Abstract
Little is known about the process by which clients and therapists make termination decisions. The purpose of this study was to explore clients’ and counselors’ termination decisions and experiences in counseling. Twelve clients and their counselors (N = 5) from five university counseling centers in Taiwan were interviewed about their termination experiences. Qualitative data from the interviews were analyzed. The results suggested four main types of termination – mutual, client-initiated, counselor-initiated, and forced termination. Clients in the mutual and client-initiated termination categories reported feeling ready to terminate counseling and felt that the termination process was positive. Their considerations for termination were largely based on perceived change and termination intentions over time. The participating counselors expressed both positive and negative feelings about termination. Their considerations for termination were based on their general termination beliefs, perceived client change, perceived client willingness to end, and other termination cues. Termination decisions are a multi-faceted process, with clients and therapists expressing overlapping, but different reasons for wanting to discontinue treatment. Implications and future directions are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bartholomew, T. T., Lockard, A. J., Folger, S. F., Low, B. E., Poet, A. D., Scofield, B. E., & Locke, B. D. (2019). Symptom reduction and termination: Client change and therapist identified reasons for saying goodbye. Counselling Psychology Quarterly, 32(1), 81–99. https://doi.org/10.1080/09515070.2017.1367272.
Bhatia, A., & Gelso, C. J. (2017). The termination phase: Therapists’ perspective on the therapeutic relationship and outcome. Psychotherapy, 54(1), 76–87. https://doi.org/10.1037/pst0000100.
Boyer, S. P., & Hoffman, M. A. (1993). Counselor affective reactions to termination: Impact of counselor loss history and perceived client sensitivity to loss. Journal of Counseling Psychology, 40(3), 271–277. https://doi.org/10.1037/0022-0167.40.3.271.
Brogan, M. M., Prochaska, J. O., & Prochaska, J. M. (1999). Predicting termination and continuation status in psychotherapy using the transtheoretical model. Psychotherapy: Theory, Research, Practice, Training, 36(2), 105–113. https://doi.org/10.1037/h0087773.
Charmaz, K. (2014). Constructing grounded theory. Sage.
Curtis, R. (2002). Termination from a psychoanalytic perspective. Journal of Psychotherapy Integration, 12(3), 350–357. https://doi.org/10.1037/1053-0479.12.3.350.
Elliott, R., & Timulak, L. (2005). Descriptiveandinterpretive approaches to qualitative research. In J. Miles & P. Gilbert (Eds.), A handbook of research methods for clinical andhealth psychology (p. 147–159). Oxford University Press.
Elliott, R., & Timulak, L. (2021). Essentials of descriptive-interpretive qualitative research: A generic approach. APA Books.
Fortune, A. E. (1987). Grief only? Client and social worker reactions to termination. Clinical Social Work Journal, 15, 159–171. https://doi.org/10.1007/BF00752909.
Gelso, C. J., & Woodhouse, S. S. (2002). The termination of psychotherapy: What research tells us about the process of ending psychotherapy. In G. S. Tryon (Ed.), Counseling based on process research: Applying what we know (pp. 344–369). Boston: Allyn & Bacon.
Goode, J., Park, J., Parkin, S., Tompkins, K. A., & Swift, J. K. (2017). A collaborative approach to psychotherapy termination. Psychotherapy, 54(1), 10–14. https://doi.org/10.1037/pst0000085.
Graybar, S. R., & Leonard, L. M. (2008). Terminating psychotherapy therapeutically. In W. T. O’Donohue , & M. A. Cucciare (2008), Terminating psychotherapy: A clinician’s guide (pp. 53–97). Routledge.
Greenberg, L. S. (2002). Termination of experiential psychotherapy. Journal of Psychotherapy Integration, 12(3), 358–363. https://doi.org/10.1037/1053-0479.12.3.358.
Hart, T., & Achterman, P. (2017). Qualitative analysis software. In J. Matthes, C. S. Davis, & R. F. Potter (Eds.), The international encyclopedia of communication research methods (pp. 1–12). John Wiley & Sons.
Hill, C. E., & Knox, S. (2021). Essentials of consensual qualitative research. APA Books.
Hilsenroth, M. J. (2017). An introduction to the special issue on psychotherapy termination. Psychotherapy, 54(1), 1–3. https://doi.org/10.1037/pst0000106.
Knox, S., Adrians, N., Everson, E., Hess, S., Hill, C., & Crook-Lyon, R. (2011). Clients' perspectives on psychotherapy termination. Psychotherapy Research, 21(2), 154–167. https://doi.org/10.1080/10503307.2010.534509.
Lampropoulos, G. K. (2010). Type of counseling termination and trainee therapist–client agreement about change. Counselling Psychology Quarterly, 23(1), 111–120. https://doi.org/10.1080/09515071003721552.
Maples, J. L., & Walker, R. L. (2014). Consolidation rather than termination: Rethinking how psychologists label and conceptualize the final phase of psychological psychotherapy. Professional Psychology: Research and Practice, 45(2), 104–110. https://doi.org/10.1037/a0036250.
McLeod, J. (2013). Qualitative research: Methods and contributions. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (pp. 49–84). Wiley.
Nof, A., Leibovich, L., & Zilcha-Mano, S. (2017). Supportive–expressive interventions in working through psychotherapy termination. Psychotherapy, 54(1), 29–36. https://doi.org/10.1037/pst0000094.
Norcross, J. C., Zimmerman, B. E., Greenberg, R. P., & Swift, J. K. (2017). Do all therapists do that when saying goodbye? A study of commonalities in termination behaviors. Psychotherapy, 54(1), 66–75. https://doi.org/10.1037/pst0000097.
Olivera, J., Challú, L., Gómez Penedo, J. M., & Roussos, A. (2017). Client-therapist agreement in the termination process and its association with therapeutic relationship. Psychotherapy, 54(1), 88–101. https://doi.org/10.1037/pst0000099.
Patton, M. Q. (2015). Qualitative research and methods: Integrating theory and practice. Sage.
Rennie, D. L. (2006). The grounded theory method: Application of a variant of its procedure of constant comparative analysis to psychotherapy research. In C. T. Fischer (Ed.), Qualitative research methods for psychologist: Introduction through empirical studies (pp. 59–78). Elsevier Academic Press.
Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory. Sage.
Swift, J. K., & Greenberg, R. P. (2015). Premature termination in psychotherapy: Strategies for engaging clients and improving outcomes. American Psychological Association.
Vasquez, M. J., Bingham, R. P., & Barnett, J. E. (2008). Psychotherapy termination: Clinical and ethical responsibilities. Journal of Clinical Psychology, 64(5), 653–665.
VERBI GmbH. (2015). MAXQDA: The art of data analysis. Retrieved from https://www.maxqda.com/
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of Interests/Competing Interests
None.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Public Significance Statement
This study provides an advanced understanding of client and therapist experiences in making termination decisions in counseling. Perceived change played a significant role in termination decisions for both parties.
Rights and permissions
About this article
Cite this article
Lee, Ps., Wang, Lf. & Swift, J.K. Clients’ and counselors’ termination decisions and experiences in counseling. Curr Psychol 42, 3734–3744 (2023). https://doi.org/10.1007/s12144-021-01725-4
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12144-021-01725-4