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Department of Psychology

Professional Relationships: Starting Right and Ending Well

John T. Ault, Ph.D.
Last updated: 4 April 2005

General Principles

A. Role Clarity (Professional Mission Statement; professional versus friend, parent, cleric, etc.)

B. Know ones own motives (example of staff person, Marie). Homework: Professional Mission Statement - “Why am I going into human services?”

C. Do not promise more, even implicitly, than able to deliver (I’ll be here forever)

D. Moral responsibility is proportional to depth of intervention (Bill’s behavior mod. vs. Marie)

E. Distinguish between ability and desirability (Angie Kelly, Africa, alcoholic families)

F. Resistance to extinction laws

Variable ratio reinforcement schedule                Maximum effort

Lean versus rich reinforcement schedule          Punishment during learning

Minimal reinforcement                                           (Caution: Alice example)

(All counter intuitive; doing what comes naturally leads to marginal survival, e.g. naturally pull back from bite or hair pull; value of science – verifies when natural response is good but non-natural response is better; true for Resistance to Extinction and Handling Violent Clients)

Classic Events Associated With Termination

Client

A. Crisis: New symptoms; reoccurrence of old problems

B. Helplessness: "I can't go on without you"

C. Rage: "How can you do this to me; you are like all the rest"

D. Rejection/denial: Sour grapes/minimizing significance of therapy    

Therapist

A. Guilt

B. Misjudging her/his significance in the life of the client (over and under estimating)

C. Unconscious collusion with the client in blaming or finding fault with a common

enemy, for example, the agency, a supervisor, school bureaucracy

D. False promises of continued relationships (“I’ll visit, call, write; you can visit me”)

 
Preventative Actions around Termination Time

A. Explore early the client's typical termination pattern. Note: The best predictor of how one will handle future loss is how/she reacted to it in the past

B. Clarify time and depth of commitment as soon as appropriate

C. Make decisions regarding termination when not emotionally involved (If request to extend therapy appears legitimate, tell client, “I will consider it and get back to you.”)

D. Process or review own termination patterns

E. Notify client of coming end far enough in future for her/him to work through typical termination pattern

F. Bridge across to others

G. Review history of activities, changes, gains, areas for remaining work with the client

H. Symbolic ending ceremony (blue and yellow balloons)

I. Exchange of symbols of the relationship (not expensive gifts)

J. If appropriate, use own future plans therapeutically, (rejoice with me vs. excuse for leaving)

 

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