Termination Challenges in Child Psychotherapy

By Whitehill, Amira R.; Sampson, Jennifer M. | Journal of Marital and Family Therapy, April 2016 | Go to article overview

Termination Challenges in Child Psychotherapy


Whitehill, Amira R., Sampson, Jennifer M., Journal of Marital and Family Therapy


Gil, E., & Crenshaw, D. A. (2016). Termination challenges in child psychotherapy. New York, NY: Guilford, 221 pp. $30.00.

The impact of the quality of the therapeutic relationship on the outcomes of therapy is often discussed within graduate students' academic programs and is well understood among experienced clinicians. However, the process of successfully terminating therapy is rarely mentioned in graduate coursework or discussed between supervisors and clinicians in agency and private practice settings. As a result, terminating therapy can often feel disjointed or incomplete for both therapists and their clients, as neither is necessarily prepared to address the unique issues, such as how soon to introduce the topic and the extent to which it is discussed. In this book, Treatment Challenges in Child Psychotherapy, Gil and Crenshaw, two leaders in the field of play therapy and trauma recovery, offer that effective and conscientious termination is especially important when working with children and adolescents. They share personal accounts of the strategies, techniques, and timing of effective termination in child psychotherapy in an effort to provide therapists greater clarity regarding issues they may need to address as they approach termination with child and adolescent clients.

Gil and Crenshaw begin the book by contextualizing the termination process through the lens of attachment theory. They assert that the therapeutic relationship is an opportunity to provide a corrective emotional experience for children, who have often suffered ruptures in their attachment to their caregivers. As the therapeutic relationship grows, children can increase their trust and bond with the adult figures in their lives. The authors contend that the lasting benefits of the therapeutic relationship depend on how effectively therapists terminate therapy. Related to this, Gil and Crenshaw offer a number of concepts and strategies that therapists who work with children and adolescents may benefit from considering. For example, they suggest therapists consider an "open-door" termination, in which the client is allowed to return to services in the future, as well as the implications of this approach when working within a managed care setting. In chapter 4, the consequences and research surrounding premature terminations with children and adolescents, both therapist and parent initiated, are discussed. Later in the book, Gil and Crenshaw also address smaller concerns that may arise, including the presence of unresolved prior losses for children and therapists and countertransference issues. Last, they provide specific strategies for processing termination with clients, specifically addressing the use of rituals and play therapy to symbolically say good-bye. …

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