A couple with whom I have been working just finished therapy. It’s almost always bittersweet to finish therapy with a client, but it is the icing on the cake. When a client is willing, it is important to do what is called a termination session. We did that today. It can be hard, but it’s important.
Throughout this blog post, I will use the term “termination” but “closure” is also an appropriate term.
What is a Termination Session?
A Termination Session is the last session at the end of a course of therapy. In general, the following issues are discussed:
- How does s/he or they feel about finishing therapy
- Goal assessment
- What did the client learn; how did s/he or they heal
- Challenges s/he or they still face
- How will s/he or they handle similar issues in the future
- Resources (including the therapist)
- Feedback for the therapist (what was helpful and what would have helped)
- What the therapist learned from the client; client’s strengths
Why is a Termination Session Important?
Closure
It’s purpose is to provide closure. Why is closure important? Many clients lack closure in previous relationships and situations. We can teach them what it is like to wrap things up well. To look at what was accomplished is very important. In sessions with clients, we look at the goals, where we started in relation to those goals, periodic status updates, and then where we finished. It helps both client and therapist to see the progress that was made and changes the client made in his/her life.
Challenges and Resources
It is common for the client to still face challenges in his/her life. Acknowledging what these are and highlighting the tools they have learned helps to see progress. We also talk about the resources the client has to face challenges in the future. The client often feels empowered.
Feedback
For the therapist, feedback provides an invaluable source of self evaluation. It helps you improve, but it also helps you realize what you did well. As therapists we so seldom get feedback either way unless we actively solicit feedback. If you solicit feedback from a client, you need to be open to hearing both the good and the bad. Realize that most feedback is constructive and remain positive. They have been vulnerable in providing you feedback so be sure to thank them!
Why Doesn’t a Termination Session Happen and What to Do About It?
It can be difficult to have clients show up for the final session. Many clients schedule and either cancel or just don’t show up.
Why do people not want to do termination sessions:
- They feel rejected by the therapist
- It brings up feelings of situations that didn’t have closure in the past
- They think they are done and don’t want to pay for another session
- They don’t want to or never learned how to say goodbye
- Fear of losing a support person
- They don’t want to end the relationship
- Clients may be afraid of critiquing the therapist
How to get the client to the termination session:
Discuss the fact that many clients don’t want to come to a termination session and talk about it- Talk about what will be discussed in the final session so clients know what to expect
- Explore the specific benefits of a termination session
- Perhaps use a different word other than “termination” such as “closure” or “final” session
As a licensed therapist of over 20 years, I provide clinical supervision for therapists seeking LPC and LMFT licensure. I can help you develop the practice you desire and explore a variety of tools within your therapeutic frame.
Call me at (303) 444-2003 to schedule a supervision session.



Mary and Dean (names and other details have been changed) and I had been working together for a while. When we started therapy, they had been married for over 17 years. Mary said she wasn’t sure she wanted to stay in the marriage. She said she’d been working so hard, had been to another therapist, but things weren’t getting better. Through us doing EFT (Emotionally Focused Therapy) and other couples’ therapy modalities, their marriage improved, but there was still one last big unresolved issue.
We’d worked through issues including communication, expectations, past emotional injuries, and shared living space. The last great frontier was intimacy. Numerous approaches were used. Things had gotten better but were still not where the couple wanted them to be. Mary wanted to make love with her husband. Both partners understood that making love included more than intercourse. Dean said he wanted to but made few attempts at connecting with her. Mary went through periods of hopefulness and hopelessness. We decided to try Brainspotting.
Brainspotting
When we think of factors that influence our physical and mental health, we often think of diet and exercise. The missing piece of this puzzle is social connectedness and community. Listed in “40 Developmental Assets” developed by the South Fraser
I was listening to NPR (National Public Radio) a few weeks ago when I heard the report of a study that talked about the effects of community on peoples’ health. For people who have a supportive community, the rate of heart attacks and stroke decreases; blood pressure is lower. In my reading of January’s Reader’s Digest, I came across a story about a Greek island where people are 2.5 times more likely than Americans to reach the age of 90 and men are 4 times more likely than American men to reach the age of 90. The article bespeaks their diet and schedule. It mentions visiting with friends each day but, unfortunately, does not mention it as a factor in longevity and health. I think the author missed the proverbial boat.
Isolating yourself and being/feeling depressed can happen in either order. Someone who is depressed often isolates him or herself; someone who isolates him or herself can start feeling depressed. This can definitely be seen with the recent weather patterns. Many people who ended up staying at home for days because of the recent storms say they “need to get out”, they feel like they have “cabin fever”.



Get professional help. A good nutritionist can help with food and supplement suggestions to support the healing your body is doing. A psychotherapist who specializes in trauma can assist you in moving from merely surviving to thriving. It is important to find a therapist who does more than talk therapy. Explore things like Brainspotting, Somatic Experiencing, EMDR and other mind/body modalities.
A good example is fear of flying. Sometimes, phobias are based on a past trauma. Many times, the origin of the fear is not evident. By using
Who will make your healthcare decisions if you are unable to make them yourself?
Living Will
A Do Not Resuscitate order, commonly called a DNR, is an advanced directive medical order that directs medical personnel not to resuscitate in the event that the breathing ceases or the heart stops beating. It is a decision only about CPR. It does not include decisions about pain medications or nutrition. Unlike a Living Will or a Medical Power of Attorney, which are typically drafted by an attorney, a DNR is a form discussed, completed and must be signed by your doctor.
Robin Williams suicide brings to the forefront the serious issue of depression.
Steps for a Typical Brainspotting Session:
In September 2013, many of us on Colorado’s Front Range and nearby mountain towns experienced a flood we will always remember. As the rain came down, little did we know the impending impact on our lives and our communities. We saw the stream waters rise, the streets flood, and damage to our homes and businesses.