Separation, termination process and long-term outcome in psychotherapy with severely disturbed patients

Long-term consequences of working through of intratherapeutic separations were studied in combined psychotherapy and milieu therapy with severely disturbed adult patients. Seven of the 10 cases were consistent with the hypothesis about the significance of therapeutic work with separation for the longitudinal outcome. Inability to mourn was connected with less emotional and functional improvement. Besides the therapist's contribution in the middle phase, the patients' different ways of dealing with the trauma of termination were decisive.