Last week, after 3 years of practice, I closed the doors to my Palo Alto office location. Over the last year, I have gradually been transitioning to a full time practice in Sacramento, where I recently moved. As much as I am excited to be fully grounded in the Sacramento community, and to be able to stop the weekly commute between the two locations, there is also a sadness as I have had to say farewell to many clients who I have been working with for some time.
Final sessions (or terminations, in therapist jargon) in therapy come for many different reasons. Sometimes the client’s goals have been met and the therapy in no longer necessary. Sometimes scheduling conflicts, financial constraints, or other practical issues interfere with therapy continuing. Then there are times when either the therapist’s or client’s life changes (moving, new jobs, having children, etc) lead to an end of the therapy. What ever brings about that final session, when it arrives, it may come with a mix of emotions.
In the final sessions, I typically try to reflect with the client on the initial goals that brought them in, and where they feel they are with accomplishing those goals. We discuss what the client has learned about themselves, and themes that were important in the therapy. We also take time to consider areas where the client would like to continue to grow and how they would like to pursue this growth. If it is necessary, we discuss referrals or ways that the client can continue to grow on their own. Relapse prevention and considering what to do if relapse does occur are also topics to examine. Finally, we take time to discuss our relationship, how we have felt about each other during the work, and how it feels to be ending our time together. The therapeutic relationship is unusual as it is one in which great intimacy is shared and yet it has a clear and definite ending. In other close relationships, we say goodbye and expect to speak with the person again at some point in the future, but in the therapeutic relationship you may never have contact again. Clients sometimes experience feelings of sadness about this ending, while other times they feel it is a relief to be done and moving forward without the therapist’s support.
People often ask me how ending with clients is for the therapist. Do therapists feel a loss with an ending? In my case, the answer is absolutely. While the length of time we have worked together and the kind of work we have done, certainly affects how close I feel to a client, I almost always feel some sadness when saying goodbye. I feel honored that they have trusted me with their thoughts and feelings over the time we have spent together and while I experience joy at their successes that lead to them no longer needing my support, I know that I will miss them. I often find memories of my past clients will be triggered and make me smile or wonder what has become of them. Therefore, even when therapy has come to a close, both the client and I carry the shared memories with us as we go forward on our own.