I am doing my practicum placement in a high school, and I plan to return there next year after a summer break. Several of my clients have said they want to see me again in the fall, so I’m wondering how to talk with them about taking a break and returning to therapy.
It is wise to think ahead about how to handle this situation. I would recommend thinking of the therapy as ending when the school year is over with the possibility of resuming when school begins in the fall. There are many factors outside of the control of you and your student clients that make the continuation of your relationship uncertain. For example, they may move, their presenting issues and symptoms may improve or worsen in a way that changes the decision about your work with them, or the school may set different priorities for which students can receive therapy. There are clinical benefits for clients to engage in a thoughtful process of termination, and they will miss those benefits if you assume continuation of therapy and it isn’t possible to do so.
I have previously published some general guidelines related to psychotherapy termination which may be helpful to reference (Psychotherapy Termination and Termination Tasks). There are some additional issues that are present when you may be resuming therapy in a few months. The first is the variation in your feelings of closeness and enjoyment with different clients. Talk with your supervisor about your countertransference feelings related to all of your student clients and your preference for seeing them next year or discontinuing permanently. It is important to examine these preferences and to discuss your plans to return to the placement next year in the same way with all of your clients. If you are more explicit with some clients than others about returning to therapy next year, you are probably expressing your countertransference, unless your statement is based on a clear clinical decision approved by your supervisor. Examining and understanding the countertransference is preferable.
A second issue is the likelihood of changes in the life of your clients over the summer, both logistically and psychologically. The client may feel differently about therapy in a few months, and issues in her life may change in a way that affects her decision. Your desire to focus on the continuation rather than termination of therapy may be a way of avoiding the potential loss of ending your therapeutic relationships and the realistic ambiguity about the coming school year. Maintaining a focus on the ending of the current therapy by reviewing the progress that has been made and acknowledging the importance of your relationship with each other provides more therapeutic benefit to your client.
Third, talk with your supervisor about recommendations you may make to your clients and their parents about ways to reinforce the gains they have made in therapy. Parents and teenagers often view summer as a time for vacation from therapy, especially when therapy has taken place at school. However, your clients may be participating in activities that provide opportunities to practice some of the coping skills they have acquired or to take on new social and emotional challenges.
I hope you find this helpful in managing psychotherapy termination when the circumstances are ambiguous. Please email me with comments, questions, or suggestions for future blog topics.