Proper Termination
Photo credit: Ruit Miit (Unsplash)
Ah, graduation season. College students are getting their caps and gowns, stores are filled with "Congrats Grad!" party swag, final exams and papers are wrapping up, and so are internships. A social work internship, or "field work", is a crucial aspect of social work education. After all, there's only so much we can learn from a textbook. Internships are where future clinicians get to put theory into practice--the most vital therapy skills are learned through direct contact with real, live people.
Termination is the process of disengaging and ending a therapeutic relationship. It is important to allow clients enough time to process their feelings of saying goodbye. This might be very challenging for some folks, particularly if they have abandonment or attachment issues, and/or a clinician made a profound impact on their lives. That is why we must give ample time to process these feelings.
In many clinical settings, the suitable length of time for termination is typically around 3 sessions or meetings, or more. This is important because it allows for at least 1 session to deliver the news, another session to process feelings that came up from it after giving the client time to think, and then the final goodbye. Without that time to prepare and examine feelings, termination can be a shock to a client, and that is certainly not in the best interest of their wellbeing.
Termination may lead to feelings of anxiety, potentially a backslide from progress, can reopen old wounds, and more. If a client is in crisis or a danger to themselves or others, the termination timeline may not be linear. As an intern, your supervisor and agency will have specific protocols and offer assistance during this process. For licensed professionals, it is unethical and, in fact sometimes illegal, to terminate under some circumstances and the process may be delayed until safety is established.
There are some important components to good termination. These may include, when applicable, a review of goals and successes, a plan for continued care, referrals and assistance in transition to a new provider, emergency planning, and room for questions. It may be appropriate, in some settings, to write a termination letter. Sometimes, post-termination follow up may be appropriate, but I caution interns to be very weary of blurring any lines. The relationship must always remain purely professional, even after discharge. Your agency will assist you with appropriate contact methods, if appropriate. And always document all aspects of the termination process (just like everything else).
It's also noteworthy that the termination process can be difficult for the intern or clinician as well. Particularly early on in one's career, we feel strong connections because the world of clinical work is brand new and the student is experiencing leaps and bounds of growth. Interns are growing in empathy and perhaps hearing some pretty wild stories that may feel very heavy to handle. Clinicians are allowed to feel their feelings too! Self-care and sticking to the process of termination are good ways to manage the feelings that arise.
The end of a school year isn't the only time we need to terminate. Some therapeutic encounters have a set length of time (such as in brief therapy or inpatient treatment), sometimes clients must stop services due to an inability to pay, termination happens when goals are met and the therapeutic encounter reaches its natural conclusion, sometimes people move away, and there are numerous other reasons. When possible, the same termination rules apply to most of these circumstance.
If you have a story about termination, please feel free to share it!
