On Being a Student Therapist: Unsatisfying Endings
Three weeks left in the semester, and the goodbyes begin.
Technically, I did say goodbye to four clients earlier in the semester, but over the next few weeks, I’ll be saying goodbye to clients with whom I’ve worked “long term,” as in, longer than our four required sessions, and therefore, with whom I have built more of a relationship.
The client I said goodbye to today made incredible progress during the semester. She came in very closed off, afraid to show emotion, and dealing with issues that would be hard for anyone to deal with, let alone a 20-year-old undergraduate. During our time together, she worked hard and was a rewarding client. However, today during our termination session, I was reminded of what counseling is really about: the client and her needs, not my needs or expectations as a counselor.
Last session, I had reminded my client that today would be our last meeting, and she was fine with that. Today she arrived a little late for our session, which is unusual for her, and was obviously feeling flustered. When I asked my usual, “How are things going?”, she proceeded to answer my question as she would have during any other session. Normally, that would have been great, but I had expectations that today’s session would go differently. Here’s where my expectations and my client’s expectations diverged: For her, today was a “normal” day of counseling, with maybe a quick “thanks” and “goodbye” at the end. For me, I had (what I thought would be) a profound activity for us to do to wrap up our work together.
It didn’t happen. Not even close.
As my client talked, I found myself glancing at the clock more often than usual. I caught myself thinking, “When is she going to stop? What she’s talking about isn’t that important! I really, really want to get to what I want to do!”
Of course, she didn’t stop and I knew that interrupting her to “get to what I wanted to do” was not appropriate. When we had about 10 minutes left in the session, I took the opportunity during a break in her speech to remind her that this was our last session and to start reflecting the themes of the topic at hand to all of the work I’d seen her do this semester in counseling. Ultimately, I was able to praise her for all the progress she had made and to encourage her to keep building on her strengths and successes. When I was done, she sincerely thanked me for my help and said that both she and others had noticed a change in her, which was gratifying, and more than I expected.
After I walked her out the door of the clinic for the last time, I could only manage a half-smile. I know we did great things together. I know she feels better about herself and her life than she did three months ago. She has changed tremendously. This was a successful counseling relationship. And still, I’m upset that I didn’t get to score a touchdown in the final session. What is that all about?
I’m actually surprised at my strong reaction to “not getting my way” in a session. I think I’m pretty well grounded in the philosophy that the counseling relationship is not about me and my needs and wants. One of the items we have to evaluate about our sessions is “Keeps the focus of the session on the client,” and I’ve always rated myself highly. As a former teacher, I came into counseling at the beginning of the semester with a “lesson plan” of sorts about what a client and I would talk about that day, but quickly learned that what was relevant for a client last week is often not this week, and therefore, the best laid plans often were not used. Some counselors might be more directive and steer the session the direction they wanted anyway, but I chose to try the approach of letting the client guide the topic of the day, while still being mindful of client resistance and avoidance of previous topics presented.
But I wanted this last session with this client to be memorable for her. And if I’m going to be honest, for me as well. What I had planned really seemed like the “perfect” ending, but that’s my bias about what the client “needed.” I have to trust that what the client “needed” is what she presented in the session today, and if it just so happened to coincide with this being our last session, I need to accept that. For all I know, something I said to her today was the most profound thing I’ve said all semester. Or maybe the “perfect” final activity I had planned would have turned out to be the most disastrous choice I’d made all semester.
I’ll never know. And I need to be okay with that.
Thieda, K. (2010). On Being a Student Therapist: Unsatisfying Endings. Psych Central. Retrieved on May 22, 2015, from http://psychcentral.com/blog/archives/2010/04/14/on-being-a-student-therapist-unsatisfying-endings/