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.
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Thanks for all your writings about your student therapy sessions. I’ve really enjoyed reading your perspective, and wish you the best of luck in your career!
“I think I’m pretty well grounded in the philosophy that the counseling relationship is not about me and my needs and wants.”
You have needs and wants. It’s just that those have mostly to be satisfied in a support system outside of therapy. You need that support system. That is what I think.
Oh this sounds so familiar. I remember feeling this way at the end of each of my 1 year internships in grad school. I usually have a very client-centered, systems approach to therapy but I found that it is so essential to allow for enough time to say goodbye (other than very young children I’ve rarely found less than 6 weeks sufficient). And during those 6 weeks I noticed I became much more directive, in the sense that I looked to find the connection to termination in everything the client brought in. We were taught that anything the client brings up since you initially address termination is all a reaction to termination itself. Almost all of my focus in sessions became about understanding that connection and I found that even if the client did not go into a deep heartfelt wonderful process of termination at the end, each and every final session with a client after that seemed more significant and meaningful. And you also have to trust that therapy continues long after the client stops seeing you. So that meaningfulness will come.
Wait until you get clients who just stop showing up to sessions and you don’t know what happened to them or why they left, let alone have a proper ending. Or clients who have to stop for money reasons.
How about designing a survey questionaire to be sent to those who decide to never come back? I’ve never heard of anyone implementing this in practice, but think it may be a good working tool for a therapist for improving outcomes or techniques.
People may be more likely to be direct if asked on paper rather than face-to-face. If the questionaire is designed appropriately, the results could be quantified and then analyzed. With patient feedback data collected over time, in addition to initial data tracking of patient demographics and characteristics, a therapist might find patterns and be able to run regressions to find correlations.
As a patient who has had several therapists in the past, I’d love to design an assessment strategy and questionaire for this purpose. It would be an interesting experiement.
im totally intrigued…what was your super awesome final activity?
I am with Shatani….what were your plans(without breaching any confidentiality rules or anything like that)…I am quite curious!
I am a student at college in the same university system (not the same college, though), and to respond to what S. said, I am allowed 10 individual sessions per academic year, and at the beginning, the middle, and the end of that time, I filled out questionnaires about my experience at the counseling center and with my therapist. It monitored changes in my responses as far as moods went, but I could also record anything that I didn’t like. I don’t know if her university uses the same system or not, but they might.
And from personal experience, my last session wasn’t my most memorable, but I got a ton out of all of my sessions. It doesn’t bother me at all that the last session was more like a typical session.
Thanks for the comments, all! Writing these blogs have been fun and a great way to reflect on my experiences as a student and counselor.
While I would love to share my “super awesome” plans for my final session, I am uber cognizant that I would not want any of my clients to be able to recognize themselves in my posts, should they ever come across them, so I don’t want to be specific. I will say it was a Gestalt technique that I had hoped would help the client reach some closure with her presenting issue. Sorry for being vague, but I know you understand that client confidentiality comes first.
@Kaycee’s comment: the clients do rating scales for each individual session, but there is no place to write comments, and it’s given directly to me at the end of sessions. I agree that a feedback questionnaire would probably be very helpful, especially for after counseling is complete. That is something I have thought about for once I am “out in the real world.”