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 Nat RomanMarriage & Family Therapist, MSc RP):
There are typically three reasons why therapy is terminated:1) Client has met therapy goals2) Client is not progressing 3) Therapist is not a good fit for clientIn order to properly assess whether therapy is helping and what progress is being made, the therapist needs to have ways of consistently checking in with clients sessions-by-session to determine what is helping, what isn't, and where the client is at in relation to their original therapy goals. When a client has met their goals, that is a good time to end counselling sessions unless the client has new goals or simply wants to check-in periodically to make sure that they are still on track (sometimes referred to as relapse prevention). When a client is not progressing, and feedback has been taken and attempts have been made to make the therapy more helpful for the client but to no avail, than it is considered unethical to continue to work with the client. In these circumstances, referring out to another therapist who may be a better fit is a good idea.

Answer (from Kevin MimmsBuilding Better Connections):
It is usually time to end counseling sessions when it is clear to both the client and the counselor that therapeutic goals have been reached and enough improvement has been made that the client can continue without that support. There are exceptions to this rule, but for the most part this is when counselors begin termination. For some clients, this is an easy process that marks the achievements they have made in working through their emotions and difficulties. For some other clients, however, this is a difficult process in which they are losing a valuable support and are understandably anxious about what life will be like without the frequent meetings. Ultimately, termination is different for everyone, and there are many ways that termination can be healthy and helpful.

Answer (from Shawn Thomas Berthel, M.S., LCMHCStep into your new life path.):
Hello. The end of the counselor/client relationship is one of mutual respect and engagement. Counseling sessions can end for any number of reasons. Among them are the client's inability to make forward progress in therapy; the clinician's inability to help the client (for a variety of reasons); a mutually agreed upon time frame for a number of sessions to be provided; or the financial challenges of the client who decides that they need to put their resources elsewhere. In this last case, a counselor should never cancel sessions with a client simply on the basis of the client's inability to pay. That is traditionally seen as an unethical practice. Other arrangements can be made to provide care to the client, which in itself should be paramount.When the client and therapist decide that services are done, it is best if there is at least one or two more sessions to allow a case file review to occur, and to bring an appropriate psychological sense of closure to the client (and vicariously to the clinician as well, those this is perhaps not as important). This transition gives both a sense of having reached the end of a journey...rather than some abrupt departure from it. (An abrupt ending in therapy can have a varying level of impact both emotionally and psychologically on the client and therapist). Sometimes the closure of therapy is the result of a program of therapy being formally completed, in which there is a mutually known (albeit perhaps approximate) date of when that program will be finished. In this case, the client is likely feeling that impending closure and has time to prepare mentally and emotionally from a place of being the client in therapy, to a place of healing, growth and situational resolution.I have always worked in therapy with the following slogan (if you will), that I learned years ago during graduate school: "Not every therapist is good for every client, and not every client is good for every therapist." It is perhaps one of the most important guiding views I hold in working with clients. The therapeutic relationship is driven by mutuality - the desire of the client to get better at living life, and the therapist's desire to truly see the client heal and grow. When there is a block in this process from either side that prevents that synergy from occurring, the relationship that should be established may not be able to form. Or, if already formed, may at some point be unable to move forward. In these instances, referring the client to another type of service or clinician is appropriate. Usually, this can be seen pretty quickly by either party, though sometimes it is not always clear.Ultimately, the client and counselor need to work together to discover if the needs of the client (which is paramount) are being met in the therapeutic engagement with their current counselor, or if other arrangements need to be made to go elsewhere. If both are observant in this process, they can work together to maintain that sacred space and continue to reach the goals that have been set. Eventually, therapy will end, but hopefully based on the client's successful journey to the place where they wanted to go, and thus opening the next chapters of their life to a space that is more whole and brighter.

Answer (from Miriam Dyak):
Hopefully both the client and counselor would together decide when to terminate counseling sessions. It's really helpful for the client to leave counseling with a solid sense of what he or she has accomplished in counseling, so it can be a good idea to spend some time acknowledging that in the last session or sessions. Sometimes, however, a client has needs beyond the scope of the counselor's expertise. That's a good time for a conversation about those needs and ideas of  how best to meet them, whether by adding in care with an additional mental health professional or transferring care entirely to a new mental health provider.