When Are Clients Ready to Terminate?

Termination of psychotherapy has received less attention in the research literature than other aspects of the treatment process. This paper presents a structured framework emphasizing observable markers to indicate when termination with a client is appropriate during cognitive behavioral treatment. The 7 criteria that indicate when a client is ready for termination are: (a) decrease in symptoms as assessed by sound measures; (b) decrease in symptoms that is stable and maintained for 8 weeks; (c) decrease in functional impairment; (d) evidence that the decrease in symptoms is not a spontaneous remission, such as lower symptoms associated with the use of new skills; (e) usage of the new skills, particularly at times or on themes of former vulnerability; (f) sense of pride regarding the new skills, in contrast to initial doubt regarding whether the techniques would work; and (g) carryover of decrease in symptoms to other areas. A case report and discussion regarding the clinical application of the framework is presented.