Ending a Counseling Session

Ending Counseling Sessions When a client ends a session by disclosing a critical piece of information (when there is clearly no time to discuss the issue in full), it is incumbent upon the counselor to address the reference directly and briskly, with reference to the next session.

To some degree, it might be possible to understand this pattern of disclosure as the client's way of setting the agenda for the next session -- although in a number of cases it is quite obviously the client's way of stating something directly that they do not otherwise know how to disclose in therapy.

It should not be treated as an invitation to extend the session past its deadline, for this would be unprofessional and would create the illusion for the client that sufficiently sensational disclosures will be "rewarded" with extra clinical attention. Obviously the counselor needs to take account of the content of the disclosure, because certain things -- suicidal ideation, intention to commit a criminal act -- legally obligate a counselor to report them to the appropriate medical or legal authorities.

The first specific step would be to analyze what the client says in terms of whether it required an immediate response or intervention with external authorities -- this could be a matter of calling a client's medical psychiatrist in the case of suicidal ideation being expressed, or of calling the local police if you believe a client has expressed intention to follow through on a constantly-lingered-over revenge fantasy.

It is necessary to approach any end-of-session disclosure on an ad hoc basis, based on the counselor's larger sense of the patient's mental state and stability. For me, the personal challenge would be evaluating patients who express hopelessness or potential suicidal ideation (such as Case Studies 1 and 3 below).

My own instincts are so profoundly empathetic that the thought that a client whom I had been counseling would take his or her own life is something that I can scarcely imagine, and my own instincts would be to err on the side of taking such claims on the part of the client very seriously indeed.

But I am aware that many people in counseling feel safe to express their more despairing and bleak thoughts, even as such disclosure would be too vulnerable for them in a less therapeutic context, and that not every one of them requires medical intervention to prevent suicide.

I think the only way to rise to this challenge would be practical: I imagine that only after counseling a number of depressed persons (and being forced to evaluate their statements on an ad hoc basis) I might be able to gain a better practical grasp of how seriously to take statements of potentially suicidal intent. Case Study #1,.