Counseling Today, Online Exclusives

The loss of a meaningful relationship

By Kristin Schofield May 4, 2016

As counselors, we are trained to focus on our clients’ needs and assist them through the therapeutic process. This focus on client needs is highlighted in the termination process. Counselors are trained to help clients prepare for termination from the beginning of therapy, to support clients through the termination of therapy and to ensure that termination is not unnecessarily delayed because of the counselor’s own needs or desires.

However, termination can be a deeply moving phase of therapy not just for clients, but also for clinicians. Viewed through the lens of attachment, counselors might expect to experience feelings of sadness and loss intermingled with feelings of hope and accomplishment during the termination phase. Because of the focus on client needs, the poignancy of this phase for clinicians appears often to be ignored, perhaps diminishing the process for both the clinician and the client.

Navigating the termination phase with all of my clients as I completed my internship brought up deep emotions for me that needed to be processed. I personally sought out information from others and Depositphotos_38192737_m-2015guidance from the literature but, surprisingly, there is little research addressing the loss the therapist feels during the counseling termination process.

One of the more encouraging sources I found was an older article in which the author said the counseling relationship could be viewed as an attachment bond and that termination could activate the attachment system (see “Caregiving in attachment relationships: A perspective for counselors” in the Fall 1999 issue of the Journal of Counseling & Development). This affirmed and normalized my feelings around the loss of the relationships I was experiencing. Although the article was helpful in supplying a theoretical framework for the experience, it provided little guidance to me as a novice counselor on how to navigate and perhaps utilize my own experience in the termination phase. Most of the other available research simply describes clients’ feelings of grief and loss during the termination process and is silent on the counselor’s feelings.

Fortunately, relationship loss and transition are not unique to the clinical experience. The field of anthropology provides rich information on how cultures use (and have used) rituals and ceremonies to denote transitions and commemorate transformation. Rituals and ceremonies can restore dignity, acknowledge a relationship or significant event, provide a new status, assist in integrating changes into a personal framework, mark development and reduce isolation.

Looking within the field of anthropology, I came across “definitional ceremonies,” a term coined by anthropologist Barbara Myerhoff. These ceremonies are a tool counselors can use to address both the therapist and the client in the counseling termination process.

In a 2012 article (“A narrative approach to terminating therapy”) in the Journal of Professional Counseling, Practice, Theory & Research, Stephen A. Lenz, Manual X. Zamarripa and Stephanie Fuentes described five stages of a definitional ceremony: initiation, preparation, participation, emancipation and commemoration.

The initiation stage, or first stage, is one in which the client and therapist discuss the definitional ceremony. This can be discussed in the first or second therapy session with the client.

The preparation stage involves the therapist and the client discussing the ceremony agenda, who will be invited to serve as an insider witness and what artifacts will be used. According to the authors, insider witnesses are significant people in the client’s life who have known the client while he or she has been in therapy. Artifacts are items that represent or commemorate the client’s therapeutic transformation.

The participation stage is when the client tells his or her transformation story that could include changes, themes or future wishes. The insider witnesses listen to the story, ask questions and provide input on the story. The client and the witnesses collaborate in creating a consensual transformation story. The counselor’s role in the ceremony is to present the artifacts, assist in the meaning-making of the ceremony and create a safe atmosphere for the client and witnesses.

In the emancipation stage, the counselor reiterates the images, themes and significance of the client’s transformation. According to Lenz and his co-authors, the counselor may also ask to retell the client’s story in the future with someone who is having a similar journey.

Commemoration is the final stage of the definitional ceremony. The client is presented with a certificate that contains his or her name, completion of therapy date, the transformation theme and an applicable quote. The counselor, client and witnesses can then celebrate, potentially using cake, music, balloons or other symbols of celebration.

As Lenz and his co-authors describe, the counselor writes a letter to the client after the ceremony is completed. The letter contains a summary of the ceremony, what aspects of the ceremony resonated with the counselor, the client’s strengths and the counselor’s hopes for the client’s future. This letter provides the therapist with a way of expressing how the client has transformed. It may assist in closure for the therapist and aid the therapist in processing the change in the attachment relationship, while keeping the client the focus of therapy.

The definitional ceremony can provide both the client and the counselor with closure in the termination process. It may also utilize the counselor’s experience in the termination process to further the client’s therapeutic process.

Depending on the client’s needs, I might utilize all stages of the ceremony or only one or two stages. Some of the stages could be adapted based on location or monetary limitations. For example, a small counseling office could limit the number of insider witnesses, or the symbols of celebration could be omitted.

Termination is an integral phase of therapy for both the client and the clinician. The attachment bond can provide another framework for the meaningful relationship between the counselor and client. The definitional ceremony addresses the therapeutic attachment bond. The five stages of the definitional ceremony can assist the client and clinician in processing the significance of the relationship, highlighting the client’s transformation and providing closure.

 

 

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Kristin Schofield, a member of the American Counseling Association, is working toward counselor licensure and eye movement desensitization reprocessing certification. She works with women dealing with trauma. Contact her at krsmr6@gmail.com.

 

2 Comments

  1. Tamara Suttle

    Thank you for addressing this issue. Termination can be both a celebratory and sad event. I appreciate you addressing this in terms of loss. It’s something that is not addressed often enough in our graduate programs and the emotions that arise can be particularly disorienting for new clinicians who gave little forethought to this stage of practice. I’m happy to share this with my colleagues and supervisees.

    Reply

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