Psychotherapy Termination Practices with Older Adults: Impact of Patient and Therapist Characteristics

ABSTRACT

Objectives: The aims of this study were to survey clinicians’ opinions regarding psychotherapy practices in mutual termination with a specified population (depressed older adult outpatients) and to examine the patient and therapist characteristics that may influence such practices.

Methods: We surveyed psychologists’ (N = 96) psychotherapy termination practices, using a hypothetical depressed older adult as a referent, to assess consensus on the appropriateness of various guidelines to termination and to examine whether these differ as a function of patient and therapist characteristics.

Results: Several practices were generally agreed to be “extremely appropriate” when terminating psychotherapy with older adults, including collaborating to determine the end date of treatment and discussing patient growth. Data also indicate that patient factors, such as personality pathology, and therapist factors, such as having an Integrative theoretical orientation were associated with differential endorsement of termination practices. Identification as a geropsychologist or working regularly with older adults were associated with a more cautious approach to termination.

Conclusions: There is substantial consensus regarding many approaches to termination, but modifications might be appropriate depending on patient characteristics.

Clinical Implications: Clinicians agree on a set of fundamental termination practices when working with older adults, but modify these based on orientation and diagnosis.

KEYWORDS:

• Geropsychology
• psychotherapy
• termination
• personality disorders
• older adults

Acknowledgments

The authors would like to thank those who contributed greatly to the development of this study including Chaya Rubin, Catherine Eubanks-Carter, Gregory Hinrichsen, Martin Rock, Yoav Cohen, Merla Arnold, Vicki Passman, William Salton, and Lisa Napolitano.