Chapter 12.Ending Play Therapy and the Process of Termination

Termination represents a universal outcome of therapy; many writers have referenced the inevitable but somewhat ironic treatment situation wherein the intimate therapeutic relationship is established only to foster its own dissolution (Bergmann 1988; Craige 2009; Pinsky 2002). Ideally, termination embodies a process that arises organically as an outgrowth of patients’ improved functioning and fuller engagement with life. Often, however, the end of treatment is precipitated by reality-based exigencies (the patient relocates, the therapist’s training at a particular site has come to an end) or hastened by intensification of resistance during a particular phase of the therapy (Loewald 1988). In child treatments, endings that are premature (at least by the therapist’s standards) are frequently precipitated by parental reactions (Deakin et al. 2012; Midgley and Navridi 2006); however, they are also initiated by young people themselves, reflecting their drive for autonomy and aspirations for greater social, academic, and extracurricular immersion. Indeed, children’s desires to terminate, even when embedded with more complex motivations, may represent real gains in the treatment that correspond with restored developmental momentum: a previously separation-anxious teen can finally leave home to attend boarding school or university, or a school-age child, formerly too conflicted or inhibited to enjoy after-school activities, now wants greater involvement in the world of peers and seeks age-appropriate outlets. Ellie’s dawning interest in termination partly reflects an increasing investment in and capacity for age-salient tasks such as peer socialization (play dates) and mastery of skills (gymnastics); time spent with Dr. Green now poses a conflict, as it detracts from these other exciting and pleasurable activities in the outside world.