The final session of psychodynamic psychotherapy for satisfied and unsatisfied clients who initiate the end of treatment

Shafran, Naama; Kline, Kathryn; Marks, Ellen; Gupta, Shudarshana; Pinto-Coelho, Kristen G.; Kanazawa, Yoshinobu; Hill, Clara E.

doi:10.1080/09515070.2019.1635435

Cited by 1 publication

(1 citation statement)

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“…117–128) and be open to discussing their feelings of fear and pain regarding ending the relationship. Often, therapist’s self-disclosure regarding their own feelings facing termination, may enable patients to engage in this intimate discussion (Frank, 2009; Shafran et al, 2015).…”

Section: The Cmra Modelmentioning

confidence: 99%

Teach them how to say goodbye: The CMRA model for treatment endings.

Saidon

Shafran

Rafaeli

2018

Journal of Psychotherapy Integration

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The ending of treatment brings with it unique challenges. Traditionally, different therapeutic approaches have emphasized distinct aspects of the termination process. Insight-focused approaches emphasized the therapeutic relationship and retrospection, whereas symptom-focused approaches emphasized therapy goals and prospection. In this paper, we present an integrative model for treatment endings, which unites the different approaches' emphases and identifies four main challenges for the end phase. Specifically, we argue that as termination nears, therapists need to actively assess and address (a) the progress and consolidation of gains achieved in therapy, (b) the maintenance and generalization of those gains in the future;, (c) the celebration of the meaningful relationship alongside resolution of ruptures that may have occurred in it, and (d) the acceptance of the impending separation between therapist and patient. We argue that these four challenges map onto two axes. One axis is temporal, and helps distinguish tasks focused on reviewing or reflecting on the past from ones devoted to planning and anticipating the future. The other axis is substantive, and helps distinguish tasks focused on the therapy's goals from ones centered on the therapeutic relationship. We conclude the paper with a discussion of the model's implications for clinical practice, training, and research.

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Section: The Cmra Modelmentioning

confidence: 99%