Whenever possible, the counselor encourages the client to complete between-session practice exercises. The counselor provides a careful rationale and description of the exercise, gives specific instructions, and explains how the task relates to treatment goals. The counselor ensures that the client understands each practice exercise, follows up on between-session exercises during the next session, and examines obstacles. When the counselor ignores noncompliance with the exercise, early dropout may follow.
Termination can be a problem for many clients and can lead to clinical deterioration or some emotional dysregulation just before the end of treatment. Several weeks before the last session, the counselor should review the treatment timetable to sensitize himself or herself and the client to termination issues. Session 6 is a good time to broach the topic of termination. The degree of attention to termination can vary according to the client. As the end of treatment nears, it is useful to remind the client of the number and the topics of the sessions remaining and respond to the client’s reactions.
The final session explores one of four elective skill topics, but the counselor should ensure that enough time is devoted to termination issues. Whatever the structure or content of the final session, the counselor must allow sufficient time to process the ending of treatment with the client. Processing includes summarizing what happened in treatment, discussing aspects of treatment that were most helpful and least helpful from the client’s perspective, eliciting client reactions and feelings about treatment, and exploring next steps for the client.