience with and reaction to the

ending of the treatment. Coker (1996) describes her use, as

an intern, of psychoanalytic theories to facilitate her ter-

mination with a man diagnosed with chronic paranoid

schizophrenia. While she briefly mentions feeling guilty

and wanting to rescue the client, the account focuses on the

client’s responses, and the potential for even premature

endings to be meaningful and promote growth if they are

well managed. To this end, Coker recommends the use of

contemporary psychodynamic approaches to provide a

holding environment, understand the client’s strengths and

needs, and make ‘‘full use of the relationship’’ between

worker and client (p. 355).

There are two studies interviewing or surveying MSW

students regarding their management of forced termina-

tions (Baum, 2006; Gould, 1978). Both sets of students

reported feeling anxious, depressed, moody, angry, and sad

during termination. They worried about whether they had

actually helped their clients, and expressed guilt about

leaving. Gould’s (1978) respondents report that field

instructors played a significant role in guiding termination,

advising interns if and when to tell clients they were stu-

dents, if and when to tell clients they would be leaving on a

specified date, and how much time to devote to termina-

tion. Baum (2006) suggests that field and classroom

instructors take an active role in helping interns manage

what they report perceiving as a very challenging phase of

treatment.

Field Instruction and Premature Terminations

As this research indicates and the experiences of interns

presented in this paper will underscore, field instructors play

a crucial role in how interns manage termination, both

technically and emotionally. There is a large body of liter-

ature and research on supervision and field instruction

(Bogo, 2006). The term supervision is increasingly being

used to describe only the oversight of social workers in

agency settings, while the term field instruction refers to the

professional education of social work students in the field

practicum (Bogo & McKnight, 2006). Throughout this paper

we employ the terms field instruction as well as supervision,

which we define as the educational and supportive aspects

of training students for clinical social work practice

occurring within the broader context of field instruction.

While there are no published empirical studies specifi-

cally on the role of field instructors in the management of

termination, findings in broader field instruction-related

research support the centrality of this relationship both in

providing information regarding termination and in mod-

eling how termination can be properly accomplished. For

example, multiple studies have established that students’

satisfaction in placement is largely determined by satis-

faction with the quality and quantity of supervision

(Cimino, Cimino, Nuehring, Raybin, & Wisler-Waldock,

1982; Fortune & Abramson, 1993; Fortune et al., 1985;

Knight, 1996). Specifically, students report that field

80 Clin Soc Work J (2007) 35:79–90

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instructors who provided information and helped them ap-

ply theoretical knowledge to field practice most enhanced

their learning (Choy, Leung, Tam, & Chu, 1998; Fortune,

McCarthy, & Abramson, 2001; Knight, 1996, 2001). Stu-

dents also view their field instructor as a model and tend to

imitate his or her style (Itzhaky & Eliahou, 1999). Thus,

interns will likely feel most supported by field instructors

who provide conceptual frameworks and information on

technical aspects of termination, invite exploration, and

share their own experiences with loss and feelings regarding

previous terminations with clients and supervisees.

This stance fits well with contemporary relational ap-

proaches applied to clinical supervision, which further

underscore the centrality of the field instructor–intern

relationship in the learning process (Frawley-O’Dea &

Sarnat, 2001; Ganzer & Ornstein, 1999, 2004; Ringel, 2001;

Williams, 1997). In contrast to the traditional conceptuali-

zation of a hierarchical, didactic relationship where the

field instructor is all-knowing and the intern is the novice

receiver of information, a relational approach posits a tri-

adic matrix with multiple, reciprocal relationships between

field instructor, intern and client (Ganzer & Ornstein, 1999).

Through on-going dialog, both field instructor and intern

contribute knowledge, understanding and expertise; learn-

ing occurs mutually and in the context of this relationship.

Such a model seems particularly suited to helping interns

manage termination, with its challenging themes of end-

ings, separation, and loss reverberating for clients, interns,

and their instructors. Ganzer and Ornstein (1999) offer an

example of how a relational model, by providing the space

for both field instructor and intern to discuss feelings gen-

erated by previous losses and the impending endings with

clients and each other, facilitated learning and the termi-

nation process for intern, instructor, and clients alike.

This review of the social work literature underscores a

paucity of writing and research on premature termination

experienced by students, especially from their perspective.

Existing articles agree that field instructors play a signifi-

cant role in how interns manage termination and that fur-

ther work is needed for improved training and support of

students (and, ultimately, their clients). The following four

case studies detail MSW interns’ experiences with forced

termination during their first field placement under varying

degrees of supervisory guidance. Based on the literature

and these students’ experiences, areas for discussion and

reflection between intern and supervisor in optimally

managing this phase are offered.

Example 1

Patricia Cole is a 58-year-old White married woman

returning to school after a career as a video editor and

producer. Her internship was at an outpatient clinic of a

state psychiatric hospital. Her experience illustrates the

complications that can arise in termination if the field

instructor fails to provide sufficient guidance, support, and

modeling, the strong reactions both clients and students can

experience, and also the possibility of constructive endings

if termination is handled thoughtfully.

Background on Client

Polly Harris is a 48-year-old, African–American single

mother of an adult son with a diagnosis of Bipolar Affec-

tive Disorder I, Depressed, who has been a client of the

clinic for 12 years. Polly’s abusive mother died when she

was twenty-five; her protective father died 10 years later.

After her mother’s death Polly was institutionalized for

attempting to kill her brother with a knife. After her

father’s death Polly tried to commit suicide and was

hospitalized.

Work with Client

Polly was transferred to me (Patricia) as a client by my

supervisor, Ann, who had been her psychotherapist for the

past 2 years. This seemed to be a win/win situation for

Polly, who would benefit from more frequent contact than

Ann could currently provide; would continue with Ann in

group therapy; would have her case supervised by Ann;

and would ultimately return to individual therapy with Ann

when I ended my internship. The fact that Polly might

experience this change as a termination was never ad-

dressed. Polly readily agreed to the transfer and we quickly

formed a therapeutic alliance. At the time I believed that

this was because I took a strengths-based approach and

helped Polly recognize the many successes in her life, such

as completing 2 years of community college and staying in

treatment. In hindsight, it may also have been a response to

Polly’s feelings about Ann’s termination with her.

From our first session Polly brought up a history of

maternal abuse, which she had never revealed before. She

also began splitting between Ann and me, casting Ann as

the feared abusive mother and me as her father/protector,

petitioning me to intercede with Ann on matters related to

their group sessions. At this point I too was beginning to

have problems with Ann. For example, Ann asked her

colleagues not to speak to me about any clinical issues.

This disturbed her colleagues since it eliminated any

opportunity for me to experience a team approach to

dealing with a patient’s complex problems. This had been

done without my knowledge, so when several team mem-

bers brought it to my attention I questioned Ann about it.

She said that she felt it was necessary because alternative

approaches would confuse me. When I disagreed, she

Clin Soc Work J (2007) 35:79–90 81

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refused to reconsider. In terms of parallel process, Polly

and I were both experiencing a negative transference to

Ann, who resembled an overbearing authority figure to

each of us. Transferentially I felt that Polly and I were

siblings dealing with an abusive parent.

This odd therapeutic triad—with its convoluted trans-

ferential, counter-transferential, and real relationships—

complicated both the client work and supervision. For

example, I was reluctant to accept guidance from Ann be-

cause I felt that I had a better, more productive, relationship

with Polly. Even though I had intellectually recognized

Polly’s splitting of Ann and me into abusive parent versus

protective parent, emotionally I found myself identifying

with and enacting the role of protector. I did not have

enough trust or experience with supervision to explore these

issues, and Ann did not invite their exploration.

Termination and Supervisory Support

Ultimately Ann and I were unable to resolve our problems

and I was to be transferred to a different setting, resulting

in a forced termination for my clients. My field advisor

treated this strictly as an administrative issue, and not an

opportunity to attend to some of the emotional responses I

might have. As a first year intern with no prior experience

of a good supervisory relationship, and no sense of norms

or boundaries in this type of relationship, I felt like a failure

for not being able to survive. In addition I felt sad and

guilty about leaving my clients, and apprehensive that my

leaving might cause them harm.

Ironically, once the decision to separate was made Ann

and I collaborated closely to deal with the terminations in a

way that would most benefit the clients. I would have one

session prior to Christmas vacation and a final session

when I returned to terminate with my clients. We worked

out a ‘‘script’’ in which I would introduce the termination

as an ‘‘unexpected event,’’ probe for the client’s emotional

responses, allowing them to vent, and collaborate with

them in a way that would give them a sense of control and

support. Polly would be transferred to Ann for individual

therapy and Ann would join us in the final session to dis-

cuss the therapeutic issues that Polly wanted to deal with.

While this structure was valuable and provided some

support, it stayed on the concrete level, rather than pro-

viding any preparation for the intensely emotional termi-

nation responses by the clients or intern. Also, because of

my tension with Ann, I was unable to process my feelings

and concerns in supervision.

Client’s Reactions to Termination

Polly had a range of responses to the termination, begin-

ning with the report of a dream about existential issues

around the meaninglessness of life and our lack of con-

nection to one another. I linked our termination to the

dream by discussing the ways in which we continue to live

on in each other even after separation, citing as an example

her continuing relationship with her deceased mother and

father. Also, in the past Polly’s dreams were like flashbacks

of abuse by her mother. The report of this symbolically rich

dream may have been an unconscious attempt to get me to

remain by becoming the ‘‘ideal’’ client.

Over the Christmas holidays Polly left several voice

mail messages for Ann demanding that the decision to

transfer me be rescinded. Ann felt this signified a loss of

control on Polly’s part. I saw this as an attempt by Polly to

regain control, and I was concerned that my acquiescence

to the transfer might look like passivity or indifference to

her. However, I stifled the desire to tell her that I too had

looked for alternatives to the transfer.

The timing of the termination could not have been

worse. Polly’s father had died during the holiday season,

and every year at this time she entered a depression. Much

of our work had dealt with these issues, and as a result

Polly had decided that instead of ignoring the holiday, this

year she would celebrate with her family. During the

Christmas dinner she and her husband had a disagreement

that would have ended in violence had her son not inter-

ceded. This regression to her symptoms came close to

reenacting the violent event that marked the beginning of

her psychiatric history. Unfortunately, at the time I was

unaware that regression is a common response to termi-

nation, and I felt guilty for causing harm to a client.

For the rest of the session, Polly and I discussed the

meaning of this pivotal event, the possible consequences

should it be repeated, and alternative ways of dealing with

her rage. Since I would be working on the same campus,

we also discussed the probability of seeing each other.

While the relationship would change, we could continue to

stay in touch with each other. Ann and I had discussed this

continued contact in supervision, and we both agreed that it

would be inevitable, and that I would have to establish

boundaries on the topics of conversation.

At the end of the session I gave Polly a thank-you note

that included what I had learned from her and the ways in

which she had influenced my life. The goal was to let her

know that I had internalized her and would carry her with

me always. Subsequently she told me that she refers to this

note when she is feeling unappreciated or insecure about

herself.

Student’s Reactions to Termination

My own responses to termination seemed chaotic. I was

shocked at the intensity of both Polly’s and my emotions. I

was uncomfortable that our relationship had become so

82 Clin Soc Work J (2007) 35:79–90

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important to her, and felt relieved that it would be ending.

Simultaneously, I felt sad and feared I might never have

such a feeling of efficacy as a social worker again. I felt

despair at Polly’s transfer to Ann who, I believed, could

never establish the relationship that Polly and I had. But

most of all I felt guilt because I believed that I could have

precipitated a major setback for Polly.

Reflections

As a first year intern, I encountered two experiences that I

had never had before: forced termination with a client, and

a relationship with a supervisor. Knowing more about

forced termination would have helped anticipate and

normalize many of Polly’s and my own responses and

feelings. The information covered in supervision tended to

be concrete; a mutual exploration of parallel process,

transference, and countertransference in the supervisory

relationship would have facilitated termination and

perhaps even obviated my transfer to a different unit. On

the positive side, having experienced this turbulent termi-

nation helped me prepare for subsequent terminations with

my new clients. This was due to a real appreciation of the

importance of the termination process and the therapeutic

gains that can be achieved, as well as an understanding of

my own issues of loss that were triggered by separation

from the client, the supervisor, and the placement.

Example 2

Background on Student

Daniel Wagner is a 33-year-old White man pursuing an

MSW after 10 years in the music industry. His internship

was at a hospital’s outpatient clinic, treating pediatric

oncology patients, where termination issues are compli-

cated by the underlying specter of death and loss. His

experience illustrates issues of self-disclosure, the impor-

tance of taking the clients’ context into account in under-

standing potential reactions to termination, the usefulness

of natural breaks such as holidays in previewing termina-

tion, and the centrality of strong supervision in guiding the

student through this process.

Background on Client

The Gerrard family, father, mother, and Thomas, presented

at the pediatric oncology outpatient clinic at the start of the

semester. Two weeks earlier, during Thomas’ 1-year visit,

his pediatrician had found a malignant mass on his kidney,

which was removed. Thomas was now beginning a 7-

month chemotherapy protocol. In their mid-thirties, father,

an executive, and mother, staying at home to care for

Thomas, presented with severe anxiety and fatigue.

Work with Client

Working with catastrophically ill people had a tremendous

psychological impact on me. My own anxiety and my

tendency toward somatization often left me feeling sick,

overwhelmed, and frightened. I met this family early in my

internship. These first-time parents struggled with the

fundamental changes in their life and daily routines, their

child’s illness-related regression, his physical changes

stemming from chemotherapy, and the loss of control

inherent in experiencing a serious illness. Our work cen-

tered on psycho-education and empowerment to strengthen

their parenting when they were feeling so ineffective. Both

began to look forward to the weekly visits, where they

would tell me the difficulties they were experiencing, but

also what they had accomplished.

Termination and Supervisory Support

My supervisory relationship was excellent—supportive,

professional, with good boundaries, clear communication

and appropriate definition of roles and responsibilities. In

early December, my supervisor suggested I discuss the

upcoming break with my clients. When I met with the

family, I stated, ‘‘As you I told you when we first met, I am

a student. I’ll be finishing the first semester and going on

break for 3 weeks.’’ They congratulated me and we talked

about the clinician who would be available should any

concerns arise. We moved on to discussing their child. As

the session came to a close I repeated the dates of my

absence. They asked me if I would be going anywhere. I

said, ‘‘Yes, to Israel.’’

I realized, instantly, that I had said something troubling

to them. The disclosure regarding my trip to Israel (and all

its inherent danger, both real and imagined) touched many

aspects of anxiety that they struggled with on a daily basis,

including separation, loss, and even potential death. It

became another potential loss. I assured the parents that I

was staying with family and would be safe. We managed to

come to an understanding regarding my trip, but at a cost:

mother and father looked more exhausted and anxious than

when I had entered the room.

Later, after processing the session with my supervisor, I

realized how nervous I was about going to Israel, and that I

had brought this fear into the session. He suggested that my

own difficulties with separation and separating from this

family may have contributed to my self-disclosure and that

it might be helpful for me to explore this in my own therapy.

We discussed how the self-disclosure itself may have

impacted the family in terms of their presenting issues. My

Clin Soc Work J (2007) 35:79–90 83

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supervisor explained that for oncology patients/families,

clinicians breaks, even short ones, can be experienced as

additional losses (with the potential of exacerbating the

already traumatic experience). The interaction also allowed

me to experience some of the parents’ difficulties with

separation, loss and abandonment, and enabled me to

interact with them more empathically. It also led me to

commence end of year termination 2 months before the last

day of my placement, earlier than I might have initially

intended.

During termination the parents and I reviewed their

process of recovery. Thomas’ prognosis was excellent, and

he was getting back on a typical developmental path. We

discussed all the family had accomplished and how they

had changed over the past 6 months. They wanted to

become a resource for parents with children with Thomas’

type of tumor and left their information for such parents to

contact them. I interpreted this as their desire to give

meaning to the illness.

The final session offered a chance for us to achieve

closure. The Gerrards wanted to give me their phone

number and email address, despite knowing I would not

contact them. My supervisor had explained that as a method

of integrating the treatment, the clinician should become

more ‘‘real’’ to the patient. I discussed what I had learned

from them: how to be a couple caring for one’s child in a

crisis, how to accept assistance from others, and how con-

nection can affect psychological growth. Lastly, I disclosed

that I would be getting married. At the time, I believed that

by telling them this, my intervention around what I had

learned from them would be all the more effective. It was a

very emotionally charged moment: I was very moved (al-

though outwardly composed), they were both crying.

Reflections

The first self-disclosure was inadvertent; the second had an

intentional component to it, but again was driven by my

countertransference. I admired these parents’ dedication,

love, and sacrifice for their son, and in some way wanted to

feel their love, pride, and joy directed at me. My supervisor

felt that neither self-disclosure had negatively affected the

treatment, but we did discuss the potential negative impact

of some self-disclosure. In retrospect, my self-disclosures

were aspects of my difficulties with separation and my

struggle with losing and missing these people that had

become important to me.

Example 3

Elizabeth Slate, a 25-year-old White woman, worked in

case management and advocacy before beginning her

MSW. Her internship was at a dysfunctional hospital-based

outpatient mental health clinic that is no longer used as a

placement. Her experience illustrates the potential for

termination to be an opportunity for growth even under the

most challenging circumstances, and the importance of

establishing follow-up plans.

Background on Client

Calvin Ross, a 23-year-old African–American man diag-

nosed with schizophrenia, mild mental retardation, and a

substance abuse history, was newly admitted when he was

assigned to me (Elizabeth). He was unable to read and had

experienced several immediate familial losses including

that of his father and oldest sister. Calvin’s expressive,

emotional, and interpersonal capacities were greatly af-

fected by his chronic mental illness and cognitive impair-

ment.

Calvin had been institutionalized many times since age

13 without receiving appropriate treatment or discharge

planning, resulting in his return to his mother’s home

without the necessary resources to insure his or her safety

and stability. Because I felt that it was not that Calvin could

not be reached, but, rather, no one had yet found a way to

reach Calvin, I sought a new means of communication with

him. Playing checkers became our means of connection,

permitting discussions of loss, a theme which transcended

every aspect of Calvin’s life, from the deaths of his father

and sister to the years spent in hospitals and prison.

Termination and Supervisory Support

During our first session, I told Calvin about our impending

termination. In February, I reminded him of the termination

date and continued to occasionally refer to my departure in

the weeks leading up to our final session. The ending phase

underscored the dysfunctional system in which Calvin

received treatment. In the last 2 months of our treatment

together, Calvin was discharged from his residential setting

against clinical advice to his mother’s home without a

home visit and only a tenuous plan to continue treatment at

the clinic. I attempted to tie up the loose ends of Calvin’s

treatment in the hopes of leaving him with a network of

care that would insure his safety, health, and stability after

my departure.

I arranged a home visit with Calvin and his mother.

I was working to access permanent case management ser-

vices for Calvin and in March brokered an interview for

him to be considered for employment at the clinic. Mother

seemed responsive to these updates but was frustrated as I

was unable to access services that would address his

numerous psychosocial needs. Furthermore, because the

clinic was so poorly organized, I was not able to provide

84 Clin Soc Work J (2007) 35:79–90

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Calvin with the name of his new clinician until the second

to last session. I could not decide which would have been

more disconcerting, not knowing the name, or knowing

that the assigned clinician was notorious for a lack of affect

or quality clinical treatment, acting more as a warden than

a therapist. I experienced immense guilt about leaving

Calvin without the assurance that he would receive the

treatment to which he is entitled and which he so desper-

ately needs. This response was representative of a larger

issue; I felt that I had inherited the burden to provide the

remedy for over two decades’ worth of systemic neglect.

The sense of burden was further exacerbated by the lack

of consistent and meaningful supervision. I felt isolated and

unsupported in my work with Calvin. I had been assigned

five different supervisors over the course of the year and

the final supervisory relationship was superficial at best.

This supervisor was in the midst of leaving the clinic and

had emotionally departed several years ago. She patholo-

gized my own feelings regarding termination, making me

doubt the validity of my responses and silencing my efforts

to seek support and instruction.

Client’s Reactions to Termination

Initially, Calvin had no reaction to ending except to say, ‘‘If

you gotta go, you gotta go.’’ I wondered if he was so

accustomed to people departing that it did not really matter.

I decided not to force the issue, but rather found ways to try

to incorporate the information into our work. For example,

in discussing future housing plans, I would remind Calvin

that his new clinician would have to follow up on the state

housing application. As the ending drew closer, I asked

specific questions regarding how Calvin felt about my

leaving and what he thought about having a new therapist.

Calvin said that sometimes it was hard to have people go

because ‘‘You might miss them.’’ Calvin also concretely

stated, ‘‘It’s a little bit sad. We can’t play checkers any-

more.’’ He wondered aloud whether or not his new therapist

would play checkers and we discussed the possibility that

Calvin could ask his new clinician to play the game. These

discussions, while seemingly superficial, demonstrated

Calvin’s capacity to experience termination and provided us

opportunities to plan together Calvin’s transition.

Intern’s Reactions to Termination

I subsequently became very conscious of my eagerness for

a release from a setting where idealism and the phrase ‘‘in

service of the client’’ are scorned. My anticipation of my

own ‘‘freedom’’ juxtaposed with my meaningful connec-

tion with Calvin produced an internal struggle inflamed by

guilt, sadness, and fear. I needed assistance from a super-

visor in developing a more clinical understanding of the

parallel process of my termination from the clinic and my

termination with Calvin. In addition, the lack of a well-

defined plan for transferring clients from students to staff

precluded me from reassuring Calvin of his continued care.

The lack of supervision around these two issues resulted in

an extremely difficult termination process with Calvin. As I

reflect on my work with him, I am touched by his struggles

and find that his progress serves as a reminder that even

minute interactions can be meaningful. I also developed as

a clinician in that I was once uncomfortable and unsure that

I would ever be able to engage him, but later became

familiar to Calvin, as well as a source of assistance and

positive validation.

Reflections

During one of our final checkers games together, Calvin

had the opportunity to jump my last piece and did not do

so. A few moves later, the opportunity presented itself

again. This time Calvin moved his piece around my piece,

finishing the game. When I asked him why he did not try to

win the first time, he responded, ‘‘I thought you needed a

second chance.’’ I think Calvin may have felt that our time

together gave him a second chance to reconnect and I find

this hopeful. I believe our relationship and termination will

facilitate his engagement with other providers. There is a

sensitive person wishing and needing to connect with

others.

Example 4

Julia Miles, a White woman, made a career change from

financial services to social work in her early thirties. Her

first field placement was with a legal service agency

assisting families of children in the foster care system. Her

example underscores how having proper supervisory sup-

port and setting clear boundaries with clients from the

beginning helps the student manage termination’s complex

feelings, including guilt, and thus facilitates the process.

Background on Client

A new client, a 14-year-old African–American girl named

Laura Edwards who suffered from depression and had

suicidal ideation, was assigned to me (Julia) for individual

therapy at the beginning of my internship. She had been

removed at birth from her biological parents, both drug

abusers. She was raised, with her three younger siblings, by

her paternal grandfather’s second wife, Barbara Edwards,

who had separated from him and succeeded in becoming

the younger children’s legal guardian and in adopting

Laura.

Clin Soc Work J (2007) 35:79–90 85

123

During the previous summer Laura had swallowed some

pills, but Mrs. Edwards had not sought treatment. The case

was brought to our agency because ACS was considering

removal of the children due to Laura and her sister’s refusal

to go to school and reluctance to leave their house. Laura

was also overweight, and had health problems and poor

social skills.

Work with Client

At first I visited Laura at home and, although she would not

go to school, she eventually agreed to meet with me at the

agency. The key to treatment was to create a strong bond

and trusting relationship with Laura that eventually corre-

lated with her improvement. After 9 months of therapy,

Laura began summer school and was eager to return to

school full-time in September. She was socializing, had

been without any suicidal ideation for 7 months, and had

lost 20 pounds.

Termination and Supervisory Support

Despite all our progress, there remained one hurdle in our

work. As the end of our time approached, Laura mentioned

several times that she did not want me to go. My supervisor

recommended broaching the subject no sooner than

4 weeks prior to my leave due to Laura’s difficulties with

separation. What I did not realize at that time was that

precisely because of her fears and history of abandonment I

needed to allow additional time for Laura to discuss and

experience termination. I also needed to identify and work

through my own reluctance to end. I felt no one would be

able to connect with Laura as I had and follow up on her

treatment. The month I was ending my work, Laura’s

siblings were removed from Mrs. Edwards’ care because

one sibling was still refusing to go to school. My agency

closed the case. I arranged to transfer Laura to a social

worker from an outside agency.

Client’s Reactions to Termination

Laura refused to see the new worker and a few weeks after

my departure she started acting out again, including

fighting with her friends. In light of the difficult situation

Laura faced, my supervisor and I agreed that I should stay

in touch with her via telephone to help her through this

transition of unrest until she developed a relationship with

a new clinician.

Intern’s Reactions to Termination

On one hand, I felt relieved to have the opportunity for

additional contact with Laura. I had mentioned to her that I

was leaving but I had not been specific on the date. I

realized that I was attached to this client, and felt that she

still needed my help. I was feeling guilty about leaving her.

Naively, I thought that I could use a few more weeks to

help her with the transition to a new worker. On the other

hand, my instinct was telling me that I had failed to set up

clear boundaries with this client since I could not let her go.

Although my supervisor had approved giving Laura my

cellular phone number in order to keep in touch after I left

the agency, I realized that I had made a mistake, as I had

not established a specific plan, and she was calling me as

often as four times a week. Although I wanted to provide

the best transition for her, progressively I felt it violating

my personal life, especially when she called on my wed-

ding day. I wish my supervisor had assisted me in setting

clearer boundaries during this termination.

Reflections

The problem with post-termination contact is determining

when to ‘‘draw the line.’’ I was finally able to arrange for a

social worker to see Laura once a week. I told Laura we

would have to terminate within 3 months, and I would be

available over the phone once a week, then once a month,

and then we would end. She responded well to this gradual

plan. By setting clear goals and boundaries I had reassured

the client. We talked about her progress. I was happily

surprised to see that she was doing better than I expected

during this termination process. She was respecting the

boundaries I had set up. She was also going to school,

maintaining good grades, and developing relationships

with peers. However, Laura was still resisting speaking to

her new clinician. Only when I finally terminated did Laura

begin work with the new worker. This reinforced my

feeling that the termination period should have been shorter

and more clearly defined in order to allow Laura to begin a

new relationship. I can see today that we never addressed

in supervision my own resistance to terminating the

internship. This, in turn, directly impacted the termination

process with my client.

In retrospect, I realize that termination is a loss for both

the client and the social worker. I wish my supervisor had

assisted me in consolidating the therapeutic experience and

mourning its loss. This experience has helped me to face

my feelings of guilt and to look at termination as a po-

tential beginning for the client, rather than an ending.

The Cases Revisited

Several conclusions can be drawn from the literature

review and the case studies presented. First, the relative

dearth of research and writing on forced termination

86 Clin Soc Work J (2007) 35:79–90

123

experienced by social work students completing their

internship suggests the need for further exploration of this

important topic. Second, because of the inherent challenge

to ending well, but also due to insufficient knowledge and

skill and lack of preparation for the strong feelings

engendered in both worker and client, interns experience

these terminations as difficult, and are in need of further

guidance. A survey of interns’ experience with termination

undertaken at the same school of social work attended by

the interns presented here found that students felt termi-

nation was well-covered in practice classes, less so in

supervision, and felt moderately prepared for the process.

Nevertheless, asked to assess the ease of termination, stu-

dents found it significantly harder than their sense of

preparation indicated, and more than half of respondents

reported that the topic was not covered in class or the field

until the end of the semester, concurrently with the actual

terminations. Thus, they recommend earlier, more com-

prehensive training in classroom and field settings to

upport them and their clients.

Third, instructors, supervisors, and colleagues can play

an important role in how interns manage this phase of

treatment. For example, in one of the cases presented, the

field instructor helped prepare both intern and client for

termination through the preview of a holiday break.

Another field instructor failed to help an intern set clear

boundaries for ending and did not provide space for

exploration as to why this was so difficult for her as well as

for the student. Thus, including more content on termina-

tion at earlier points and mutual sharing of experiences and

feelings about ending in the context of the supervisory

relationship would likely be helpful to interns. Particular

points to discuss and reflect on, as identified in existing

literature or borne out by these interns’ experiences, might

include the following:

Termination as an Opportunity for Growth

While terminations are difficult for both clients and interns,

they can be viewed as potentially positive opportunities to

consolidate gains of treatment and have the client experi-

ence separation differently than they have in the past, with

greater control and mastery (Sanville, 1982; Siebold, 1992;

Webb, 1985), and as growth-promoting, rather than merely

a loss (Anthony & Pagano, 1998; Levinson, 1977). If

handled well, as in the first three cases, and ultimately the

final one, in renowned social worker Jessie Taft’s words,

termination can lead to the ‘‘discovery that an ending willed

or accepted by the individual himself is birth no less than

death, creation no less than annihilation’’ (Robinson, 1962,

p. 170). Indeed, research with experienced social workers

suggests that both clients and practitioners experience more

positive than negative reactions during termination. This

includes feelings of pride, self-accomplishment and inde-

pendence on the part of clients, and pride in the client’s

success and one’s therapeutic skill on the part of clinicians

(Fortune, 1987; Fortune, Pearlingi, & Rochelle, 1992).

Walsh (2002) promotes termination as inherently positive

by defining it as the process of bringing a relationship with a

client to a constructive end. Students should recognize that

even experienced clinicians may require consultation and

support in achieving these types of endings.

Disclosure of Student Status and Length of Internship

Students should identify themselves as interns from the

beginning of their work with clients and state specifically

when placement will be over (Gould, 1978; Mason,

Beckerman, & Auerbach, 2002). There are clinical and

ethical reasons for doing so. Clients have a right to know

who is treating them and that the work will be discussed

with a field instructor. This information allows clients the

option of seeking treatment elsewhere, and, significantly

for termination, forewarns them about the time-frame for

ending (Penn, 1990). The intern can also derive important

information regarding how the client is likely to react to the

short-term nature of the work and to what will likely be a

premature termination. From a clinical perspective, many

believe that setting a time limit furthers the work by

encouraging active client participation and the setting of

realistic goals (see, for example, Mann, 1973).

Students often fear clients will refuse to work with them,

and thus are reluctant to disclose their status. However,

available research indicates that most clients do not object

to working with interns (Feiner & Couch, 1985; Mason,

et al., 2002).

Previewing Termination

Natural breaks in the client-intern relationship, such as

vacations, can be used as opportunities to discuss and

preview terminations (Sanville, 1982; Webb, 1983), as was

done in one of the cases presented. These ‘‘petit partings,’’

(Sanville, 1982, p. 124), provide a preview of the client’s

reaction to termination, helping the intern better plan for

this phase. They also offer an opportunity to discuss ending

at multiple points and well-ahead of its occurrence.

Individualizing Termination Plans

A typical time frame offered in the literature for discussing

termination is 4–6 weeks (Siebold, 1991). However, as

mentioned, termination is best addressed from the begin-

ning and throughout treatment at relevant times. In addi-

tion, how much time to devote to actively implementing

termination must be based on a variety of factors, as

Clin Soc Work J (2007) 35:79–90 87

123

illustrated in the vignettes presented. The greater the

client’s level of engagement, and length and depth of

contact, the greater the time needed for processing termi-

nation (Levinson, 1977). Discussions are available of the

special considerations for ending treatment with specific

populations, such as developmentally vulnerable early

adolescents who have experienced multiple losses (Bembry

& Ericson, 1999; Bolen, 1972), and people with schizo-

phrenia (Walsh & Meyersohn, 2001).

Maximizing Supervision

Given the difficulties of termination and the added feelings

of responsibility and guilt that interns may feel, supervision

is crucial to guiding and supporting students and enhancing

gains for clients, as illustrated in these case vignettes and

addressed in the literature (Robb & Cameron, 1998; Wedd-

ington & Cavenar, 1979). Particular areas of focus include:

Client Reactions to Termination

In discussion with their supervisors, interns might consider

anticipating, based on a client’s age, level of development,

diagnosis, history, experience with loss, and length and

quality of the relationship, expectable client reactions to

the termination and how to respond to each. Multiple

potential client reactions are reported as common in the

literature (Bostic, Shadid, & Blotcky, 1996; Glenn, 1971;

Levinson, 1977; Penn, 1990). These include anxiety,

depression, regression, and anger in response to the

imminent loss of the intern. The return of symptoms or

appearance of new symptoms may express anger—’’See,

you didn’t help me’’—or an effort at maintaining the

connection—’’You can’t go, I still need you.’’ Clients

might ‘‘forget’’ ever having been told of the intern’s status

and the inherent time-limitation. Clients may also seek to

become the perfect patients, as did Polly Harris, in a bid to

maintain the worker’s interest, or attempt to retaliate

against the intern for hurting them by leaving the rela-

tionships first, searching for a replacement, or denying the

importance of the relationship or of having any reaction to

termination. When termination is well-planned and antici-

pated, clients may also have positive feelings of achieve-

ment, growth, and a sense of mastery and control over the

ending of the relationship. The intern can discuss with

the client these predictable reactions to termination to

normalize his or her feelings and challenge feelings such as

anger and denial that could potentially derail the work.

Intern Reactions to Termination

In discussion with their supervisors, interns might consider

exploring and anticipating, based on their own experiences

with loss and termination, and the particulars of each client

relationship, some of the feelings they might have and how

to attend to them. Common intern reactions, as evidenced

in the vignettes presented and as discussed in the literature,

include a sense of loss, guilt for leaving, and anxiety about

the client’s response and one’s level of skill (Gould, 1978;

Gutheil, 1992). Interns often may feel that they are the only

ones who can help or really care about their client, making

a definitive termination with clients even more difficult.

Alternatively, they may deny the importance of the rela-

tionship to both the clients and themselves, in order to

minimize the challenge of termination.

Theoretical Approaches

Several theories and concepts are relevant to understanding

termination and in guiding clinical responses. For example,

Coker (1996) used object relations theories to identify that

her client had suffered significant developmental deficits,

which made him particularly vulnerable to experiencing

termination as a loss. She thus planned accordingly,

enlisting other staff to offer the client support and pro-

viding space for both client and worker to share the range

of feelings engendered by termination. In this paper, using

a similar theoretical approach, Patricia, recognizing the

positive paternal transference and the significance of fa-

ther’s loss to Polly, but also the latter’s capacity for

internalization, provided a transitional object in the form of

the letter underscoring Polly’s strengths.

Techniques for Terminating

As illustrated in the vignettes, during the ending phase it is

crucial to review the progress made in treatment, focus on

gains and client strengths, and emphasize that the client can

continue growing beyond the clinical relationship. As

Edelson writes, ‘‘what has been happening keeps on

‘going’ inside the patient’’ (1963, p. 14). Termination can

be viewed as a process of integrating, reviewing, and

developing a perspective of what has occurred in treatment

so that growth and change can continue beyond it.

Specific techniques for facilitating this process have

been described in the literature. For example, Elbow (1987)

discusses the creation of a memory book when terminating

with children. The worker and child together write down

and discuss the reasons they came together, what they did,

what has changed, and how they feel about this and each

other. Other rituals facilitating an effective ending may

include creative arts projects or formal celebrations.

In addition to reviewing and consolidating progress,

some specific information about the reasons for termina-

tion, in this case the completion of the internship, may

prove helpful to clients. This includes, from a relational

88 Clin Soc Work J (2007) 35:79–90

123

approach, a discussion regarding the intern’s own feelings

about ending and sharing what strengths they have ob-

served in the client and what they have gained from the

work together (Bostic et al., 1996; Goldstein, 1997; Levin,

1998; Martinez, 1987). This serves as a model for the client

and highlights the reciprocity of the relationship (Walsh &

Meyersohn, 2001). Patricia and Daniel did this with their

clients to good effect.

Finally, interns might consider developing a follow-up

plan with each client, as done by Elizabeth in her work

with Calvin. What can the client do on their own to sustain

and build on the gains of the work? Depending on the

client’s needs, a referral to a new worker may be necessary.

The intern may need to play an active role in this process,

providing referrals, and possibly having a joint meeting

with the new worker to ensure that the transfer is made.

Issues of Post-termination Contact

Given the strong feelings generated for both clients and

workers, as discussed above, questions regarding post-ter-

mination contact will likely arise. The client may request to

see the intern outside the treatment framework, and the

intern may, for a variety of reasons, be tempted to maintain

contact (Baum, 2006). This is a complex and controversial

area, with little literature or research to provide guidance

(Schachter, 1992). Most clinicians feel that there should be

no post-termination contact unless initiated by the client,

and then only within the professional framework, with the

client contacting the worker at his or her place of

employment and within the role of social worker. The

parameters of the client–worker relationship are main-

tained so that the client can return in the future for treat-

ment if they so choose. However, this assumes that the

client is able to contact the worker within a professional

setting, which is rarely the case for students, who may still

be in school or have yet to obtain a professional position.

The possibility of maintaining the relationship with the

intern may affect the client’s capacity to form a therapeutic

alliance with a new worker at the agency where they can

more readily and consistently continue their work, as was

the case with Julia’s client Laura. Maintaining client con-

tact also may pose a burden for the intern, who does not

have the structure of an agency or supervisor to support his

or her work. Webb (1985) includes one case example from

a first-year MSW student who had difficulty ending her

contact with a client. Rather than facilitating the termina-

tion, the supervisor suggested the intern maintain telephone

contact with the client over the summer until the new

worker arrived in the fall. Confused and in need, the client

continued to contact the intern. The intern felt guilty about

not wanting any further contact with the client, and angry

at the agency for thrusting her in this untenable position.

For these reasons, terminating with the client in a clear,

definitive way, and providing referrals to other profes-

sionals as needed is highly recommended.

Conclusion

The premature terminations that interns (and their clients)

experience as a result of the completion of the field

placement are complex phenomena that have received

insufficient attention in the social work literature. As the

existing literature suggests and the student cases presented

illustrate, interns find these terminations difficult, and re-

quire further knowledge and skills and significant support

in negotiating this complicated passage for themselves and

their clients. In presenting students’ work and deriving

some discussion points for interns and field instructors

based on the students’ experiences and the relevant litera-

ture, we hope to stimulate further reflection, research, and

training on this important but neglected topic. Particular

areas for exploration include the development and evalu-

ation of timely, comprehensive training, including that

occurring within the relational matrix of supervision, on

both interns’ and clients’ experience of termination.

References

Anthony, S., & Pagano, G. (1998). The therapeutic potential for

growth during the termination process. Clinical Social Work Journal, 26(3), 281–296.

Barton, B. R., & Marshall, A. S. (1986). Pivotal partings: Forced

termination with a sexually abused boy. Clinical Social Work Journal, 14(2), 139–149.

Baum, N. (2006). End-of-year treatment termination: Responses of

social work student trainees. British Journal of Social Work, 36(4), 639–656.

Bembry, J. X., & Ericson, C. (1999). Therapeutic termination with the

early adolescent who has experienced multiple losses. Child and Adolescent Social Work Journal, 16(3), 177–189.

Bogo, M. (2006). Field instruction in social work. The Clinical Supervisor, 24(1), 161–191.

Bogo, M., & McKnight, K. (2006). Clinical supervision and field

instruction in social work. The Clinical Supervisor, 24(1), 47–65.

Bolen, J. K. (1972). Easing the pain of termination for adolescents.

Social Casework, 53, 519–527. Bostic, J. Q., Shadid, L. G., & Blotcky, M. J. (1996). Our time is up:

Forced terminations during psychotherapy training. American Journal of Psychotherapy, 50(3), 347–359.

Choy, B. K., Leung, A. Y. L., Tam, T. S. K., & Chu, C. H. (1998).

Roles and tasks of field instructors as perceived by Chinese

social work students. Journal of Teaching in Social Work, 16(1/ 2), 115–132.

Cimino, D., Cimino, F., Nuehring, E., Raybin, L., & Wisler-Waldock,

B. (1982). Student satisfaction with field work. Contemporary Social Work Education, 5(1), 68–75.

Coker, M. (1996). Ending where the client is: A psychodynamic

approach to forced terminations. In J. Edward, & J. Sanville

Clin Soc Work J (2007) 35:79–90 89

123

(Eds.), Fostering healing and growth: A psychoanalytic social work approach (pp. 353–371). Northvale, NJ: Jason Aronson.

Edelson, M. (1963). The termination of intensive psychotherapy. Springfield, IL: Charles C. Thomas.

Elbow, M. (1987). The memory book: Facilitating terminations with

children. Social Casework: The Journal of Contemporary Social Work, 68, 180–183.

Feiner, H., & Couch, H. E. (1985). I’ve got a secret: The student in

the agency. Social Casework, 66, 268–274. Fortune, A. E. (1987). Grief only? Client and social worker reactions

to termination. Clinical Social Work Journal, 15(2), 159–171. Fortune, A. E., & Abramson, J. S. (1993). Predictors of satisfaction

with field practicum among social work students. The Clinical Supervisor, 11(1), 95–110.

Fortune, A. E., Feather, C. E., Rook, S. R., Scrimenti, R. M., Smollen,

P., Stemerman, B., & Tucker, E. L. (1985). Student satisfaction

with field placement. Journal of Social Work Education, 21(3), 92–104.

Fortune, A. E., McCarthy, M., & Abramson, J. S. (2001). Student

learning processes in field educationl realtionship fo elarning

activities to quality of field instruction, satisfaction, and perfor-

mance among MSW students. Journal of Social Work Education, 37(1), 111–124.

Fortune, A. E., Pearlingi, B., & Rochelle, C. D. (1992). Reactions to

termination of individual treatment. Social Work, 37(2), 171– 178.

Fox, E. F., Nelson, M. A., & Bolman, W. M. (1969). The termination

process: A neglected dimension in social work. Social Work, 14(4), 53–63.

Frawley-O’Dea, M. G., & Sarnat, J. E. (2001). The supervisory relationship: A contemporary psychodynamic approach. New York: Guilford Press.

Ganzer, C., & Ornstein, E. D. (1999). Beyond parallel process:

Relational perspectives on field instruction. Clinical Social Work Journal, 27, 231–246.

Ganzer, C., & Ornstein, E. D. (2004). Regression, self-disclosure, and

the teach or treat dilemma: Implications of a relational approach

for social work supervision. Clinical Social Work Journal, 32(4), 431–449.

Glenn, M. L. (1971). Separation anxiety: When the therapist leaves

the patient. American Journal of Psychotherapy, 25(3), 437–446. Goldstein, E. G. (1997). To tell or not to tell: The disclosure of events

in the therapist’s life to the patient. Clinical Social Work Journal, 25(1), 41–58.

Gould, R. P. (1978). Students’ experience with the termination phase

of individual treatment. Smith College Studies in Social Work, 48, 235–269.

Gutheil, I. A. (1992). Rituals and termination procedures. Smith College Studies in Social Work, 63(2), 163–176.

Itzhaky, H., & Eliahou, A. (1999). Do students reflect their field

instructors? The relationship between supervisory and learning

styles in social work field instruction. The Clinical Supervisor, 18(1), 75–84.

Knight, C. (1996). A study of MSW and BSW students’ perceptions

of their field instructors. Journal of Social Work Education, 32, 399–414.

Knight, C. (2001). The process of field instruction: BSW and MSW

students’ views of effective field supervision. Journal of Social Work Education, 37(2), 357–379.

Levin, D. (1998). Unplanned termination: Pain and consequences.

Journal of Analytic Social Work, 5(2), 35–46. Levinson, H. L. (1977). Termination of psychotherapy: Some salient

issues. Social Casework, 58, 480–489. Martinez, D. (1987). Pains and gains: A study of forced terminations.

Journal of the American Psychoanalytic Association, 37, 89– 115.

Mann, J. (1973). Time-limited psychotherapy. Cambridge, MA: Harvard University Press.

Mason, S. E., Beckerman, N., & Auerbach, C. (2002). Disclosure of

student status to clients: Where do MSW program stand? Journal of Social Work Education, 38(2), 305–316.

McRoy, R. G., Freeman, E. M., & Logan, S. (1986). Strategies for

teaching students about termination. The Clinical Supervisor, 4(4), 45–56.

Penn, L. S. (1990). When the therapist must leave: Forced termination

of psychodynamic therapy. Professional Psychology: Research and Practice, 21(5), 379–384.

Ringel, S. (2001). In the shadow of death: Relational paradigms in

clinical supervision. Clinical Social Work Journal, 29(2), 171– 179.

Robb, M., & Cameron, P. M. (1998). Supervision of termination in

psychotherapy. Canadian Journal of Psychiatry, 43(4), 397–402. Robinson, V. P. (1962). Jessie Taft: Therapist and social work

educator. Philadelphia: University of Pennsylvania Press. Rubin, G. K. (1968). Termination casework: The student, client, and

field instructor. Journal of Education for Social Work, 3, 65–69. Sanville, J. (1982). Partings and impartings: Toward a nonmedical

approach to interruptions and terminations. Clinical Social Work Journal, 10(2), 123–131.

Schachter, J. (1992). Concepts of termination and post-termination

patient-analyst contact. International Journal of Psycho-Analy- sis, 73(1), 137–154.

Shapiro, C. H. (1980). Termination: A neglected concept in the social

work curriculum. Journal of Education for Social Work, 16(2), 13–19.

Siebold, C. (1991). Termination: When the therapist leaves. Clinical Social Work Journal, 19(2), 191–204.

Siebold, C. (1992). Forced termination: Reconsidering theory and

technique. Smith College Studies in Social Work, 63(1), 325– 341.

Walsh, J. (2002). Termination and your field placement. The New Social Worker, 9(2), 14–17.

Walsh, J. (2003). Endings in clinical practice: Effective closure in

diverse settings. Chicago: Lyceum.

Walsh, J., & Meyersohn, K. (2001). Ending clinical relationships with

people with schizophrenia. Health and Social Work, 26(3), 188– 195.

Webb, N. B. (1983). Vacation-separations: Therapeutic implications

and clinical management. Clinical Social Work Journal, 11, 126–138.

Webb, N. B. (1985). A crisis intervention perspective on the

termination process. Clinical Social Work Journal, 13(4), 329– 340.

Weddington, W. W., & Cavenar, J. O. (1979). Termination initiated

by the therapist: A countertransference storm. American Journal of Psychiatry, 136(10), 1302–1305.

Williams, A. B. (1997). On parallel process in social work supervi-

sion. Clinical Social Work Journal, 25(4), 425–435.

90 Clin Soc Work J (2007) 35:79–90

123