Endings and Beginnings Chapter 15 Endings and Beginnings By: Noah M.P. Spector and Shaofan Bu

When is it over? Determining when to end therapy Clients should have reasonable warning about when therapy will end. Endings can be an opportunity to review accomplishments. Endings can also take place gradually over time by for example initially increasing time between sessions (“fading”).

Ending with clients When to end? A function of preferred outcomes established You and I have been reflecting on a number of significant changes you’ve made; I’m wondering if you might be thinking it’s getting to the time to take a break from this process and put those changes to work?

Ending with clients Possible sense of loss for client and counsellor Client concern about “flying solo” Can “fade” frequency or schedule future “check in” Counsellor: sign of failure? Counsellor; is the client ready? Marks accomplishment on part of client Rite of passage A new beginning Chance to celebrate & review learnings Opportunity to anticipate backslides (relapses)

The ending of therapy as a rite of passage Rites of passage (Van Gennep, 1960) is a useful metaphor to understand the end of therapy. A distancing from a former state of being—may be at the start of therapy Thin Descriptions Separation phase: This may be the middle part of therapy as clients are making changes. Liminal or betwixt and between phase: A time for thick description-the ending- amalgamation of therapeutic gains Re-entry to society:

“Termination” as a rite of passage Rite of passage metaphor (van Gennep, 1960)—stages of change: Separation– detached from familiar ways of being. Liminal space—Betwixt and between. Reincorporation- moving into a new phase of life (White & Epston, 1995)

Taking stock of learnings With the changes you’ve been making, what would you say is one piece of yourself or way of being that you’re leaving behind you as you go forward? What is it about this “part” that no longer fits for you? What are tips you’d share with others going through similar challenges?

Taking stock of learnings How would you describe what’s different about your relationship with yourself now? Which priorities have risen to the surface? What skills and abilities have you uncovered that were dormant or at least not very visible to you before?

Celebrating, documenting and soliciting witnesses to change The ending of therapy, like other significant rites of passage warrants celebration. Examples of documents: Letters Certificates Therapeutic gains may also be formally recognized by others

<Your Organization Name Here> <Name created together> Sample Document <Your Organization Name Here> honors <Client Name> We Admire Your Hard Work & Dedication. You are Inspiration. You are a Winner and It Shows. Congratulations on Your Success. Psychotherapist Typed Name Here 00 / 00 / 00 <Name created together> Date Therapist signature

Celebrating, documenting and soliciting witnesses to change Friends and loved ones may also bear witness to changes at the end of therapy. Sometimes these loved ones are remembered or imagined as being present…other times they may be invited to attend a session.

Spreading the word Who do you know who’d be most likely to predict the changes you've been making? What would they tell me about what they know about you that would help me understand the accuracy of their predictions?   Who would be most interested to hear about these developments? What would s/he find interesting about it? How could you catch her/him up? Who will be most affected by the changes you’ve made? Are they aware of them or do you plan to talk to them about what’s been going on?

Preparing for setbacks The end of therapy will not mark an end to struggles. It is important to prepare for setbacks— also known as “relapse prevention”.

Preparing for setbacks -How will you know that X is creeping back into the picture next time? -What are the situations (contexts, people, times of day, etc.) in which X is most likely to reappear? -How will you respond differently next time your boss pushes your buttons again? -How will you remember to re-connect with your breath next time that feeling comes on? -What have you learned about your ability to deal with X that will help you if X does reappear?

Changing the Social Context -Are there certain circles of friends who are most likely to encourage the Drinking’s return? -What situations are most likely to tempt you to start using again? -Who do you figure stands against Trouble in your life, and who stands with it? -Who do you most associate with your old lifestyle and who fits with your new lifestyle?

Reflecting on your own learnings What preferred developments have occurred in your own practice as you’ve engaged in this course? Who would be most likely to predict your successes? On what basis? What potential setbacks lie ahead (opportunities for backslides) and what have you learned about how to anticipate and respond to them? How will you acknowledge and commemorate your successful completion of this course?