Abstract

Therapists often struggle to determine the most important things to focus on during termination. Reviewing the treatment, identifying plans for the future, summarizing positive gains, and saying goodbye receive the most attention. Despite our best intentions, termination can end up becoming intellectualized. Attachment theory and recent developments in neuroscience offer us a road map for facilitating endings that address client’s underlying relational needs, direct us to foster engagement, and help us facilitate new relational experience that can be transformative for clients. We argue that endings in therapy activate client’s and therapist’s attachments and these endings trigger emotion regulating strategies that can elicit client’s engagement or more defensiveness. The current paper will highlight through de-identified case examples how clients automatically respond termination and how therapists can foster rich relational experiences in the here-and-now that clients can take with them.

Keywords: attachment, termination, loss, polyvagal theory, engagement, alliance

+2

-1

Cheri L. Marmarosh, Ph.D.

Cheri L. Marmarosh, PhD, is a full-time associate professor of professional psychology at the George Washington University and a licensed psychologist. She has published numerous empirical and theoretical articles that focus on how group and individual therapy facilitate change and is the lead author of two books- Attachment in Group Psychotherapy and Group: Facilitating a Culture of Change. She is an associate editor of Psychotherapy and on the editorial boards of Group Dynamics: Theory, Research, and Practice and the International Journal of Group Psychotherapy. Dr. Marmarosh is a Fellow of the American Psychology Association, Division 29 (Psychotherapy) and Division 49 (Group Psychotherapy). She has a private practice in Washington, DC. Dr. Marmarosh’s research applies attachment theory to understand the development of the psychotherapy relationship, and she has focused on how client and therapist attachments influence both the process and outcome of psychotherapy.