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endings_and_transitions.pptxEndings and Transitions
What do you think?
You are a counselor at a community agency. Some time back, Keisha, a 25 year old African-American woman, entered counseling to work on issues related to anxiety. When she began counseling, she indicated she was having a hard time sleeping, was feeling constantly stressed, and found herself withdrawing from family and friends. Now you have reached a point in counseling where you think it would be good to end your sessions with her. What is happening at this time that brings you to this conclusion? What are the circumstances for ending your counseling relationship and reasons supporting this judgment?
Client-Counselor Relationship: Not Your Typical Relationship
One way – Based on counselor providing help to a client but not the other way around
Strict confidentiality
Time-limited
Expectation is the relationship is temporary
Lasts only until the problem is resolved or some other factor ends the relationship
Why Do We End a Counseling Relationship?
Work is completed
At an impasse
Client decides counseling relationship is over
Outside forces
Managed care
Moves
Impasse - deadlock
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Jim has been working with you over the past several months. When he started counseling he had recently lost his job and was struggling with anxiety. Since that time he not only acquired a new job but he has also managed to make considerable progress on learning to manage his anxiety. Today when you meet with him, the subject of ending your counseling sessions comes up. Both of you agree that, while everything is not perfect for Jim, you have made good progress together and it is time to terminate. How will you go about doing this? What do you need to do and/or talk about as you finish with Jim?
Preparing for ending
Foreshadowing the end
Tapering off meetings
Closure: Processing the counseling experience
How does it feel?
The entire experience
Ending at this point
May encounter negative feelings from clients who are unsure about ending
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Ending Well
Remembering: Where were you when we began?
Review goals and accomplishments
Important to step back and get a long range view on progress
Review highlights of work together: What have we gotten done?
Identifies what has occurred to help client make progress
Ending Well
Current status: Where are you now?
Any current concerns that need to be monitored?
Any need for referral to another source?
The future: Where are you heading?
How will you handle troubles if/when they crop up in the future?
What direction are you heading now that you have completed counseling?
Ending Well
Unfinished business: Anything else to cover before we end?
Feedback about the meaning of the relationship
Issues around future contact
Shifting to a social relationship
Restarting the counseling relationship at a future point in time
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Other Transitions
Planned breaks
Vacations, major events, etc. that call for extended break in regular meeting schedule
Develop clear plan for re-starting (scheduling next appt., etc.)
Identify backup plan for care if needed (colleague, walk-in clinic, etc.)
Establish guidelines for contact by phone, email, etc. during break
Referrals
When should you make a referral?
When a client’s problem is beyond your expertise
When you don’t have the time or resources needed to adequately help the client
When there is a conflict of interest
When your relationship with the client would get in the way of helping them
Referrals
To whom should you refer?
Does the professional match the problem?
What are the policies of your agency?
What financial resources are available to the client?
Abrupt endings
Eric has been in counseling for about six months. For the first four months he showed up regularly for appointments but over the last two months he had cancelled several times and he failed to show up for his last session. When you call to check on him to see if he would like to reschedule, you get his answering machine. Since you don’t know if there are others living in his house you don’t leave a message. It has now been a month since Eric has come to counseling. What should you do?
Termination letter
Include
Reason for the letter
Intention to end counseling
Invitation to call to reschedule
Open door for rescheduling if client chooses to discontinue counseling at this point
Dear Eric,
I am writing to let you know that I am closing your file. Since our last meeting six weeks ago we have had two cancellations as well as a time when an appointment was scheduled that you did not make. I have tried to get in touch by phone but did not reach you. Our agency has a policy that we will close cases when clients have not been seen for several weeks except for prior arrangements. If you would like to reschedule either now or at a time in the future I would be happy to re-open your file and continue working with you. I wish you the best.
Sincerely,
Summary Video
http://study.com/academy/lesson/termination-during-the-counseling-process-function-timing-related-issues.html
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