End of Therapy 👐🏻

Following are key comprehensive points summarized and translated to English in her Article titled: Introduction au dossier: Les fins de thérapie, Line Gérard (psychologue)

Introduction au dossier – Les fins de thérapie - Ordre des psychologues du Québec

1. Purpose of the Dossier

• The article introduces a thematic issue of Psychologie Québec focused on how therapy ends, a topic rarely explored in depth despite its clinical and ethical importance.

• Ending therapy involves complex variables: ethical obligations, clinical judgment, developmental considerations, relational dynamics, and the client’s internal world.

2. Why Therapy Endings Matter

• There is little formal training on therapy termination; universities do not offer dedicated courses.

• Freud’s 1937 text on “analysis with end and without end” remains foundational, highlighting:

  • Therapy should end when symptoms and inhibitions are resolved.

  • The clinician must judge whether pathological patterns are unlikely to recur.

• Some authors argue that endless therapy may serve developmental functions, especially when clients struggle with separation or loss.

  
  

3. Ethical Framework

• Psychologists and psychotherapists are bound by deontological obligations when ending therapy.

• Ethical guidelines act as a protective structure for both client and clinician, especially in non‑consensual endings.

  
  

4. Clinical Frame: Therapy as a Time‑Bound Encounter

• Therapy, short, medium, or long term, is always a relationship with a beginning and an end.

• Gestalt therapy emphasizes the need to complete unfinished situations; otherwise, past experiences intrude on the present.

• According to Allan Schore, therapy can be a second developmental chance, especially for clients with early emotional dysregulation—making endings particularly sensitive.

  
  

5. The Beginning Shapes the End

• Early sessions establish:

  • The therapeutic frame

  • Expected duration

  • Approach and goals

  • Sometimes an explicit termination plan

• Strong working and relational alliances help clients navigate separation later.

• In longer therapies, personality, developmental, and relational issues become more central, influencing how endings unfold.

  
  

6. Therapist’s Internal Experience

• Clients may reenact internal conflicts, including fears of separation, within therapy.

• Therapists are also emotionally affected:

  • Sudden client departures can trigger countertransference reactions.

  • Therapists must manage their own responses to avoid unconscious defensive behaviors.

    
    

7. Short‑Term vs Long‑Term Therapy

• Short-term therapy requires:

  • Rapid alliance building

  • Clear, realistic goals

  • Constant visibility of objectives

• Long-term therapy involves:

  • Deeper relational patterns

  • More complex endings

  • Greater emotional resonance for both partners

    
    

8. What Happens at the End

• Endings typically involve:

  • Reviewing progress and challenges

  • Discussing the therapeutic relationship

  • Identifying remaining work

  • Saying goodbye or transitioning to another provider (“passing the baton”)

• Clients leave with a mix of:

  • Satisfaction

  • Unfinished elements

  • Ambivalence

  • Grief

  • Hope

    
    

9. Overview of Articles in the Dossier

The issue includes contributions exploring different facets of therapy endings:

a. Short-term group therapy (Isabelle Tremblay)

• The end is present throughout the process.

• Group endings can trigger major insights.

• Therapist relational capacity is crucial.

  
  

b. Adolescence and termination (Marie-Laurence Paré & Leonor Lopez)

• Adolescents face developmental tensions between dependence and autonomy.

• Goals and endings must be co‑constructed.

• The process is delicate and often brief.

  
  

c. Premature termination (Cyrielle Richard)

• Many therapies end before they truly begin.

• Research explores what premature endings mean for both client and therapist.

• Alliance is a key predictor of engagement.

  
  

d. Relational dynamics of endings (Fanie Fontaine‑Zuchowski)

• Endings can involve attunement or misattunement.

• Naming and processing these moments helps find the best path forward.

  
  

e. Endings in indeterminate‑length therapy (Gilles Delisle)

• Explores the psychological complexity of open‑ended therapies.

• Reflects on what constitutes an “optimal” ending.

  
  

10. Conclusion

• Every therapy ending is part of a larger story of transformation.

• Clients leave with new paths, insights, and sometimes unresolved threads.

• Despite challenges, therapists are privileged to accompany clients through these meaningful transitions.

Article summarized by Damyan Edwards, PhD, psychologist at D2 Psychology Clinic

d2psychology.com

Westmount/Montreal based psychology clinic