CHCCSL503B Facilitate the counselling relationship

#5: Bringing the counselling process to an end

Lesson outline

• Closure of individual sessions• Ending a series of sessions• Identifying the closure stage• Reasons for terminating therapy• Evaluating impact of earlier issues• Planning closure• Inform clients of further support• Discuss ongoing client needs• Documenting the termination

Ending a session

Closure of individual sessions:• A good way to terminate a counselling session is to

summarise the important awarenesses that have emerged during the session.

• Give some positive feedback• Additionally, if necessary, identify areas that the client

may want to discuss in future counselling sessions.• At this time avoid asking a question or reflecting

feelings/content as it invites the client to continue the conversation

Ending a session

• Talk about the need for ongoing appointments; if you don’t the person may believe you don’t think they need any

• You may need to be assertive if the client lingers

• Don’t feel that you have to follow this process strictly. Instead, allow the process to happen naturally as it emerges. Geldard, D. & Geldard, K. (2012)

Corey, G. (2009)

Ending a series of sessions

Termination of counselling is the final stage in the helping process:

• Assess the appropriateness of terminating by reviewing progress in conjunction with the client

• When to end a series of sessions may be clear and is often initiated by the client when they feel ready

• Terminating the counselling relationship requires sensitivity and appropriate timing

Ending a series of sessions

• It may be difficult if dependency makes either client or counsellor want to continue the relationship (rather than the wellbeing of the client)

• The client may have unrealistic expectations about continuing the intimate relationship they have developed during the counselling process

• Where clients and even counsellors may not wish to end the counselling relationship, it is important to maintain professional boundaries in spite of fears of loss, abandonment and insecurities

Geldard, D. & Geldard, K. (2012)

Ending a series of sessions

• Mutually agreed endings are ideal but not frequent in the community sector

• Some degree of grief will be associated with the loss of that meaningful relationship

• Strategies to aid closure include spacing final sessions out over longer periods of time so the client gradually develops more independence

• Having a follow up session 2 or 3 months later may allow loose ends to be tied up

Ending a series of sessions

Identifying the closure stage

How to know when the client is ready for closure:

• To enable clients to identify when they reach this point, the counsellor can guide them back to their original conversation about what they wanted to achieve from counselling

• The counsellor could ask “When the problem is solved, what will you be doing differently?”

• Such questions prompt clients to monitor their progress and to recognise when they no longer need or benefit from counselling

Corey, G. (2009)

Identifying the closure stage

• In reaching the closure stage, the counsellor should assist the client to acknowledge what has changed in their life, but also what they are not able to change

• In this way, the client can judge the efficacy of their counselling experience

• Some clients get stuck, maintaining the same issues for discussion

Corey, G. (2009

Reasons for terminating

Assessing when it is appropriate to end the counselling process may involve:

• Mutual agreement – goals have been achieved or it is time to move on

• Client relocates or dies• Service/funding limitations• Dissatisfaction• Disappearance

Summers, N. (2012)

Evaluating impact of earlier issues

• Hindsight affords much clarity; ongoing review during the counselling process should have helped the client to understand their issues. The closure process should add to their understandings

• Clients may benefit from greater clarity on the initial issues which brought them to counselling after the counselling process has calmed them and reduced their overall stress levels

Planning closure

Structure & contract the ending process appropriately

• Counsellors need to plan the termination of each counselling relationship at the beginning, conscious of the affect it can have on each party

• Factors considered in this process are client needs, organisational policy, funding arrangements and waiting lists

• It’s unethical to extend the counselling relationship if the client does not appear to be benefitting

http://linda-smallwood.suite101.com/counselling-and-endings---how-to-manage-them-a298878

Planning closure

• During the initial contracting phase of the counselling relationship, the counsellor and client negotiate how many sessions they’ll have. Some clients still try to extend this, ignoring established boundaries

• When endings do not go as planned, they need to be dealt with ethically and in accordance with the organisation’s policies and procedures

http://linda-smallwood.suite101.com/counselling-and-endings---how-to-manage-them-a298878

Planning closure

• Avoid fostering dependency

• Dependent clients develop dependant attitudes and behaviours and assume too little responsibility for bringing change into their life

• If counsellors do too much for the client, clients may fail to find their own direction

Corey, M., & Corey, G. (2011)

Yuoutube video: Ending counsellinghttp://www.youtube.com/watch?v=7sv6emlOJeI&feature=related

Inform clients of further support

During closure tell clients of further support which is available

• Counsellors often use the termination stage for recommending programmes or making referrals aimed at maintaining the client’s independence and autonomy

• Counsellors also tend to welcome clients to come back in the future if need arises, in relation to the current circumstances or regarding future issues

Corey, M., & Corey, G. (2011)

Discuss ongoing client needs

Discuss with the client any unresolved issues or needs for further work

• Single or multiple unresolved issues occur frequently

• As with underlying issues, unresolved issues can cause disturbances

• Resolving them can eliminate their negative impact

• So it is common for clients to continue or return to counselling due to unresolved issues

• DVD on closure: Theory & Practice of Counselling & Psychotherapy - The Case of Stan - #13: Integrative approach

Documenting closure

Discharge forms generally include pertinent information to summarise the significant aspects of working with a client

Discharge forms may be referenced by other staff, if the client returns or requests case notes transferred upon relocation

There are important points to include:

Documenting closure

Discharge forms may include this information:

• Diagnosis• Medication• Reason for leaving• Presenting problem• Counsellor’s goals• Client’s participation in formulating goals• Progress• Unaddressed issues• Client presentation at intake and at termination• Attempts to locate (if disappeared)

Summers, N. (2012)

References

Active Listening (Do’s & Don’ts), online video, accessed 5 June, 2012. http://www.youtube.com/watch?v=yIjnB9zp0sw

American Counseling Association (1996) A Practitioner's Guide to ethical Decision Making http://www.counseling.org/Counselors/PractitionersGuide.aspx Site last updated: 2012

An introduction to Person Centred Therapy, online video, accessed 5 June, 2012.http://www.youtube.com/watch?v=Qpfm5sY0OX0&feature=relatedAustralian Counselling Association (2012) Professional Supervision

http://www.theaca.net.au/documents/Supervision_Complete.pdf Site last updated: not disclosed

Biblos (2011) http://bible.cc/psalms/23-4.htm Online Parallel Bible Project, Site last updated: not disclosed

Centre for Global Health (2012) Encouraging Dialogue: Listening, Questions, Paraphrasing, and Reflecting Feelings http://www.globalhealthcommunication.org/the_center/contact_us Site last updated: not disclosed

Corey, G. (2009) Theory and Practice of Counselling and Psychotherapy 8th ed. Brooks/Cole Cengage Learning, California p.386

Corey, G., Corey, M.S. & Callanan, P. (2011) Issues and Ethics in the Helping Professions, 8th ed. Brooks/Cole Cengage Learning, California p.78, 117, 141, 269

Dictionary.Com (2012) Roget’s Thesaurus http://dictionary.reference.com/browse/ambivalence Site last updated: not disclosed

Egan, G. (2007) The Skilled Helper, 9th ed. Brooks/Cole Cengage Learning, California

Feltham, C. & Dryden, W. (2004) Dictionary of Counselling 2nd ed. Whurr Publishers Ltd, London p.9

Geldard, D. & Geldard, K. (2012) Basic Personal Counselling, A Training Manual For Counsellors 7th ed. Pearson NSW p.376

ReferencesCorey, M., & Corey, G. (2011) Becoming a Helper, 6th ed. Brooks/Cole Cengage Learning, California

p.151, 152, 153Counselling Skills Lecture 4: Paraphrasing & Reflecting Feelings, online video, accessed 4 June, 2012,http://www.youtube.com/watch?v=_M67ioQ1K2Y&feature=channel&list=UL

Dictionary.com, 2012, accessed 6 June, 2012, http://dictionary.reference.com/browse/ambivalence Site last updated: not disclosed

Ending counselling, online video, accessed 7 June, 2012, http://www.youtube.com/watch?v=7sv6emlOJeI&feature=related

Industry Skills Councils (2011) CHC51708 Diploma of Counselling Training Package Australian Government Department of Education, Employment and Workplace Relations

Interview Stories: Open versus Closed Questions, online video, accessed 4 June, 2012.http://www.youtube.com/watch?v=RoB--jhPIus

Ivey, A.E., Ivey, M.B. & Zalaquett, C.P. (2010) Intentional Interviewing and Counselling, Facilitating Client Development in a Multicultural Society 7th ed. Brooks Cole, California

Johari Window, online video, accessed 6 June, 2012,http://www.youtube.com/watch?v=c7rlCgy6i88&list=UUSnEXvOOpzPkB01mvlUl-2g&index=1&feature=plcp

“Listening skills – Paraphrasing” , online video, accessed 6 June,2012, http://www.youtube.com/watch?v=V_T4B9XANCw

National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2003) http://pubs.niaaa.nih.gov/publications/niaaa-guide/index.htm Site last updated: not disclosed

Psychology Suite 101 (2012) http://linda-smallwood.suite101.com/counselling-and-endings---how-to-manage-them-a298878 Site last updated: not disclosed

References

Ruskin, John, 2009, How to.com, Brighton, U, acessed 6 June, 2012,. http://www.howto.co.uk/wellbeing/counselling-skills/helping_the_client_feel_safe/

Steven, J. C. (2010) http://www.basic-counseling-skills.com/strengths-based.html Site last updated: 2010

Stevens, T.G. (2010) Overcome Anger and Aggression http://www.csulb.edu/~tstevens/b-anger.htm Site last updated: not disclosed

Strengths-Based Counseling, online video, accessed 5 June, 2012, http://www.youtube.com/watch?v=RtADcIJYLzA

Summers, N. (2012) Fundamentals of Case Management Practice, Skills for the Human Services 4th ed. Brooks Cole, California p.335, 337, 409

The Red Couch Counselling & Psychology Clinic (2009) http://www.redcouchpsychologycounsellingtherapyclinicmelbourne.com.au/ Site last updated: not disclosed

Tom rath why we focus on weakness, online video, accessed June 5, 2012,http://www.youtube.com/watch?v=_A0ZE4_37As&feature=autoplay&list=PL974DFE9331A092A8&playnext=2

Victorian Government Department of Health (2009) Community Health Priority Tools http://www.health.vic.gov.au/pch/downloads/community_health_priority_tools.pdf Site last updated 2009

Western Ottawa Community Resource Centre (2012) http://www.wocrc.ca/en/programs-and-services/counselling-information-referral/Limitations-of-Counselling.aspx Site last updated: not disclosed