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Endings – whether planned or unplanned – can be tough, both for the client as well as the clinician, as termination is fraught with emotional dynamics. Yet endings, if navigated properly, can also be healing and serve as powerful growth points. In this training, we will explore the various ways in which clinicians can facilitate positive termination experiences with their clients. We will discuss clinician- and client-initiated endings and examine the psychological dynamics inherent in each. We will also review best ethical practices when it comes to managing client referrals, planned breaks such as vacations, and (un)expected interruptions of service.

Upon completion of this training, participants will be able to:

  • Identify different ways that a clinical relationship with a client can end
  •  Discuss how to best navigate terminations with clients
  •  Recognize the psychological dynamics that are a part of the termination process, both for the client as well as for the clinician
  •  Describe how to best manage referrals, planned breaks, and interruptions of service

Syllabus:

Objective #1: Understanding Termination in Therapy

  • Identify the different ways a clinical relationship may come to an end
  • Explore the emotional and psychological impact of termination on both client and clinician
  • Examine cultural influences on how endings are handled in therapy and society

Objective #2:Clinician-Initiated Endings

  • Review reasons for clinician-initiated termination including illness, retirement, relocation, or completed goals
  • Discuss ethical grounds for ending therapy such as safety concerns, lack of benefit, or dual relationships
  • Understand legal and professional standards regarding nonpayment and clinician competence

Objective #3:Client-Initiated Endings

  • Identify client-driven reasons for ending including financial changes, dissatisfaction, or relocation
  • Recognize unplanned terminations and their emotional impact on the client and therapeutic process
  • Explore the concept of client abandonment and strategies to avoid it

Objective #4:Preparing for a Planned Ending

  • Begin therapy with the end in mind through clear goal setting
  • Signal upcoming endings and create space to process related emotions
  • Review the therapy journey including growth, highlights, and remaining concerns
  • Discuss future plans, support systems, and unfinished business

Objective #5:Honoring the Therapeutic Relationship

  • Invite clients to reflect on the meaning of the relationship and what they are taking away
  • Offer space for mutual feedback on the experience of therapy
  • Explore appropriate boundaries for future contact
  • Incorporate rituals such as letter writing, tokens of appreciation, and symbolic crafts

Objective #6: Navigating Client Dropouts

  • Understand statistics and reasons behind therapy dropout
  • Identify risk factors including age, diagnosis, rapport, and socio-economic barriers
  • Develop practices to reduce dropout such as early education, check-ins, and clear expectations
  • Document all efforts to reach out and follow ethical guidelines in unexpected endings
  • Support clinician self-reflection and emotional processing after a client leaves therapy

Social workers completing this course receive 2 Clinical asynchronous continuing education credits.

For other board approvals, this course qualifies for 2 Clinical continuing education training.

Instructor: Dreya Blume, LCSW

Recording Date:  1/18/2024

CEUS On-Demand, LLC, provider #2274, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/7/2026 - 08/6/2027. Social workers completing this course receive 2hrs Clinical continuing education credits.  

CEUs On-Demand, LLC has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7091. Programs that do not qualify for NBCC credit are clearly identified. CEUs On-Demand, LLC is solely responsible for all aspects of the programs.

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Request for Special Accommodations: Learners can request special accommodations by contacting the administrative team at admin@ceus-ondemand.com


Course Instructor: Dreya Blume is a licensed clinical social worker, with her MSW from Radford University and an MA in anthropology from the University of Hawaii. Dreya has twenty years of experience working in mental health, from case management to intensive in-home services to leading groups for addicts in recovery. Dreya began a part-time counseling practice in 2004, and as a psychotherapist, her focus has been on serving the LGBTQ+ community. Dreya also has been a teacher for thirty years. Prior to her career in social work, she taught English in places such as Japan, Thailand, Australia, and Hawaii. Since 2010, Dreya has been an adjunct professor for Virginia Western Community College, preparing future social workers for the field. In her spare time, Dreya loves to write. She is the author of a number of books (published under her former name, Andy Matzner), including “Everyone Has a Story: Using the Hero’s Journey and Narrative Therapy to Reframe the Struggle of Mental Illness,” “The Tarot Activity Book: A Collection of Creative and Therapeutic Ideas for the Cards,” and “The Buddha Diet: A Guide to Creating a Positive Relationship with Food and Eating.”

Course Content

Begin Lesson – Endings and Transitions in Therapy
Endings and Transitions in Therapy
Online Training Evaluation For Asynchronous