Title

When a therapist leaves a client: Closing the therapeutic relationship effectively

Department

Social Work

Date of Paper/Work

2016

Degree Name

Master of Social Work (M.S.W.)

Type of Paper/Work

Clinical research paper

Advisors

Michael Chovanec

Abstract

Premature termination of the therapeutic relationship occurs when the therapist leaves a client before the clinical work reaches a natural conclusion. This exploratory research study asked the following research question: What are best practices for the facilitation of premature termination of the therapeutic relationship? The conceptual framework guiding this research was based on common factors research in psychotherapy. This was explored through a mixed-methods research design, combining quantitative and qualitative questions in an online survey completed by mental health therapists about their experience with premature termination. The sample consisted of 31 psychotherapists who had all completed graduate training and had an active practice of individual psychotherapy clients. Data was collected through an online survey. Quantitative data was analyzed using Qualtrics Survey Software, and qualitative data was analyzed through the use of grounded theory techniques. 90% of participants reported having encountered premature termination during their careers. From qualitative data, seven themes emerged: 1) Facilitate referral and identify other resources; 2) Reflect on progress and identify unmet goals; 3) Therapist reflect own feelings and reflect on relationship (both sides); 4) Provide early notice; 5) Validate loss of relationship; 6) Honesty; and 7) Highlight client strengths. The researcher wishes to emphasize the ethical imperative of a departing therapist to arrange for an effective transfer of care and the importance of graduate education coursework, continuing education credits, and supervisor training on premature termination. Strengths of this study include a targeting of clinicians closest to the problem of premature termination and a relevance for clinical social work students currently in field placement. Limitations of this study include the lack of follow-up questions in an online survey, which could be remedied in future studies by using qualitative interviews instead.

Keywords

premature termination, closure of therapeutic relationship

Creative Commons License

Creative Commons Attribution 3.0 License
This work is licensed under a Creative Commons Attribution 3.0 License.