Determining Client Readiness to End

While many factors outside of client readiness impact the decision to end, we want to end this chapter with how to decide when the client is ready. Ideally, this is a joint decision between you and the client, and the big question becomes when to end. You can tell when a client is ready by evidence of healing, consistently shallow depth of work, and client confidence to not be in therapy.

The first cue that it is time to end is that you see evidence of healing that has transferred to situations outside the office. What they came to see you about is not a problem anymore. Symptoms are gone, because the need for them is gone. The client is doing positive things that could not be imagined before. You may also notice a radiance in their faces and hear expressions of contentment.

The second cue that it may be time to end is consistent shallower work that is more aimless. When clients are deeply working, they are generally quieter, more intense, and highly focused. When the work is done, they talk more, are more relaxed, and less focused. While Creative Play Therapy cycles through different depths of work, and you often see shallower work between stages, you are looking for an absence of deep work. When sessions are consistently at a shallower depth, the client is generally done with therapeutic work (unless a temporary situation limits resources to be able to do deep work). Clients know their situations better than anyone, and they can be trusted to know when their overall work with you is done. This is different than working through a significant core need, keeping it shallow for a few sessions while experiencing healing, and then diving deep into another layer of core need. After multiple cycles, the work stays at a shallow level when a client is ready to end therapy.

A third cue that it is time to end is the client’s confidence to continue without services. Sometimes, the client will express the desire to try it on their own. Other times, the client likes the safety net of seeing you consistently, even after the deep work is done. These clients may need a little longer to become confident that they can return when needed, and it may help to taper off services more gradually.

Skill: Trust

Clients trust you to move through the stages of Creative Play Therapy. The ending stage may require you to be aware of trust again. For some clients, you believing that they can continue on their own is a critical first step for them to believe it for themselves. However, to earn that trust, you must be trustworthy. Never promise, soothe or cheerlead to try to make the client feel better. Be honest. If a client fears what will happen if therapy ends, then cycle back and do a creation to explore that fear. Maybe what they fear will happen. What then? The fear is pointing to a core need that is not yet resolved. As you honestly process their fears, hear their core needs and affirm their progress, clients gain confidence about ending.

In the ideal scenario, you and the client see evidence of healing in behaviors outside the office. The work is shallow, comfortable, yet it may be aimless. Plus, the client is ready to end. Much variance exists across clients, but often progressing to ending happens much quicker than traditional therapy.

Creative Technique: Recollection and Mementos

When ending, most creative techniques are about recollection, not creation. All throughout the process, expressive arts creations may produce a lasting, tangible product that the client can reflect on at any time during the client’s progression or regression (Perryman et al., 2015). At the end, however, these mementos may be especially poignant. One idea is to create a scrapbook to collect creations (or pictures or symbols of creations) documenting the client’s journey. This gives the client a memento of the work with you, but also a reminder of how they were able to successfully navigate it before when core needs resurface in the future. This is a great ending exercise because it naturally allows you to point out patterns and affirm the client’s work, while reviewing how far the client has progressed.

Prompts

The prompts for this stage of Creative Play Therapy do three things:

• 1. Review the Past
• 2. Assess Present Resources and Confidence
• 3. Plan for the Future.

You could prompt a creation (which will likely be shallower in depth than past creations) for these three things, or it might just be a verbal conversation. In those cases, you might start with ‘Show me ... .’ Prompts help keep it client-centered, rather than you waxing into a long monologue.

"We’ve been working together for eight months now. I’d like you to create a timeline and show me the significant points for you in our work together.” "As we talk about ending our time together, I see a little hesitancy. Would you show me what your confidence is like about ending?”

"Looking ahead, what do you think things will be like in the future?” Endings, like every other stage of Creative Play Therapy, are intentional. They are centered on the clients’ experiences, but in this stage, you prepare for both you and your clients’ ending preferences. This stage reviews the progress of clients, assesses their resources and confidence to end, and prepares them for future needs. Endings are a loss, so it is appropriate to express grieving, even while celebrating the difficult work it took to get here.

References

Perryman, K. L., Moss, R., & Cochran, K. (2015). Child-centered expressive arts and play therapy: School groups for at-risk adolescent girls. International Journal of Play Therapy, 24(4), 205-220. Retrieved from http://search.ebscohost.com/login.aspx?direct=true& AuthType=shib&db=pdh&AN=2015-43879-003&site=ehost-live&custid=s8863735.