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Terminating Therapy


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Table of Contents

Foreword by Arthur Freeman, Ed.D., ABPP vii Preface xi Acknowledgments xiii 1 Termination Strategy: A Pragmatic Approach in Contemporary Practice 1 The Importance of Termination 1 Pragmatic Strategy for Termination 18 Summary Points for Applied Practice 23 2 Professional Skills and Termination 25 Building A Base of Collaboration 25 Applying Reasonable Professional Standards 36 Summary Points for Applied Practice 46 3 Positive Closure from the Start: Groundwork for Termination 47 Optimize the Match 47 Set Policy and Shape Expectations for Termination 52 Formulate a Termination Plan 60 Summary Points for Applied Practice 76 4 Talking about Termination: A Closer Look at Communications 77 Orientation to the Topic of Termination 77 Making the Decision to Terminate 86 Creating a Record 104 Summary Points for Applied Practice 106 5 Achieving Closure: Assuring Professional Action 109 Directing the Termination Process 109 Managing Risks 123 Summary Points for Applied Practice 133 6 Adapting Termination to Client Needs: A Consumer-Oriented Perspective 135 Sociocultural Context 135 Clinical Needs 138 Developmental and Health-Related Needs 163 Practical Concerns 168 Summary Points for Applied Practice 171 7 Provider Challenges 173 Termination Dissonance 173 Sudden or Crisis Terminations 180 Self-Management Challenges 189 Summary Points for Applied Practice 198 8 Termination with Couples, Families, and Groups 201 Attending to Multiple Interests 201 Termination and Group Therapy 212 Summary Points for Applied Practice 216 9 Supervisory Termination 219 The Supervisory Relationship 219 Problems in Supervisory Termination 233 Summary Points for Applied Practice 244 10 A Consumer's Guide to Ending Psychotherapy 247 Understanding How to End on a Positive Note 248 References 265 Subject Index 275 Author Index 287

About the Author

Denise D. Davis is Assistant Director of Clinical Training for the doctoral pro-gram in Clinical Psychology at Vanderbilt University. She has nearly twenty-five years of experience as a private practitioner, clinical educator, and consultant.


"Denise Davis is right on point in her book Terminating Therapy: A Professional Guide for Ending on a Positive Note. In this book she addresses the confusion that exists in this area of professional practice in a very productive way, clarifying it in fashion that offers guidance that is ethical, legal and in the best interests of both the patient and the therapist. Her common sense approach to termination issues is refreshing and makes this book a must read for all mental health professionals regardless of their specialty." ?Jeffrey N. Younggren, Ph.D., Risk Management Consultant, American Psychological Association Insurance Trust Denise Davis' review of the process of termination grounds the reader in practical fundamentals of initiating, framing and maintaining treatment as she consistently focuses on the needs, goals and progress of clients, yet never overlooks the at times knotty concerns of clinicians striving to deliver safe and ethical service that reflects best practices and evidence-based accountability. With sensitivity, Denise Davis provides a helpful compilation of practical pitfalls that might befall any therapeutic alliance. This work is a "must-read" clinical treasure? Davis? work clearly fills a gap in the literature to enrich client and clinician alike. ?James L. Rebeta, Ph.D., President, Manhattan Psychological Association, Assistant Professor of Psychology in Clinical Psychiatry, Weill Medical College of Cornell University "Terminating Therapy provides a thoughtful and comprehensive discussion of the many issues involved in termination. It addresses underlying principles and concrete actions in a way that will be consistently helpful to practicing clinicians. This is the single best source I have seen on the subject of termination." ?Steven D. Hollon, Ph.D., Professor of Psychology, Vanderbilt University

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