A Narrative Approach to Terminating Therapy
Lenz, A. Stephen, Zamarripa, Manual X., Fuentes, Stephanie, Journal of Professional Counseling, Practice, Theory, & Research
Increasing the diversity of strategies for facilitating meaningful termination of therapy may be useful to practitioners in a number of settings including those conducting group guidance in the schools and meeting with clients in a private practice or community agencies. We present definitional ceremonies as one such strategy. Following a brief overview of this narrative therapy practice, the authors present a five-stage model for implementing this approach to termination of therapy. This process is illustrated using the case example of Trisha to highlight process, contextual, and multicultural considerations. Considerations for practitioners and research are provided.
Counselors may begin more therapeutic relationships than they mutually terminate. One recent investigation reviewing client records (N=22,122) estimated that only 40% of therapy endings are planned (Connell, Grant, & Mullen, 2006). Despite requirements for counselors to implement responsible and reasonable termination efforts by regulating bodies such as the American Counseling Association (ACA, 2005) and the American Association for Marriage and Family Therapists (AAMFT, 2001 ), this trend has persisted. Several researchers have made efforts to identify client and counselor variables that influence this trend across several therapeutic settings (Lampropoulos, Schneider, & Spangler, 2009; Renk & Dinger, 2002; Roe, Dekel, Harel, &; Penning, 2006; Venable & Thompson, 1998); however, attention to enhancing termination practices is scant in the professional literature. A review of conference programs for ACA and the Association for Counselor Education and Supervision in the past five years also corroborates a need for more discussion about issues and innovative strategies related to promoting meaningful termination practices.
For many clients, the experience of parting with the therapeutic atmosphere in which they are acknowledged, accepted, and validated unconditionally while mitigating life circumstances can range from hopeful to anxiety provoking. Many (2009) suggested that termination of counseling may provide a model of change for a client that embraces loss of an important relationship as a part of healthy growth. From a narrative therapy perspective (Speedy, 2004; White, 2007), termination may provide a venue for clients and the important people in their lives to agree upon, re-grade, and acknowledge development made in counseling.
A number of examples were provided noting the fit between narrative practices and other therapeutic orientations such as rational-emotive behavior, solution-focused, cognitive-behavioral and systemic family therapies (Dallos, 2004; Guterman & Rudes, 2005; Hansen, 2002). Therefore, one implication is that practitioners from many different backgrounds may enhance their professional services and fidelity by implementing the strategy for termination illustrated here, Furthermore, the approach presented was implemented with clients of diverse ethnic backgrounds presenting with an array of issues. We believe that implementing a definitional ceremony synonymous with narrative therapy (Speedy, 2004; White, 2007) does not require practitioners to reinvent themselves. However, readers may benefit from some knowledge regarding basic concepts including externalizing problems, identifying unique outcomes, and facilitating re-membering conversations.
Definitional Ceremonies in Narrative Practice
The practice of utilizing definitional ceremonies as described by narrative therapists such as Speedy (2004) and White (2003, 2007) provides a unique framework to facilitate meaningful closure to the therapeutic relationship. The term definitional ceremony was borrowed by Michael White from the work of anthropologist Barbara Myerhoff (1986), who suggested that when individuals tell their stories amongst others, a process occurs that authenticates views about their lives, experienees, and identities. …