Topic: professional-ethics

Question: How does counseling end?
How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer (from Cimberly R. NeskerRegistered Psychotherapist (3579)):
Hi there, There are a number of reasons why a therapeutic relationship might end including, but not limited to the client reaching their goals, the client reaching a place of acceptance where they wish to remain or even a breach within the relationship.  The last aspect should likely be taken to supervision in order to be fully processed.  All of these things could happen, and usually happen organically (again, except for the last example). Your question, however, was about the counselor ending treatment. This is a bit more difficult and can be very nerve-wracking.  It may be beneficial to take this with you to supervision, as well.  It's important to understand why you feel the need to end or terminate with the client, as well. Do you feel that they would be better suited for another therapist, have they achieved their goals or is it something else?In regular, open-ended sessions, I try to make a point of checking in with the clients fairly frequently. In these check-ins, I use the time to ask the client how they feel about the sessions and if there is anything they wish to focus on more astutely.  I also ask if they have any immediate goals that they would like to prioritize.  In goal-oriented sessions, I check in more frequently to ensure that both the client and I remain focused and, should they wish to shift their focus, that they recognize it is part of my responsibilities to make sure we move back to the desired goal. Often, especially in longer term therapeutic relationships, we as clinicians can see that the client has reached their goal, however they are apprehensive about ending therapy.  This is actually a great place to go with them; why would they feel unable to handle issues in their external or internal environment without you? Often, having this open discussion can increase empowerment and mastery. That said, it could also highlight other issues which the client may have been apprehensive about going into within therapy and now, as the relationship seems to be ending, feels more confident in bringing these up. In the case where the relationship is a toxic one, terminating with a client may be the best option for both of you. It's a difficult conversation, but recall that part of the role of the therapist is to model that these discomforts can be managed. I hope that this brief response can assist you going forward!

Answer (from Lauren Ostrowski, MA, LPC, NCC, BC-TMH, CCTP, CCHI tailor my therapeutic approach to each client's strengths and goals):
This is a question that is very specific to each person. There are definitely some variables, but I can give you some general ideas for when counseling might end:When a client has met all of their goals, at least to a degree when they feel that they no longer need to work on them with the assistance of a counselorSometimes a decision is made that a client is no longer benefiting from counseling at a certain timeSometimes clients have to remain in counseling in order to receive medication. This depends on agency policy, but sometimes it is a requirement. If the medication is necessary and cannot be prescribed by a primary care physician, frequency of sessions is usually decreased greatlyI'm not sure why you are asking this question, but it is also something that is often discussed at the beginning of treatment. Oftentimes "discharge goals" change as treatment progresses because more is known about clients, their goals, changes in their goals, and many other things. Changes are normal, but your counselor probably has discharge goals in mind, at least generally, from the beginning. I strongly encourage you to ask about it!