For guidance on writing a client termination summary, review pages 693–712 of Wheeler (2014) in this week’s Learning Resources.
Identify a client who may be ready to terminate therapy.
Identifying information of client (e.g., hypothetical name and age)
Date the client initially contacted therapist, date therapy began, duration of therapy, and date therapy will end
Total number of sessions, including number of missed sessions
Whether termination was planned or unplanned
Major psychosocial issues
Types of services rendered (e.g., individual, couple/family therapy, group therapy)
Overview of treatment process
Goal status (goals met, partially met, unmet)
Treatment limitations (if any)
Remaining difficulties and/or concerns
Follow-up plan (if indicated)
Instructions for future contact
With the client you selected in mind, address in a client termination summary (without violating HIPAA regulations) the following:
Clients Name: S.K
Date of Initial Contact with Therapist: 1st June, 2018
Therapy Duration: 12months
Termination Summary Date: 1st August 2019
Number of Sessions: 35
Duration of Every Session: 60mins
The patient had an improved state of health and expressed personal desire to terminate the therapy having been contented with her progress. Her new academic goals had place additional time and financial constraints to her daily activities. 1st August 2019 was set as the date of terminating the therapy which the client complied with and expressed gratification for the progress she had recorded
Client’s Presenting Problem and Major Psychosocial Issues
The client is a 28-years Hispanic Latino lady who has had a disagreement with her boyfriend. Her suppressed emotions forced her to undergo psychotherapy to relive the social withdrawal and her inability to express herself. Her condition has interfered with her professional advancement because she has been experiencing tense moments characterized by traumatic thoughts. She admits having gone against the religious beliefs by cohabiting with her boyfriend
The client had insomnia though she had stopped thinking about the death of her father. Therefore, the service provided targeted the insomnia with additional therapy targeting the grief about her father’s death.
Overview of Treatment Process
The client was subjected to cognitive behavioral therapy because she reported signs of traumatic nightmares, panic attacks, and insomnia (Gordon, Brandish & Baldwin, 2016). At first, it was very difficult to develop trust with the client to foster a conducive therapeutic relationship to achieve a positive outcome. Lack of concentration and inability to express personal feelings and opinion were the major therapeutic concerns for this client because she had not had sufficient psychological space for self-expression for quite a long time. However, she remained fully aware of her role of resolving conflicts in the family. Upon undergoing CBT, she overcame the negative behavioral pattern and had an improved social and relational life (Kaczkurkin & Foa, 2015). It is suspected that PTSD was responsible for the traumatic flashbacks of the tragic accident that claimed her father. It was, therefore, necessary to examine the anxiety of the client to overcome the negative thoughts and fears using exposure therapy (Kaczkurkin & Foa, 2015). Finally, the client was subjected to a sleep hygiene therapy to improve her professional and social life.
The client was contented with all the treatment process because she was able to express her opinions at the end of the therapy. The client also reported an increased level of social interaction with family and friends. She also improved her ability to resolve conflict with empathy (Teng et al., 2015). The patient explored her maximum desires during the therapy and thus addressed most of the impediment to her decision-making. The supportive therapy enabled the client to cope with obsessive compulsive disorder of her boyfriend as well as the grief of her father’s death. Therefore, the cognitive restructuring assesment for her behaviour addressed the insomnia and traumatic flashback as evidenced by the improved self-esteem, attention, and mood (Teng et al., 2015).
Although all the treatment limitations were addressed, some conflicts arising during the treatment were never investigated. For instance, the issues to do with religious conflict were not addressed yet they were significant in helping the client to possess a positive religious subscription.
There is no concern that remained addressed after the therapy and the client never raised any concern with the treatment she received.
It is recommended that the client continue to undergo a continuous exploratory analytic therapy for a couple of months to ensure that she maintains the significant progress in goal attainment. The additional therapy will help the client to maximize the treatment time and promote her psychological wellness to achieve an individual level of understanding.
The client is free to seek further medical help whenever she feels like even though no follow-up plan for her case was formally documented.
Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in clinical neuroscience, 17(3), 327.
Gordon, R. P., Brandish, E. K., & Baldwin, D. S. (2016). Anxiety disorders, post-traumatic stress disorder, and obsessive–compulsive disorder. Medicine, 44(11), 664-671.
Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in clinical neuroscience, 17(3), 337.
Teng, E. J., Barrera, T. L., Hiatt, E. L., Chaison, A. D., Dunn, N. J., Petersen, N. J., & Stanley, M. A. (2015). Intensive weekend group treatment for panic disorder and its impact on co-occurring PTSD: A pilot study. Journal of anxiety disorders, 33, 1-7.