An exploration of ending psychotherapy: The experiences of volunteer counsellors

An exploration of ending psychotherapy: The experiences of volunteer counsellors

Abstract

Background/aims: Literature suggests that the ending phase of therapy can be difficult and challenging for counsellors. Despite this, there is limited research in this area and no study has specifically looked at the experiences of volunteer counsellors. This is the first study to explore the experiences and challenges of volunteer counsellors and the impact of ending therapeutic relationships.

Method/design: A verbatim account of semi-structured interview data was analysed using thematic analysis. The participants were six volunteer counsellors working in a mental health charity.

Findings: Three main themes were identified during the analysis-length of therapy, impact of organisational structure and strategies for managing challenges.

Discussion: The counsellors perceived the fixed number of eight sessions as insufficient to address the presenting issues and problematic with regard to managing endings. The organisational structure (most likely influenced by the commissioning contracts) had a particular impact on these experiences. Endings were generally experienced as challenging; however, some of the participants perceived the time-limited therapy as helpful in working with less difficult and complex issues.

Clinical implications: The study highlighted the need for an ongoing consideration of the impact of inflexible regulations/structure by counselling organisations and funding bodies in order to empower and enable these clinicians to practice and manage endings effectively. There is need for therapeutic settings to consider flexibility of therapy length and allow volunteer counsellors to offer their services with some degree of autonomy. Services could think of creative ways of offering interventions based on clients' needs and complexity of presenting problems.

One INTRODUCTION |

The ending of psychotherapy/counselling is a transition in which the counsellor and the client progress from working together to inevitably going their separate ways. Research suggests that the therapeutic relationship involves building a professional relationship that is finite and the ending phase can raise painful feelings and challenges for counsellors.

Quintana defined ending in psychotherapy as a loss, with potential for crisis as well as the opportunity for emotional development. Gelso and Woodhouse suggest that psychotherapists view the ending phase as a complex stage of the therapeutic process. Others suggest that the focus of therapy during this phase is crucial to review the progress of therapy and set goals for future development.

However, very limited research has explored the experiences and views of counsellors on ending therapy with clients. This is the first study to date to explore the experience of endings by volunteer counsellors. Studies suggest that the possible reason for limited research evidence on this subject is due to the deep-seated anxieties it can raise for counsellors.

Endings in counselling often have been found to trigger strong and difficult feelings for the counsellor such as anxiety, sadness and feelings of loss and separation. It may trigger past experiences of loss and unresolved grief for some counsellors. Others perceive it as a painful and sad time involving defences, separation and difficulties.