Children and youth mental health services are currently responding to high levels of need with finite resources. That’s why the Anna Freud National Centre for Children and Families has created guidelines for therapists working in services offering time-limited services
Due to cuts and lack of funds many mental health services have had to limit the number of therapy sessions that they can offer to young clients.
This means that when a young person comes to leave therapy their difficulties may be ongoing.
Most therapists have, in their training, looked at how to deal with endings and what they might mean. But despite increasing cuts to services practitioners are not generally trained to manage endings that have to happen due to a lack of funds or resources.
The Anna Freud National Centre for Children and Families has published recommendations for how therapists can work with an ending in order to properly prepare a young person and not take away from any good work that might have been carried out up until this point.
Here we summarise the main points, or you can read the Anna Freud National Centre for Children and Families' guidelines in more depth.
1. Begin with the ending
Be clear and upfront, say the centre, about the parameters of the therapy right from the beginning. Are there any fixed guidelines for the number of sessions they might receive? Share what the young person might realistically expect from the time-limited work. E.g. that problems are a part of life. Aim to have shared expectations with the young person you are working with.
2. Plan for the ending
The guidelines recommend to arm yourself with knowledge about other centres and how they can help, if you can’t. You could also give the young person a choice of how they might like to end e.g. staggering follow up sessions or having a session to say goodbye.
3. Talk about the ending
The centre say to communicate an understanding that the work you have done together is part of a process, e.g. ‘this phase of the work has ended, you might need to come back later so we can do some more work, and that’s fine’.
4. Avoid a blame culture
Have open conversations within the service about possible risks in order to avoid a blame culture, says the centre.
5. Be flexible
Allowing practitioners flexibility when it comes to managing a challenging ending, e.g. the ability to offer staggered sessions and follow ups.
6. Engage in supervision that focuses on endings
As a service organise group supervision sessions that focus on endings. These could help therapists to handle the emotional impact of ending in order to reflect upon their own vulnerabilities.
7. Good enough?
In challenging circumstances where the service can only realistically offer time-limited services, the report says that as a therapist you could ask yourself ‘have you been a good enough therapist?’