February 8, 2023 • 19 mins
Couch Talks is the bonus episode of You Need Therapy where listeners send questions to kathryn@youneedtherapypodcast.com.
This week we have a more specific follow up to last week's question about therapists finding closure when clients terminate the therapeutic relationship.
The three more detailed questions explored in this episode are:
1. How do you find a sense of closure when there is no final conversation to process ending a therapist-client relationship?
2. What is the best way to respond to an email when a client wishes to discontinue therapy for the time being?
3. Is there a way for early therapists to communicate that therapy is not only used to process negative thoughts and events, but also maintenance and process positive thoughts and events?
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Have a question, concern, guest idea, something else? Reach Kat at: Kathryn@youneedtherapypodcast.com
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Produced by: @HoustonTilley
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:09):
Hi guys, and welcome to a new episode of Couch
Talks on You Need Therapy Podcast. My name is Kat.
I am the host. And if you're new and you
don't know what couch Talks is, let me tell you.
It is the special bonus episode of You Need Therapy
where I answer questions that you guys send to me
and you can send those to me via email at
(00:31):
Catherine at you Need Therapy podcast dot com. And before
we get into the episode, quick reminder that I like
to give all the time that although this podcast is
about therapy and I'm answering some questions for you, it
does not serve as a replacement or substitute for actual
mental health services, although we always hope that this podcast
(00:51):
is helpful in some way. Okay, so I hope everybody
is having the day they need to have. I personally
am having a really good day. I just finished a
full day of clients and I had some really cool
sessions today and it was one of those days where
it just felt good to be a therapist, which is
nice to acknowledge because those days are not every day,
(01:14):
you know, And that actually has something to do with
the question we're gonna answer today. And also speaking of
last week's question, same things. Sometimes there's some tough things,
it's some uncomfortable things, and some you know, just not
so great things being a therapist, and so I think
it's really important, like any other job or any other thing,
to celebrate the winds and when things feel really good,
(01:35):
and today felt really good. When it comes to the question.
For those that are new, of course, reminder, I answer
one question a week and I keep them anonymous, so
I won't say your name, so you can feel like
you can send your question in and people are not
going to know that it's you unless you write very
obvious identifying information in the email, which in that case
(01:57):
I would just ask you maybe you don't do that.
So the question we have today is a follow up
to last week's question from couch Talks, and if you
didn't listen to last week's couch Talks, it was about
client termination and how to find closure when a client
terminates therapy. And what I mean by that is when
client ends therapy, and therapists can end therapy, but a
(02:18):
lot of times clients are the ones that do that,
and this specific listener, I wanted to know how to
kind of cope with that and find closure. I recorded
last week's episode before I got the context. I got
more contacts, so I want to talk about it again
because there's some more stuff that I think we can
talk about that might be helpful for anybody who is
processing the ending of a relationship. Specifically, we're talking about
(02:42):
the client therapist relationship from the therapist perspective, but I
think when it comes to closure, you can apply this
stuff to any relationship. And if you're somebody who goes
to therapy, it's really cool to hear this kind of
stuff because you know what's your responsibility, what's not your responsibility,
and kind of um some healthy expect patients. So here
is the email that I got clarifying what this client
(03:05):
was asking. They said, I am referring to when clients
terminate with the therapist without a final session to process
feedback and experiences, I can provide more context. I had
a client who I was working with for approximately thirty
sessions and then asked to take a pause when asking
her for feedback. She responded along the lines of I
(03:25):
don't have any specific feedback. I've gotten what I needed
of therapy for the time being and resolved the initial
issues that got me into therapy. There are feelings of
not getting closure on my part. I would be interested
in hearing your thoughts on the following one. How do
you find a sense of closure when there's no final
conversation to process the ending of a therapist client relationship
to what is the best way to respond to an
(03:47):
email like this when a client wishes to discontinue therapy
for the time being. Three is there a way for
early therapists to communicate that therapy is not only used
to process negative thoughts and events, but also for maintenance
and to process positive thoughts and events. Okay, so the
first thing, if you didn't listen to the first Couch
Talks from last week, go listen to that because it's
(04:09):
going to give a lot more context just about termination
in general. And remember couch stocks episodes are pretty shure,
so you can listen to them back to back and
get the good information in a timely manner or I
try to do that. So for this email, I'm going
to break it down with the three specific questions, and
what I'll start with before I get into that is
something that I hope anybody who listens to this podcast
(04:32):
kind of walks into whatever I say with this idea.
But I'm not the end all be all for any questions,
specifically this one. I'm going to share my experience in
my approach. But there is not just one approach to anything.
When it comes to therapy. There's not a right approach,
although there are some wrong approaches, and I think there
can be multiple healthy ways to help process and and
(04:55):
move through this stuff. So here my ideas, knowing that
there are other ideas out there that might also suit you.
The first specific question was how do you find a
sense of closure when there are no final conversations to
process the ending of a therapist client relationship. So your
closure the client's closure. Obviously, this person, this listener is
(05:18):
talking about their closure, and that's really important to identify
before I go into this. I, for one, operate from
the standpoint that closure is what we make it. Just
like in romantic relationships, when we want closure, I think
a lot of times we are actually looking for a
different outcome. So it's like when we go through breakups
and like I just want one more conversation to to
(05:39):
gain some closure. I just have some questions that I
need to answer it, And you know, I think we
can get closure with the information that we already have,
and oftentimes when we're in that space, we are wanting
to ask some of those questions because we want a
different answer, we want a different outcome, we want things
to be different, and instead of I want to be
able to actually just accept that this thing is over,
(05:59):
so we ask questions to gain answers when really we
have the answers and we just need to find acceptance.
So rather than closure, if it helps you, I might
encourage you to look at this, how do I find
acceptance that this relationship has ended? In my work? Here
is done? This email, the email that you got back
from your client really can be more than enough closure.
(06:20):
They got what they needed and really that's it. And
sometimes it gets pretty hard. I'm going to say this,
it's not so easy. And if if you're listening and
you aren't a therapist, you might be like, no, like
that's your job. Just it should be cut and dry.
But it can be pretty hard to remember sometimes that
therapy is not about us. And when we become a therapist,
we're literally saying except we might not be actually saying it,
(06:43):
so it's not literally, but we're saying, hey, I am
accepting the job that my feelings are second when it
comes to work, like that's part of our job, Like
we have to check them at the door, and we
have to really ask ourselves often, often, often, and often
Am I saying this because of me? I'm I saying
this for the client. And my one enclosure for me
(07:04):
and my one enclosure for the client is my closure
important to the client's healing process. Now, what I have
to remind myself is that it's not my client's responsibility
to help me feel better about anything, especially the work
that we do, whether we're doing a good job or
a bad job, And it's never our client's job to
take care of us. And when we start to feel
(07:26):
that way, that's a really good indicator that maybe I
need some supervision with this client in this case, in
what's going on with me, Maybe I need to do
some person of the therapist work, because if not, things
can get a little sticky and boundaries can get crossed,
and we might be doing harm when we're trying to
do good. And that's part of our ethical for a
(07:46):
license professional counselor, one of our ethical guidelines is do
no harm and do good. So I just want to
add in that acknowledging all of this is really really
a good thing, right, acknowledging when hey, I'm like dipping
my in the waters, that I'm not gonna be dipping
my toe in and everybody does that, It's really hard
to have such I mean, there's no such thing as
(08:07):
perfect strict emotional boundaries when it comes to the client
therapist relationship because it is a relationship, and emotions are
involved in relationships, and things can get a little bit strange.
So ask for feedback, ask for supervision, and like I
said in the episode from last week, talk to other
therapists that also are willing to admit that they struggle
(08:27):
with this stuff at times. So, again, going back to
the original question, closure can look a lot of different
ways with no termination session. There are clients that we
do that with, but there are also probably more often
than not, you don't get to have that, and you
don't get to have this really specific let's talk about
all the things we learned, and you say thank you
(08:47):
and I say you're welcome, and then we do this
song and dance thing, like we don't always really get
that and it's not always really necessary, And again it's
hard because when we see clients, we develop a relationship
with them, and we are humans, and so we have
to watch when that relations and ship bubbles over the edge.
And what's really important to also acknowledges. I can be
sad that a client's done with therapy and really excited
(09:07):
at the same time, I can be sad for myself
and then go process those emotions on my own and
be really excited for that therapist and not put my
desires for them on them, because if they're done with therapy,
that means they reached their goals, they did the work
they came here to do, and they are about to
go live the life that they want to live. Which
(09:27):
is another thing that I'm side tracking over here, but
it's really hard to remember as a therapist that we
have to stay on track with the goals of the client.
Where we might see, oh, your life would be better
if you did X y Z, or your life would
be better if you wanted X y Z. We have
to realize that we are not living their lives and
we're not looking through their lens. So we might have
(09:49):
an idea of some things that could be helpful, but
when it comes down to their desires, their wants, their needs.
They are in charge of identifying those and where helping
them work on their goals, not helping them get to
a place where they want the goals that we want
for them. Okay, so let's go onto the second specific question,
(10:15):
which was what is the best way to respond to
an email like this when a client wishes to discontinue
therapy for the time being. Like many things when it
comes to therapy, it depends. It depends often on a
client and where they are with their process. But if
a client has reached their goals and they want to
end therapy, I would probably respond something along the lines
(10:37):
of that's amazing. It's pretty cool to see a client
reach their goals, and I'm happy you got there, and
I'm really excited for you. I want you to know
that my door is open and if something pops back up,
you are more than welcome to reach back out, and
if I have space, I will welcome you back into
my schedule with open arms. I make sure to let
clients know like sometimes therapy is weekly, and sometimes you
(10:58):
move into a space where you're going every other weekends.
Sometimes it's maintenance and you're going once a month, or
maybe it's just when something comes I go back to
therapy and I see a therapist for six sessions or
three sessions, and I move on. And so I might
say something along the lines in that email as well,
reminding like, remember, if there's ever anything you need to
come in for, even if it's just one session, if
(11:19):
I have space in my my schedule for that to happen,
please do not hesitate to reach out and make that
a thing, because I do think that sometimes clients think that,
like if I'm not going every week, I'm not going
to be able to go back. No. I have clients
that I haven't seen in years that come in and like, hey,
I just need to process this for three sessions and
then I'm out of here. And I think that's really
(11:39):
cool because you've given them the tools to go out
and live their life. And sometimes new stuff pops up
and we need a little check in, you know, just
like I mean, we go to we don't go to
the doctor every week. Some people do, but when we're
in the maintenance phase of our health, we don't go
over a week. We go get a physical once a year.
I really think we should be doing that with our
mental health. But you know, I don't make the rules.
(12:02):
Let's say a client just had a really hard session, Like,
let's another example of this, and I get the feeling
that they might be running away from something. I may
say something different than I said in earlier in that
first example, like, Hey, I know last week was really tough,
and I totally get wanting to take a break from
it all. I think it would be really helpful to
at least talk through your decision before we end your therapy.
(12:25):
If you're up for that, let me know, we will
make sure to get you scheduled. If that's not something
you're interested in right now, I will respect your decision
and just know that the doors always open for you
in the future if you change your mind. I think
that's really important as a therapist to respect your clients
boundaries that our clients put in place, right because one
of the things we do is teach them about boundaries
(12:46):
and how they're important, and um continue to empower them
to know what's right for them, versus putting in the
assumption that we know better and that they should rely
on what we know. And it goes back to me saying,
like we have to be really clear you're on what
are the client's goals versus what are the goals that
I want the client to have, and I have to
respect that those are the client's goals. Now, this also
(13:10):
depends on the acuity of the population that you're working
with or the specific client that you have. It might
be different based on the protocols that your place of
work has. Um If you're in private practice by yourself,
you can make your own rules, but that's not always
the case. Also, different rules and regulations based on the
state you're in with contact and how to terminate sessions. However,
(13:32):
I do want to say when it comes to the
differences in acuity of clients, if you ever afraid that
a client is going to hurt themselves or they're not
going to be safe, we have to air on that
side of caution and make that known. And also you
got to document all of this stuff, which hopefully you've
been taught that in school that documentation is your best friend.
(13:53):
To make sure that what you're doing is taking care
of the client and you have a good record of
that very important. You don't want to learn that the
hard way. And then the third question was is there
a way for early therapists to communicate that therapy is
not only used to process negative thoughts and events, but
also maintenance and a process positive thoughts and events. What
(14:15):
I do is, in the first session with any client,
I have a whole spiel, right, So, you talk about
the limits of confidentiality, you talk about your cancelation policy, you,
I mean, all of the things that you just want
to let the client know. I I give a talk
about how therapy often gets worse before it gets better,
and if you ever feel like it's getting worse and
you want to hit the road, I'd love to have
(14:35):
a conversation about that, because the last thing we want
is for us to rip a band aid out off
and for you to run away and have it open wound.
And sometimes just we need to take things slower, and
we need to talk about that versus and them altogether.
So in this conversation is a really good place to say, like, hey,
my goal is to help you work on the goals
(14:56):
that you come to me with, and when we work
on those goals, I want to igno knowledge that and
I want you to acknowledge that because that's a big
deal and you might develop new goals or you might
want to take a break from setting goals, or you
might just want to find a way to build upon
and solidify and maintain the goals that you've reached. When
that happens, the way that we do therapy might change.
(15:18):
And I mean that in the way how often we meet.
And so I want you to know that just because
you're not coming in here with the crisis, it doesn't
mean that you no longer should want or even need
to come back into therapy. And therapy can look a
lot of different ways based on where you are in
your life. An easy way to say that is, Hey,
you might need to come here every single week for
(15:39):
a year, and then if you want to slow that down,
you're more than welcome to. And if you want to
take a break, you're more than welcome to. And once
you take that break and you want to come back,
you're more than welcome to. I want you to know
that you have a lot of autonomy and how often
you're coming to therapy, and we get to talk about
how you'll know when you need to maybe take a
step down, and how often we're working together. So you
(16:02):
get to create a little spiel for yourself that allows
the client to know, Hey, this is gonna look different
three years from now if you're still seeing me six months.
For now, it doesn't always have to look the same
way because we're working on goals that hopefully you'll reach.
So play around with some different ways to say that.
You can practice them on therapist friends. You can practice
that on therapists. You can practice that with clients and
(16:23):
see how it lands, and then allow clients to come
with you and check in. I used to never bring
up changing the pace of therapy with clients. I was
it was a rule that I had that, like, I
want clients to ask for what they need, so I'm
not going to say, hey, let's check in about this. However,
I sometimes think that with certain clients they need more
(16:45):
of a push, especially because we know some other stuff.
If they're people pleasing, if they have a hard time
with change, all of that. We might approach it and say, hey,
I know that you have a hard time with change,
and we've talked about that, and I think that this
is a really good way for us to apply that.
And here in now situation, and it looks like you've
reached some of these goals, and when you come in
(17:07):
to talk, you're kind of talking about just some really
simple things that you know, and I know that you
have the ability to process and work through on your own,
and so I want to make sure that you are
in a place where you are still wanting to come
do that and you're getting something out of that, versus
you might be afraid to change the pace of how
therapies go in and then that turns into a whole
(17:28):
therapy session. It's really cool the things that therapists can
make therapy that we don't really think our therapy. There's
tons of things like when things happen in the here
and now in the relationship between the therapist and the client,
those can be whole sessions. We can work on those
experience for a whole session, maybe an interaction that we've had,
or a miscommunication that we have had, or just something
(17:52):
that happens within this dynamic. Those things are allowed to
be brought into the room and used his therapy. So
this is a way to do some really good therapy
about things that are happening right now in the room
versus out there. Because what I like to say is
the therapy room is really good practice for how you
want to go outside into the real world and live
your life in a really safe place to practice that.
(18:13):
So I hope that was helpful. Round two and I
love these questions. If there are any therapists out there
or any clients who have experienced this are like, oh
my therapist handled it this way or this happened. I'm
a therapist. Is how I do that? Send me an
email Catherine at You Need Therapy Podcast and we can
share those thoughts, because, like I said in the beginning,
(18:34):
there's not one way to do all of this. There's
a way that worked for me and my style, and
I'm open to learning more and shifting. And like I
just said, I used to do things one way and
I've learned that I need to be more flexible in that.
So I'm open to hearing what you guys do. So again,
I hope that was helpful and it continues to be helpful.
Thank you for your question, thank you for clarifying your question,
(18:54):
and I hope you guys are having the day you
need to have. You can follow me on Instagram at
cat dot de fata and at You Need Therapy Podcast,
and again, email me all of your questions Katherine at
You Need Therapy Podcast dot com. I will be back
with you guys on Monday
Hi guys, and welcome to a new episode of Couch
Talks on You Need Therapy Podcast. My name is Kat.
I am the host. And if you're new and you
don't know what couch Talks is, let me tell you.
It is the special bonus episode of You Need Therapy
where I answer questions that you guys send to me
and you can send those to me via email at
(00:31):
Catherine at you Need Therapy podcast dot com. And before
we get into the episode, quick reminder that I like
to give all the time that although this podcast is
about therapy and I'm answering some questions for you, it
does not serve as a replacement or substitute for actual
mental health services, although we always hope that this podcast
(00:51):
is helpful in some way. Okay, so I hope everybody
is having the day they need to have. I personally
am having a really good day. I just finished a
full day of clients and I had some really cool
sessions today and it was one of those days where
it just felt good to be a therapist, which is
nice to acknowledge because those days are not every day,
(01:14):
you know, And that actually has something to do with
the question we're gonna answer today. And also speaking of
last week's question, same things. Sometimes there's some tough things,
it's some uncomfortable things, and some you know, just not
so great things being a therapist, and so I think
it's really important, like any other job or any other thing,
to celebrate the winds and when things feel really good,
(01:35):
and today felt really good. When it comes to the question.
For those that are new, of course, reminder, I answer
one question a week and I keep them anonymous, so
I won't say your name, so you can feel like
you can send your question in and people are not
going to know that it's you unless you write very
obvious identifying information in the email, which in that case
(01:57):
I would just ask you maybe you don't do that.
So the question we have today is a follow up
to last week's question from couch Talks, and if you
didn't listen to last week's couch Talks, it was about
client termination and how to find closure when a client
terminates therapy. And what I mean by that is when
client ends therapy, and therapists can end therapy, but a
(02:18):
lot of times clients are the ones that do that,
and this specific listener, I wanted to know how to
kind of cope with that and find closure. I recorded
last week's episode before I got the context. I got
more contacts, so I want to talk about it again
because there's some more stuff that I think we can
talk about that might be helpful for anybody who is
processing the ending of a relationship. Specifically, we're talking about
(02:42):
the client therapist relationship from the therapist perspective, but I
think when it comes to closure, you can apply this
stuff to any relationship. And if you're somebody who goes
to therapy, it's really cool to hear this kind of
stuff because you know what's your responsibility, what's not your responsibility,
and kind of um some healthy expect patients. So here
is the email that I got clarifying what this client
(03:05):
was asking. They said, I am referring to when clients
terminate with the therapist without a final session to process
feedback and experiences, I can provide more context. I had
a client who I was working with for approximately thirty
sessions and then asked to take a pause when asking
her for feedback. She responded along the lines of I
(03:25):
don't have any specific feedback. I've gotten what I needed
of therapy for the time being and resolved the initial
issues that got me into therapy. There are feelings of
not getting closure on my part. I would be interested
in hearing your thoughts on the following one. How do
you find a sense of closure when there's no final
conversation to process the ending of a therapist client relationship
to what is the best way to respond to an
(03:47):
email like this when a client wishes to discontinue therapy
for the time being. Three is there a way for
early therapists to communicate that therapy is not only used
to process negative thoughts and events, but also for maintenance
and to process positive thoughts and events. Okay, so the
first thing, if you didn't listen to the first Couch
Talks from last week, go listen to that because it's
(04:09):
going to give a lot more context just about termination
in general. And remember couch stocks episodes are pretty shure,
so you can listen to them back to back and
get the good information in a timely manner or I
try to do that. So for this email, I'm going
to break it down with the three specific questions, and
what I'll start with before I get into that is
something that I hope anybody who listens to this podcast
(04:32):
kind of walks into whatever I say with this idea.
But I'm not the end all be all for any questions,
specifically this one. I'm going to share my experience in
my approach. But there is not just one approach to anything.
When it comes to therapy. There's not a right approach,
although there are some wrong approaches, and I think there
can be multiple healthy ways to help process and and
(04:55):
move through this stuff. So here my ideas, knowing that
there are other ideas out there that might also suit you.
The first specific question was how do you find a
sense of closure when there are no final conversations to
process the ending of a therapist client relationship. So your
closure the client's closure. Obviously, this person, this listener is
(05:18):
talking about their closure, and that's really important to identify
before I go into this. I, for one, operate from
the standpoint that closure is what we make it. Just
like in romantic relationships, when we want closure, I think
a lot of times we are actually looking for a
different outcome. So it's like when we go through breakups
and like I just want one more conversation to to
(05:39):
gain some closure. I just have some questions that I
need to answer it, And you know, I think we
can get closure with the information that we already have,
and oftentimes when we're in that space, we are wanting
to ask some of those questions because we want a
different answer, we want a different outcome, we want things
to be different, and instead of I want to be
able to actually just accept that this thing is over,
(05:59):
so we ask questions to gain answers when really we
have the answers and we just need to find acceptance.
So rather than closure, if it helps you, I might
encourage you to look at this, how do I find
acceptance that this relationship has ended? In my work? Here
is done? This email, the email that you got back
from your client really can be more than enough closure.
(06:20):
They got what they needed and really that's it. And
sometimes it gets pretty hard. I'm going to say this,
it's not so easy. And if if you're listening and
you aren't a therapist, you might be like, no, like
that's your job. Just it should be cut and dry.
But it can be pretty hard to remember sometimes that
therapy is not about us. And when we become a therapist,
we're literally saying except we might not be actually saying it,
(06:43):
so it's not literally, but we're saying, hey, I am
accepting the job that my feelings are second when it
comes to work, like that's part of our job, Like
we have to check them at the door, and we
have to really ask ourselves often, often, often, and often
Am I saying this because of me? I'm I saying
this for the client. And my one enclosure for me
(07:04):
and my one enclosure for the client is my closure
important to the client's healing process. Now, what I have
to remind myself is that it's not my client's responsibility
to help me feel better about anything, especially the work
that we do, whether we're doing a good job or
a bad job, And it's never our client's job to
take care of us. And when we start to feel
(07:26):
that way, that's a really good indicator that maybe I
need some supervision with this client in this case, in
what's going on with me, Maybe I need to do
some person of the therapist work, because if not, things
can get a little sticky and boundaries can get crossed,
and we might be doing harm when we're trying to
do good. And that's part of our ethical for a
(07:46):
license professional counselor, one of our ethical guidelines is do
no harm and do good. So I just want to
add in that acknowledging all of this is really really
a good thing, right, acknowledging when hey, I'm like dipping
my in the waters, that I'm not gonna be dipping
my toe in and everybody does that, It's really hard
to have such I mean, there's no such thing as
(08:07):
perfect strict emotional boundaries when it comes to the client
therapist relationship because it is a relationship, and emotions are
involved in relationships, and things can get a little bit strange.
So ask for feedback, ask for supervision, and like I
said in the episode from last week, talk to other
therapists that also are willing to admit that they struggle
(08:27):
with this stuff at times. So, again, going back to
the original question, closure can look a lot of different
ways with no termination session. There are clients that we
do that with, but there are also probably more often
than not, you don't get to have that, and you
don't get to have this really specific let's talk about
all the things we learned, and you say thank you
(08:47):
and I say you're welcome, and then we do this
song and dance thing, like we don't always really get
that and it's not always really necessary, And again it's
hard because when we see clients, we develop a relationship
with them, and we are humans, and so we have
to watch when that relations and ship bubbles over the edge.
And what's really important to also acknowledges. I can be
sad that a client's done with therapy and really excited
(09:07):
at the same time, I can be sad for myself
and then go process those emotions on my own and
be really excited for that therapist and not put my
desires for them on them, because if they're done with therapy,
that means they reached their goals, they did the work
they came here to do, and they are about to
go live the life that they want to live. Which
(09:27):
is another thing that I'm side tracking over here, but
it's really hard to remember as a therapist that we
have to stay on track with the goals of the client.
Where we might see, oh, your life would be better
if you did X y Z, or your life would
be better if you wanted X y Z. We have
to realize that we are not living their lives and
we're not looking through their lens. So we might have
(09:49):
an idea of some things that could be helpful, but
when it comes down to their desires, their wants, their needs.
They are in charge of identifying those and where helping
them work on their goals, not helping them get to
a place where they want the goals that we want
for them. Okay, so let's go onto the second specific question,
(10:15):
which was what is the best way to respond to
an email like this when a client wishes to discontinue
therapy for the time being. Like many things when it
comes to therapy, it depends. It depends often on a
client and where they are with their process. But if
a client has reached their goals and they want to
end therapy, I would probably respond something along the lines
(10:37):
of that's amazing. It's pretty cool to see a client
reach their goals, and I'm happy you got there, and
I'm really excited for you. I want you to know
that my door is open and if something pops back up,
you are more than welcome to reach back out, and
if I have space, I will welcome you back into
my schedule with open arms. I make sure to let
clients know like sometimes therapy is weekly, and sometimes you
(10:58):
move into a space where you're going every other weekends.
Sometimes it's maintenance and you're going once a month, or
maybe it's just when something comes I go back to
therapy and I see a therapist for six sessions or
three sessions, and I move on. And so I might
say something along the lines in that email as well,
reminding like, remember, if there's ever anything you need to
come in for, even if it's just one session, if
(11:19):
I have space in my my schedule for that to happen,
please do not hesitate to reach out and make that
a thing, because I do think that sometimes clients think that,
like if I'm not going every week, I'm not going
to be able to go back. No. I have clients
that I haven't seen in years that come in and like, hey,
I just need to process this for three sessions and
then I'm out of here. And I think that's really
(11:39):
cool because you've given them the tools to go out
and live their life. And sometimes new stuff pops up
and we need a little check in, you know, just
like I mean, we go to we don't go to
the doctor every week. Some people do, but when we're
in the maintenance phase of our health, we don't go
over a week. We go get a physical once a year.
I really think we should be doing that with our
mental health. But you know, I don't make the rules.
(12:02):
Let's say a client just had a really hard session, Like,
let's another example of this, and I get the feeling
that they might be running away from something. I may
say something different than I said in earlier in that
first example, like, Hey, I know last week was really tough,
and I totally get wanting to take a break from
it all. I think it would be really helpful to
at least talk through your decision before we end your therapy.
(12:25):
If you're up for that, let me know, we will
make sure to get you scheduled. If that's not something
you're interested in right now, I will respect your decision
and just know that the doors always open for you
in the future if you change your mind. I think
that's really important as a therapist to respect your clients
boundaries that our clients put in place, right because one
of the things we do is teach them about boundaries
(12:46):
and how they're important, and um continue to empower them
to know what's right for them, versus putting in the
assumption that we know better and that they should rely
on what we know. And it goes back to me saying,
like we have to be really clear you're on what
are the client's goals versus what are the goals that
I want the client to have, and I have to
respect that those are the client's goals. Now, this also
(13:10):
depends on the acuity of the population that you're working
with or the specific client that you have. It might
be different based on the protocols that your place of
work has. Um If you're in private practice by yourself,
you can make your own rules, but that's not always
the case. Also, different rules and regulations based on the
state you're in with contact and how to terminate sessions. However,
(13:32):
I do want to say when it comes to the
differences in acuity of clients, if you ever afraid that
a client is going to hurt themselves or they're not
going to be safe, we have to air on that
side of caution and make that known. And also you
got to document all of this stuff, which hopefully you've
been taught that in school that documentation is your best friend.
(13:53):
To make sure that what you're doing is taking care
of the client and you have a good record of
that very important. You don't want to learn that the
hard way. And then the third question was is there
a way for early therapists to communicate that therapy is
not only used to process negative thoughts and events, but
also maintenance and a process positive thoughts and events. What
(14:15):
I do is, in the first session with any client,
I have a whole spiel, right, So, you talk about
the limits of confidentiality, you talk about your cancelation policy, you,
I mean, all of the things that you just want
to let the client know. I I give a talk
about how therapy often gets worse before it gets better,
and if you ever feel like it's getting worse and
you want to hit the road, I'd love to have
(14:35):
a conversation about that, because the last thing we want
is for us to rip a band aid out off
and for you to run away and have it open wound.
And sometimes just we need to take things slower, and
we need to talk about that versus and them altogether.
So in this conversation is a really good place to say, like, hey,
my goal is to help you work on the goals
(14:56):
that you come to me with, and when we work
on those goals, I want to igno knowledge that and
I want you to acknowledge that because that's a big
deal and you might develop new goals or you might
want to take a break from setting goals, or you
might just want to find a way to build upon
and solidify and maintain the goals that you've reached. When
that happens, the way that we do therapy might change.
(15:18):
And I mean that in the way how often we meet.
And so I want you to know that just because
you're not coming in here with the crisis, it doesn't
mean that you no longer should want or even need
to come back into therapy. And therapy can look a
lot of different ways based on where you are in
your life. An easy way to say that is, Hey,
you might need to come here every single week for
(15:39):
a year, and then if you want to slow that down,
you're more than welcome to. And if you want to
take a break, you're more than welcome to. And once
you take that break and you want to come back,
you're more than welcome to. I want you to know
that you have a lot of autonomy and how often
you're coming to therapy, and we get to talk about
how you'll know when you need to maybe take a
step down, and how often we're working together. So you
(16:02):
get to create a little spiel for yourself that allows
the client to know, Hey, this is gonna look different
three years from now if you're still seeing me six months.
For now, it doesn't always have to look the same
way because we're working on goals that hopefully you'll reach.
So play around with some different ways to say that.
You can practice them on therapist friends. You can practice
that on therapists. You can practice that with clients and
(16:23):
see how it lands, and then allow clients to come
with you and check in. I used to never bring
up changing the pace of therapy with clients. I was
it was a rule that I had that, like, I
want clients to ask for what they need, so I'm
not going to say, hey, let's check in about this. However,
I sometimes think that with certain clients they need more
(16:45):
of a push, especially because we know some other stuff.
If they're people pleasing, if they have a hard time
with change, all of that. We might approach it and say, hey,
I know that you have a hard time with change,
and we've talked about that, and I think that this
is a really good way for us to apply that.
And here in now situation, and it looks like you've
reached some of these goals, and when you come in
(17:07):
to talk, you're kind of talking about just some really
simple things that you know, and I know that you
have the ability to process and work through on your own,
and so I want to make sure that you are
in a place where you are still wanting to come
do that and you're getting something out of that, versus
you might be afraid to change the pace of how
therapies go in and then that turns into a whole
(17:28):
therapy session. It's really cool the things that therapists can
make therapy that we don't really think our therapy. There's
tons of things like when things happen in the here
and now in the relationship between the therapist and the client,
those can be whole sessions. We can work on those
experience for a whole session, maybe an interaction that we've had,
or a miscommunication that we have had, or just something
(17:52):
that happens within this dynamic. Those things are allowed to
be brought into the room and used his therapy. So
this is a way to do some really good therapy
about things that are happening right now in the room
versus out there. Because what I like to say is
the therapy room is really good practice for how you
want to go outside into the real world and live
your life in a really safe place to practice that.
(18:13):
So I hope that was helpful. Round two and I
love these questions. If there are any therapists out there
or any clients who have experienced this are like, oh
my therapist handled it this way or this happened. I'm
a therapist. Is how I do that? Send me an
email Catherine at You Need Therapy Podcast and we can
share those thoughts, because, like I said in the beginning,
(18:34):
there's not one way to do all of this. There's
a way that worked for me and my style, and
I'm open to learning more and shifting. And like I
just said, I used to do things one way and
I've learned that I need to be more flexible in that.
So I'm open to hearing what you guys do. So again,
I hope that was helpful and it continues to be helpful.
Thank you for your question, thank you for clarifying your question,
(18:54):
and I hope you guys are having the day you
need to have. You can follow me on Instagram at
cat dot de fata and at You Need Therapy Podcast,
and again, email me all of your questions Katherine at
You Need Therapy Podcast dot com. I will be back
with you guys on Monday
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