Trauma-Informed Therapist | Clinical Supervisor | Group Private Practice Owner | Counselor Educator | Consultant, Trainer & Advocate for Culturally Responsive Mental Health Practices
Therapists, imagine it's your final session with a client, and they don't show up… You had everything planned for a beautiful termination* session: reflecting on highlights, exploring themes, expressing emotions, sharing gratitude for your time together, and possibly even engaging in expressive arts or a symbolic gesture for their next phase. But now, you won't get the chance to do any of that, despite witnessing their progress and spending so much meaningful time with them. I'll always remember a valuable lesson from my time as a graduate student intern at my university's counseling center. I was ready to celebrate the progress made with a client, only to have them not show up. I felt a mix of emotions—hurt, annoyance, disappointment, and sadness. I immediately discussed it with my clinical supervisor, who was on site that day. He reminded me that in the grand scheme of things, I was just one part of the client's life, seeing them once a week or every other week for about an hour. He reassured me that it's okay if goodbyes are difficult or if they prioritize their time in a different way. His wisdom comforted me and helped me see that the missed session didn't diminish the impact of my work with the client. Instead, it humbled me, allowed me to be vulnerable, and reminded me of my role in the client's life. As I mentioned, this experience was one of my earliest lessons in my journey to becoming a therapist. Over the years, I've come to realize that it's a situation many of us encounter. By sharing my own feelings, I hope to normalize the fact that therapists are human too. Having a supportive supervisor who is both skillful and empathetic can truly make all the difference in how we navigate these challenges. But you knew that! 😉 *Relatedly, I believe we can all agree that we need a more positive term for the final session than "termination." 😒 #mentalhealth #mentalhealtheducation #mentalhealththerapy #privatepractice #mentalhealthmatters #clinicalsupervision #therapy
I can relate to whatever you have mentioned here. Initially, when clients take time to come back or don't show up at all, it made me feel guilty. I began to feel not up to the mark and that I should improve myself to make them revisit. However, over a few experiences, I started to understand that the suggestions are to be implemented from the other end. So, if our part of support and recommendations are delivered properly we can allow ourselves to have a sigh of relief.
Chantal F.
6mo
So glad I came across this as of this week, I'm closing out with my clients and it's been a mix emotions and an experience. I told my client last night, I'm just grateful to be a small spec in your life and journey. ✨️☺️
Thank you for this. And I prefer graduation over termination 😅
Jenn H.
6mo
Monica P. Band It takes a lot of kindness and humility to view this type of cancelation in this way, and I totally agree with you. Every client does what's best for them in the moment, even if it may not be the choice we'd make for them clinically. Re: your last comment, idk if you've read "Decolonizing Therapy" by Dr. Jennifer Mullan, but she says that exact thing.
I go for "ending" rather than "termination" ☺️ agree that it's important to acknowledge that the ending might have felt too hard for the person (or another reason) and bid them a fond farewell in our minds, wishing them light, love, and peace on their onward journey
Thank you so much Monica P. Band for this genuine sharing of your daily practice. I also know how this feels like and I immediately thought that not showing up may also be a kind of neglecting or avoiding the goodbyes and the closing, it might also be hurtful for the client, and of course for the therapists!
Fiona Perkins
6mo
Always good to have an insight with the reason a client perhaps doesn't like endings. I usually start the ending process a few sessions before and start to discuss their fears about ending then nearer that last session I talk about how far they have come etc. The clients I've worked with are interested in this and what they actually discussed with me at the beginning. It shows the suffering of life is a process too and cannot be rushed but most are really happy on what they have learned and even achieved having therapy. I love that term "graduation" too
Ruth Houghton
6mo
I don't think I've ever called it 'termination', I prefer 'ending' I also reflect at times if a client doesn't show up for an ending appointment what that is about, who is the session important for. Some times they are ready to move on and don't feel the need to mark the end, other times endings can be hard for clients and there is avoidance involved in their decision to not attend. Great to explore in supervision though
I empower Psychologists on their professional development journey- mentorship, group supervision and trainings | Clinical Psychologist | New Zealand Psychologist Board
6moSuch a beautiful post Monica P. Band . Couldn't agree more! Oh yes, we need a better term than termination- it opens a pandora's box for both therapists and clients alike, isn't it? Recently, in my work with my clients I learnt, that not every client will take our invitation to process termination- and that's OK, because they are all entitled to choose what best serves them. At times, Early career Psychologists can resent that, and that's OK too, that's where supervision helps to tease out where the feelings are coming from.:) your post is a reminder how valuable reflective and supportive supervision spaces can be✨️