Measuring Client Readiness for Closure of Therapy

In case you missed the video on closure, watch it here!

You’re a supervisor helping a supervisee determine the status of their caseload. Or perhaps you are a clinician wondering how best to measure a client’s readiness for closure. Although each client case is unique, there are several things to remain aware of that can help mental health professionals start the conversation on closure of therapy with their clients from an informed, empowered place of collaboration.

Clinicians may determine that a conversation on closure can occur when the following are present:

1)    Treatment goals have been met—Upon reviewing a client’s treatment plan and recognizing their goals have been met, there is reason to celebrate with the client, followed by exploring what they need next.

2)    Notes become brief/harder to write—As the mental health professional, you may recognize notes become more brief, repetitive, or start to feel more difficult to write. This could be due to a shift from deeper therapeutic work to maintenance in therapy.

3)    A shift to maintenance or “Coffee Shop Talk”—Not only would this show up in the content of your notes, you may recognize that therapy sessions feel more like check-ins of events rather than deeper work.

4)    Feelings of Boredom—Let me be the first to normalize how moving into maintenance may create some boredom for you as the therapist if things are feeling surface level. I feel this way, often. Especially if you enjoy the deeper processing within the therapeutic work with your clients.

Additionally, clients may determine they are ready for maintenance or closure from therapy when:

1)    No further goals are identified—Clients may come to the natural conclusion to end therapy if their goals are met and they have no further goals identified to work on at this time.

2)    Feel dread or avoidance about sessions—An important piece to normalize with clients, feelings of avoidance or dread due to having limited content to talk about therapeutically may be justification for moving to maintenance and/or developing plans to close out of therapy.

3)    Frequent cancellations—Some clients may feel discomfort at the thought of closing therapy due to their own anxiety or worries of how their therapist will respond. Instead, they may start cancelling more frequently as a passive approach to ending therapy.

4)    Talk stays surface level or doesn’t last a full session—Some clients will notice that they don’t have much to share with their therapist week to week, including feeling like they are ready to wrap up earlier than their scheduled session time. This could be a great opportunity to offer maintenance such as biweekly or monthly sessions and/or develop plans to close where the client has a say in the process.

Conversations about closure from therapy are just as important as setting expectations of therapy. For clients, it may feel unexpected to discuss the closure process. However, it’s important to normalize that therapy isn’t meant to last forever, instead focusing on setting realistic expectations for a beginning, middle, and empowered end to therapy as a client progresses with their goals.

Check out Khara’s blog on the structure and elements of a client graduation from therapy for additional ideas.