terminating a counselling relationship › ~sparkins › edpy 442 week 5.pdf · homework...
TRANSCRIPT
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EDPY 442: Intro to Counselling
Sophie Yohani, Ph.D. R. Psych
TERMINATING A COUNSELLING
RELATIONSHIP
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Process of Counselling
1. Development/Building Phase
2. Understanding & Action Phase
“The Understanding and Action Phase”
Deeper working alliance
Goal oriented
3. Termination Phase
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Homework
Advantages: Can motivate, keep clients focused, help evaluate progress or outcome, help celebrate.
Types of homework:
Paradoxical
Behavioral (practicing a new skill)
Risk-taking (doing something that is feared)
Written (keeping a log or journal)
Bibliotherapy
Not doing anything (breaking habits)
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Maintenance: Prochaska’s 5th Stage of
Change
Clients engage in various activities to prevent relapse
and consolidate the changes that they made in the
action stage.
Maintenance is not static and can range in length
from a few months to a lifetime as see in some
addictions.
Counsellors can help clients in this stage by
continuing to use interventions used in the previous
stages and also assessing and preparing for situations
that may cause them to relapse.
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Transference
Transference—the client’s projection of
past or present feelings, attitudes, or desires
onto the counselor
Negative: when client accuses counselor
of neglecting or acting negatively toward
him or her.
Positive: client’s admiration of counselor
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Countertransference
Countertransference- the counselor’s projected emotional reaction to or behavior toward the client.
Overidentification: Counselor loses his or her ability to remain emotionally distant from the client. E.g.: Both counselor and client has experienced sexual assault.
Disidentification: Counselor becomes emotionally removed from client
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Countertransference
Problems with transference and counterransference can interfere with the all aspects of the work in the counselling relationship.
Like transference, countertransference has been used by some theories as a diagnostic tool to better understand client behaviours
Useful to seek supervision if one suspects countertransference issues or at the extreme, refer client to some else.
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Termination of Counseling
http://www.youtube.com/watch?v=7sv6emlOJeI
Discussion questions:
What is the client’s response to termination?
What is the counselor’s response to the client?
Based on the video, what are some of the issues that
should be addressed at the end of counseling?
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Functions of Termination
An opportunity to experience closure
A motivator for the work during
counselling
An opportunity to generalize new
learning and skills
An acknowledgement of growth or
maturation
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Functions of Termination
An opportunity to experience closure
A motivator for the work during
counselling
An opportunity to generalize new
learning and skills
An acknowledgement of growth or
maturation
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Timing of Termination
When to terminate? No definite answer.
Achievement of goals: Have clients achieved
behavioral, cognitive, or affective contract goals?
Consistency of progress: Can clients show that
they have made progress in what they wanted to
achieve. Or are they still having difficulties at times
(good and bad weeks)?
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Timing of Termination (cont.)
Helpfulness of counseling relationship: Is the
counseling relationship helpful? If not, the
counselor might consider outside referral.
Changing of context of initial counseling
relationship: Has context of the initial counseling
relationship changed? E.g.: move, illness.
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Signals for Termination
Verbal messages by the counselor and the client
Decrease in the intensity of work
More humor
Consistent reports of improved abilities to cope
Verbal commitments to the future
Less denial, withdrawal, anger, mourning, or dependence.
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Concerns When Deciding to
Terminate Counseling
Initial problem has been reduced
Stress-producing feelings have been eliminated
Better coping ability
Client can relate better to others
Client is able to love and be loved
Client has become productive
Client can better enjoy life
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Preparing for Termination
Clients should be prepared for termination
ahead of time especially those with loss issues,
fear of abandonment, dependency issues and
attachment difficulties.
One-sixth of the entire counseling services
can be spent on termination.
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Client Resistance to Termination
Behavioral manifestations of resistance:
development of new symptoms,
asking for more appointments,
asking for more time at end of
session.
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Client Resistance to Termination
(cont.)
To deal with resistance counselors can
“prescribe” limited number of future
session over a period of time
Provide connection to other resources
Establish plan in case of relapse
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Resistance to Terminate and Loss
Good ways of dealing with loss:
make it gradual,
discover the significance that different activities
have,
describe this significance to others,
enjoy what you have gained,
define continuity.
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Resistance to Terminate and Loss
Bad ways of dealing with loss:
deny,
distort experience by overglorifying,
denigrate your relationships,
distract yourself,
detach yourself.
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Counselor Resistance to Termination
8 possible reasons:
1)End of a significant relationship
2)Counselor is anxious about client’s ability to function
3)Guilt for not being more effective
4) Counselor’s professional self-concept is threatened
5)End of a learning experience for the counselor
6)End of living vicariously
7) Reminds of other goodbyes
8) Conflicts about own individuation.
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Premature Termination
Tendency is to blame the client.
Establish that it is no one’s fault.
However, counselors should be aware of
patterns of premature termination in their
work.
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Client Reasons for Premature
Termination
To see whether the counselor really cares
To try to elicit positive feelings from the counselor
To punish or try to hurt the counselor
To eliminate anxiety
To express dissatisfaction (e.g., not being
understood)
To let the counselor know that the problem is solved
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If the client wants to quit prematurely,
counselors should set up an exit
interview to:
Resolve negative feelings
Invite the client to continue the services if
needed
Connect to other resources
Let them know the availability for future
services
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Preventing Premature Termination
Schedule regular appointments.
Orient clients to counseling process.
If possible, counselor who does initial intake
should become the client’s counselor.
Send reminders to motivate attendance.
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Ending on a Positive Note
Guidelines for a good ending
Allow clients to express their thoughts and
feelings about the services
Review the major events and connect them to
the present
Acknowledge the positive changes
(accomplishments)
Request follow-up contact
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Other Issues Related to Termination
Follow-up
Short term (<6 mo.) and long term (>6mo.)
Face-to-face, telephone, e-mail, mail
A way of showing accountability
Referral
why, how, when, and who
Recycling: involves re-examining the counseling
process. Revise and reinvest.