The termination phase: Therapists' perspective on the therapeutic relationship and outcome

The termination phase of treatment is recognized as a significant aspect of the therapy process and yet remains vastly understudied in psychotherapy literature. In the present study, therapists' perspectives were used to examine how 3 elements of the therapy relationship (working alliance, real relationship, and transference) during the termination phase relate to perceived client sensitivity to loss, termination phase evaluation, and overall treatment outcome. Self-report data were gathered from 233 therapists, recruited from 2 Divisions of the American Psychological Association. Therapists completed measures for their work with a client with whom they could identify a termination phase of treatment. Results revealed that the working alliance and real relationship during the termination phase related positively to termination phase evaluation and overall treatment outcome, whereas negative transference during the termination phase related negatively to overall treatment outcome. Therapists' perceptions of client sensitivity to loss related positively to both negative and positive transference during the termination phase. Post hoc analyses revealed only the working alliance during the termination phase uniquely predicted overall treatment outcome in a model with the 3 therapy relationship elements examined together. On the other hand, all 3 therapy relationship variables during the termination phase uniquely predicted termination phase evaluation, when examined together. Limitations and implications of these findings are discussed, and recommendations for future study are suggested. (PsycINFO Database Record