Transcript for:
Mastering the Art of Therapy Closure

But starting off with that theory and practice, the ending of a session or the art, Rory, of closing a therapy session, is it an art? It is an art. It is an art, Ken. And I think it speaks to something called deliberate practice.

And that was a term, I guess, that first came into the vocabulary of psychotherapists in 2016 with the publishing of the book Deliberate Practice for Psychotherapists, a Guide to Improving Clinical Effectiveness. And it was written by an American counsellor called Tony Rousmarini, if I pronounced his name correctly. And what deliberate practice really is, is to be really thoughtful of how you work, how you use any of the skills or approaches within therapy.

And getting feedback on them and developing them and honing those skills, you know, getting that craft really high. high quality points, if you like. I'm thinking of someone who's a furniture maker, a cabinet maker, you know, beautifully finishing off the work that they do. So it's absolutely lovely.

And, you know, closing the counselling skills session, as we both know, Ken, certainly for students can be tricky. There's a lot of pitfalls. And the first observation I'd make, and I don't know if you'd agree with me, Ken, is that when we think of closing a session, we need to be thinking of that.

right from the beginning of our engagement. And that can be something as simple as having a clock or some kind of time measuring device behind the client because there's nothing worse, is there, than not knowing how long you've got. Yeah.

You know, as humans, we're not very good at counting the time. I mean, there must be some people who've got a chronometer in their head. But generally speaking, I don't know about you, but I need some kind of... time measuring device and we don't want people looking at the phones or looking at the watches when they're you know connected with a client we don't want to be in a situation where we're dropping out of process so just having i used to take a little alarm clock with me and switch the alarm off obviously and have it placed behind the client so that when i was looking at the client i could just slightly look away and see what the time is so setting up you know the ending in advanced thinking forward and using that deliberate practice I think is essential as a first point Ken.

Oh yes and I guess I mean each and every session we hold is going to have an end point to it and we would generally contract before we even start working with a client with how long a session is but a client can have material that they're bringing sometimes and you were speaking about students Rory I know from from students that we have taught may suggest oh I didn't want to interrupt you know and and it was okay for me to go five minutes over and it was okay for me to go 10 minutes over and of course we're speaking about moving past boundaries that have been set in when we first contract with that client we say maybe they they have 60 minutes within a therapy session within mine I would say that'll be five minutes to say hello and check in and then I'll let you know five minutes before the ending so we can kind of wrap that up so we kind of contracted to that therapeutic time that we're going to be spending. And when we overrun of that, we are starting to move those boundaries. And what kind of a signal might that send to the client?

And I understand we may be willing, and we may want to maybe be there, we might not have another client coming after that. But what can happen when we fall into those habits is that when we do become busy, or maybe take up another position or a job in an agency where we do have a number of clients one after another. We have to factor in that we need to after a client leaves, maybe process and maybe put some notes down and prepare ourselves to become be ready for the next clients.

It's unfair to future clients if we're overrunning and of course, to the client that we contracted and gave the boundaries to in the in the first place. Not wanting to interrupt, as I've already mentioned, feeling that you don't want to look at your watch, what kind of a signal might that send to a client? oh, I'm so bored of what you're saying, I'm now going to look at my watch to see when this is going to end.

So there are some tricks here that you can use. One trick is sometimes you can look at the client's watch. You don't need to be able to see it in great detail to understand where the hands are.

So you don't need to be able to read the minutia of that, but you can sometimes see on a client's watch. If you wear your watch backwards, so that the actual watch face sits on your wrist, it's easier to glimpse the time. But as you said, Rory, best practice is keeping your time. by having a time keeping device a clock using big words today big therapeutic words time keeping device that you can see and when i first took this to supervision um what what we kind of came out with was that i in my practice also want a clock that the client can see and within my practice when i was running it a client had a choice of where they would sit so whatever seat you sat in there was a clock there and the within your site without having to strain to look at it. And the reason for having a clock that the client can see is because the client also then is able to see when the end of that session is coming because they know the time boundaries and they might self-regulate of maybe something that they'll keep for next time rather than delve into now, rather than giving what we call a doorknob ending where they kind of drop something heavy in at the end.

I guess that those are parts of the art of that closing the session, Rory. Absolutely. And yes, you're absolutely right. Having a clock in sight of both yourself and the client is important.

A, absolutely. The reasons you've outlined, Ken, which is so both people are aware of the time. But also, so the client can self-regulate.

Because when a client is in process and talking about things that are really, really hard, at the end of the session, they have to return back. to their lives they have to you know leave your practice rooms or if you know if you're online they'll they'll have to turn off whatever you know you know zoom or whatever device they're using to contact you online and they'll have to re-engage with their own lives and i think it's really important that as a therapist you you're thinking about kind of winding the session down bringing them back into into that area where they can re-engage with their their lives and the the both of you finish and the client goes off and you know catches a bus to go home or picks their children up or go shopping or does whatever people do when they leave therapy and that is another reason why it's so important that we keep time because you know client may have something else to do they may have squeezed that hour in and after the hour they may leave and they may you know say go and pick the kids up or go shopping or go home or go back to the office So it's really important that we keep that hour in. And I think also mentioning how long the session is at the beginning of the session, saying, you know, we've just got 50 minutes, and I'll give you an indication as we come into the end. I'll just remind us both, I guess, that we're coming to the end. So the therapist is taking soft power.

I'll call it soft power. They're taking soft power and they're saying to the client, I'll help manage this for you. And then the session comes close, as you say, we've just got about 15 minutes left. And it's a point where the client can say, well, I've only got 15 minutes with the therapist, so what do I need to do?

And it's giving control back to the clients as opposed to just letting them free flow. And you get to the end and they're still stuck in process and they've got to go out into the world. So it is deliberate practice. I'm going to use the term using soft power to kind of...

bracket the process. I like it. I like the word soft power because yes, there is a holding of that space and that's what we're called on to do.

We're holding that professional space and it occupies a time that has been agreed by both counsellor and client. So there's no surprises there. And I guess what is maybe less respectful to the client is a term like, oh my goodness, wow. we've only got a minute left of the session sorry where has the time gone wow it really flies um we are there to hold that time professionally and to give that indication that we are approaching the end of the session and leaving enough time within that we are approaching the end of the session to be able to use the skill perhaps of summary to retouch on what the client has has brought so that they leave with a little neat package of our understanding of what they've brought maybe that refreshes their memory of what what the session entailed And it's respectful.

And then you might pop that over to the client and say, you know, now with that and looking back on the session and touching on all these points that you brought today, I wonder in our last five minutes, how you feel as you get yourself ready for going out into your life and back into your world. So there's a preparation, almost like a holding space there. And it's kind of directed saying, we've covered that. How might you be feeling as you transition back in.

So we're once again acknowledging that closing of the session. And it can be that the client might bring heavy material right towards the end. It happens. That's the real life of counseling.

You know, something that you might say, I wonder how you are as you're now going back in and the client may say, well, I actually wanted to speak about the loss of my mother. And we're now in the last five minutes. And as the therapist, we can we can receive that. And we can recognize that and say, wow, I hear that you want to today, maybe to have spent some time speaking about your mother. I recognize that there's probably a lot to.

go into there and and with only five minutes left and wonder if that would be okay for you to bring that next time if you choose to bring that we can really look into it so it there's a way of kind of signposting and recognizing if if there is heavy material towards the end of the session that it's not going to be ignored and oh sorry time up thank you next but there is a holding of i recognize that we can look at that again as a way of kind of Sticking to the boundary of the ending, but respectfully acknowledging that material that maybe there wasn't time for has been brought towards the end of the session. I like that, Ken. And I think also there's an opportunity to segue. You can say, you know, you brought something that I think needs the respect to look at it with a little bit more time.

Perhaps we could look at that in our next session if you wanted another session. And then, you know, the client could say yes. Yes.

And then. when you start the next session up, you know, if you've said that, you know, if you both agreed you might, it's to be inspected and looked at, you might start the next session by saying, I'm aware that at the end of the last session, you talked about, you know, the death of your mother. And I just wondered if that was something you wanted to speak about.

It's up to you. And the client can say yes or no. And I think that's useful.

And I think one of the things that, you know, kind of myself have observed, which is a bit of a rookie error is, is that over helpful. um, counselor who comes to the end of a session, really wants to help really putting heart and soul into the session and says, is there anything else? Is there anything else you want to talk about?

And I can remember observing the counseling session, counseling skills session as a tutor. Wonderful. Absolutely. Wonderful.

Came to the end, just closing on time. I thought this is going to be great. And the person that was in the role of helper counselor said, is there anything else that you need? I can help you with.

And the person went off on another tangent and the student looked at me, said, well, what do I do now? And I said, well, what would you do? And it was a really good learning opportunity. I think sometimes if you're in a helping profession, you want to help. And, you know, client comes to you and can I give you any more help?

Because I want to help. And sometimes just being a bit, you know, taking the foot off the power pedal and applying the handbrake. is to use a motoring term is sometimes more useful than just just speeding speeding ahead it's an interesting and important part of practice ending a session and i think it does fall under deliberate practice can you know strategize and thinking about it before you engage with the clients definitely and i think part of that deliberate practice and and looking at the art and i love the words you've chosen the art of closing session rory you is to recognize that there may sometimes be high emotion within the client.

The client may have brought material that is heavy, and they may be emotionally distraught. They may feel worse than when they come in in the first place. So having that ending time, those 15 minutes, those 10 minutes, whatever you decide within your practice, that's time where you might work on how that person might deal with that outside of the therapy room until we next meet. it might be a time where you might need to make a referral if something has come up the ending is a is a really important part of the session and it can take on many different flavors I think of songs as an example some songs play and then they just stop some fade out some of them will go back into recurring verses there's there's different ways of doing it and you need to find what's right for your practice but also recognize what is right for the you the client the idiosyncraticity of the clients that will sit in front of you they're all going to be different and and react differently to the endings um deliberate practice i think is the big word rory yeah that's definitely the takeaway and deliberate practice means practicing honing you know if you're if you're a student it's about getting feedback you know i've said feedback's the breakfast of champions and get getting feedback and um also If you're a qualified practitioner or if you're a student and you're in your placement, take endings as a topic to supervision. Explore and examine how you're ending.

I know some people take recordings in. It sometimes happens. But I think it's important to... you know, focus on those skills.

And I like how you've mentioned bringing in other skills. So summarizing, use of questions, silence, all very, very important when we're bringing things to an end and getting the client ready to re-engage with the life outside therapy. Really important. It is.

And as we come to the end of this topic, see what I did there, Rory. You did. It's really good. We have a handout for you.

Rory created a super duper handout. It is called Closing a Counseling Session. It's a little PDF that you can download. If you want to get that handout on closing a counseling session, go to counselingtutor.com.

That's our mother website. That's where Rory and I hang out on a day-to-day basis. Click on the podcast tab, make your way to episode 254. That's today's episode right there on the page. It's all the show notes, links to... more detailed information on the topics Rory and I speak about.

But right there at the top, you can actually download free of charge the little PDF handout on closing a session that Rory has made for you.