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Ending Therapy

Plan for the Ending

Any therapy relationship is likely to end, sooner or later. Sometimes it’ll be a happy ending, sometime less so. Although the seeds planted during therapy often means the client can continue to grow and develop, becoming more whole, more congruent, in their own time and under their own tutelage.

There are many reasons clients decide to end therapy. Sometimes they’ve reached their goals. Sometimes they need a break. Sometimes the connection with their therapist isn’t there. Sometimes they notice a red flag. Sometimes they’re about to face a new fear or realise a new insight.

Whatever the reason, it’s vital the therapist and the client brings it up as soon as either party becomes conscious of it. Wanting to end therapy is a critical topic to explore. And it could be as simple either the client or the therapist saying “I feel like it might be time to end therapy, I wonder what that’s all about?”.

An end in therapy can be more like a bittersweet parting than a sad, abrupt, or complicated loss. Ideally, clients can have a satisfying closure to therapy that will help them end other relationships well in the future.

Processing negative feelings can be a way to work through maladaptive patterns and make the therapeutic relationship a corrective experience. If clients avoid this conversation by simply discontinuing therapy, they may miss the opportunity for a deeper level of healing resulting from their therapy.

I find it helpful to mention the ending even from the outset of the therapy relationship. If only in the information conveyed as part of the setup of that relationship.

Any particular client may find it a distraction, discomforting, or scary to entertain the idea that the relationship – or, at least, the therapy – might come to an end even as it’s just getting started. So the timing of the broaching of the subject generally depends on how things are going.

Advice for Clients re: Ending Therapy

  1. Examine your reasons

A positive approach to ending therapy is to delve into the possible reasons why you’d like to leave. Is it because you feel disrespected, stuck or incompatible or because of feelings of discomfort in dealing with certain things that the therapist is pushing on me on? It’s common and part of the process of changing problematic patterns, to feel triggered and even angry with your therapist.

  1. Don’t stop suddenly

It’s important for clients to discuss the ending with their therapists, because they may suspect that the desire to part ways is somehow premature. Even if a client decides to leave therapy, processing this can be therapeutic in itself. Some sessions discussing  the subject, including feelings and what kinds of post-therapy experiences the client might go through can help ease the guilt, regret or sadness that often arise.

Plus, honouring the relationship and the work everyone has done together, with some sessions to achieve closure in a positive way can be a very powerful experience in its own right.

  1. Talk in person

Avoid ending therapy with a text, email or voicemail. Speaking directly is an opportunity to practice assertive communication and perhaps also conflict resolution, making it is an opportunity for learning and growth.

  1. Provide honest feedback

If you feel comfortable and emotionally safe doing so, it is best to be direct and honest with your therapist about how you are feeling about him or her, the therapeutic relationship or the approach you’ve been experiencing. After all, this has been a partnership, and part of growth is to embrace that, see the therapist as a human being, and see other folks’ needs met – including the therapist.

When offering feedback, do so without judgment. After all, the therapist will be working with other organisations and your thoughts may change their style and help them to better serve their clients in the future.

A good therapist will be open to feedback and will use it to continually improve.

  1. Communicate clearly

Be as direct, open, and clear as possible. Articulate the exact reasons for wanting to end therapy.

  1. Be ready for dissent

It is not unusual for a therapist to agree with ending therapy, especially if the client has reached their goals and is doing well. But they also might disagree. This disagreement can serve positively, as a spur to enhance the ability for discussing difficult topics.

Every therapy ends, there’s no reason to avoid this reality. Early in therapy, when discussing goals, why not talk about how and when therapy might end.

Advice for Therapists re: Ending Therapy

  1. Invite feedback

Most personal therapists note that having their clients share feedback on their experiences is incredibly valuable. It’s no different in the OP context. Feedback helps therapist  improve and grow as practitioners.

  1. Sometimes we won’t know why

Sometime we won’t get to know why a client ends their therapy. The connection can just fizzle out, with little to no contact or explanation. As we’re very invested in our work and in our relationship with the client, such an ending can be both a puzzle and a disappointment.

  1. Practice letting go

Some clients simply stop, so it’s not easy to know if they’re just ‘done’ with therapy or if we’ve done something to make them want to leave. When this is the case, I just let it go. It’s their issue, not mine, and I don’t need to worry over it when I don’t know the reasons behind it. Of course we could wish it were otherwise, but letting go can be the hardest thing.

  1. Enjoy the experience

When client and therapist are able to have some sessions for proper closure, it becomes a great opportunity to reflect on their work together. These sessions can be highly joyful, for both parties.

Our goal is to support our clients in confronting life and the issues they see as holding them back, blocking them from greater success. If clients have clear reasons to end therapy and we’ve had the time to talk about it and tie up the loose ends, ending therapy is a great time to reflect on our work, invite the client to talk about their future, and discuss what has been accomplished and what hasn’t. We can leave with a sense of closure, without nagging, unresolved issues. And with the sense that the client is now netter placed to tackle themselves new issues that might arise in their future.

Those precious final sessions afford the opportunity to relax, reminisce about our shared experiences, ponder the future, and learn how to be a better therapist for others.

When clients can approach the ending of therapy with respect, dignity and integrity, that sets the tone for other relationship issues. In other words, with proper closure, everybody wins.

In your practice, how often do you plan for the ending?

– Bob

Fundamentals of Organisational Psychotherapy

By popular demand, I’ve put together this post, which sets out some of the fundamentals of Organisational Psychotherapy (n.b. by no means all of them).

Note: This is a work in progress: I keenly invite your comments and questions.

Fundamental: The Nature of the Problem

The Marshall Model proposes that organisational effectiveness (productivity, product quality, staff engagement, etc.) stems from the collective assumptions and beliefs of the organisation as a whole. (Oftentimes, assumptions and beliefs of individuals concerned differ from those held collectively).

Thus, for organisations needing to improve their effectiveness, this entails a shift in these collective beliefs and assumptions.

The problem, then, for such organisations is: how to effect such a shift? Who owns the problem, and the resources to tackle it?

Fundamental: Organisational Psychotherapy is a Solution Strategy

Given the above statement of the problem, Organisational Psychotherapy proposes that Organisational Psychotherapy
Is a viable and cost-effective approach to addressing this problem. I.E. Organisational Psychotherapy
provides a means for organisations to effect a shift in their collective assumptions and beliefs (also referred to as the organisation’s collective mindset, psyche, or memeplex).

Fundamental: Points of Leverage In A System

Donella Meadows proposed that maximum leverage for changing a system (such as an organisation) derives from 2) shifting the paradigm or mindset out of which the system arises, and 1) by acquiring the power to transcend paradigms. Organisational Psychotherapy provides a means for organisations to grasp and exercise these particular levers (see diagram, below).

Fundamental: Organisations Each Have a Collective Psyche

Organisational Psychotherapy as a solution is predicated on the assumption that every organisation has a collective psyche (distinct from the psyches of the individuals comprising the organisation). And that this collective psyche is amenable to therapy much as is the individual psyche.

Fundamental: Therapy Techniques for the Individual Psyche are Transferrable

There are over four hundred different types, styles or “schools” of psychotherapy for the individual. Many of these are well-established, well-researched and well documented. And many of these are transferable, in whole or in part, from serving individuals in therapy to serving organisations in therapy.

Fundamental: It’s the Client-Therapist Relationship That Matters Most

Much research indicated that for individuals in therapy, positive outcomes are contingent mainly upon the quality of the relationship between the client and their therapist. Organisational Psychotherapy proposes that the same dynamic holds for organisations in therapy – positive outcomes are contingent upon the quality of the relationship between the organisation and its therapist(s).

Fundamental: The Therapist is a Constant Exemplar of Congruence

In some schools of therapy (Rogerian Therapy, a.k.a. Client Centered Therapy, for example) the idea of congruence looms large. And the role of the therapist in modelling/exemplifying congruence assumes a major significance in the relationship between the therapist and the client.

In engagements with larger clients, where the workload may suggest more than one therapist working with the client during a given period, the body (team) of therapists, as a collective entity, also exemplifies this congruence.

Fundamental: Therapists Have No Agenda

Outwith the basic agenda of accompanying the client of its journey, the Organisational Psychotherapist has no agenda. No pet solutions to suggest, no proposals as to how the client might choose to become better. Simply accompanying the client on their journey, with compassion and empathy, is the thing.

Solutions, strategies, new assumptions, beliefs and behaviours are the domain of the client. It’s not the role of the therapist to suggest “improvements” or changes (as might a coach). Rather, it’s his or her role to lend empathy and emotional support to the client in their journey. A journey which *might* include the client discovering more effective strategies, behaviours, assumptions and beliefs to replace some or all of their original strategies, behaviours, assumptions and beliefs.

Fundamental: Psychotherapy is About Treatment (It’s not Psychoanalysis)

I hesitate to use the word “treatment”, with its connotations that the client is somehow less than health, or needs “fixing”. I find these connotations entirely unhelpful in the context of therapy. Yet the word is sufficiently recognised to retain some explicative utility.

As intellectual understanding blocks empathy (Cf. Rosenberg, Nonviolent Communication), the Organisational Psychotherapist tries to avoid understanding what might be happening within the client’s collective psyche. Empathy without intellectual analysis (nor judgment). Just be there for the client. The world is a scary place, the organisation’s journey can be lonely without a friend.

Fundamental: Avoidance of Dependence

Organisational Psychotherapy aims to proceed toward a future where the client can take care of themselves, without the need for external intervention or support from a therapist. A future in which the client has become sufficiently self-aware and skilled in self-care that it can sustain its journey from its own resources.

The journey to self-sufficiency make take time, and proceeds at the pace with which the client is (more or less) comfortable. That is, the experience of therapy may cause discomfort on occasion, but the pace of progress Is never set, or forced, by the therapist.

Fundamental: The Client (Organisation) Owns Their Progress

As in individual therapy, Organisational Psychotherapy proceeds on the basis that clients deeply want change, even if there might be resistance to varying degrees and from various quarters, from time to time.

– Bob

Further Reading

The Nine Principles of Organisational Psychotherapy  ~ Think Different blog post

Testbash Dublin and Organisational Psychotherapy

As I mentioned in my previous post, I’m just back from presenting an interactive session on Organisational Psychotherapy at Testbash Dublin. Some folks seemed confused as to the relevance of Organisational Psychotherapy to testers and the world of testing, so I’m happy to explain the connection as I see it. (And please note that many of my previous posts on Organisational Psychotherapy may also help to illuminate this connection.)

I’ll start by riffing on something Rob Meaney said during his presentation:

“Significant quality improvements [aren’t] driven by testing. They [are] driven by building relationships and influencing the right people at the right time.” ~ @RobMeaney #TestBash

Quality (and other) improvements come from improved relationships. This has been a theme on this blog for some years now. For example see: The Power of Humane Relationships.

I asked a key (for me) question during my session (several times):

“If we accept that (as per the Marshall Model) it’s the collective mindset of the organisation that determines its relative effectiveness, how do we propose to support the organisation if and when it choses to do something about its mindset?”

Unsurprisingly perhaps, I heard no answers, excepting my own proposal for a means to that end: Organisational Psychotherapy.

I wonder how many folks involved with testing ask themselves and their peers the question “How can our organisation become more effective at testing?”. Or, using the #NoTesting frame, “How can our organisation become more effective at delivering quality products and services?”

Fellowship

Organisational Psychotherapy is not just about improving product quality, however. Through improved relationships, and a shift in how the organisation relates to its people (i.e. from Theory-X to Theory-Y), the quality of life at work also improves. Put another way, we all have more fun, more job satisfaction, and get to realise more of our potential at work. Further, for all the folks that matter, their several needs get better met. And, as a bonus for the organisation itself, it gets to see its people more productive and engaged. What’s not to like?

Incidentally

I’ve also written elsewhere about using the Antimatter Principle in practical ways during software development. For example, during development we eschew requirements gathering in favour of incrementally elaborating hypotheses about the needs of all the folks that matter, and then conducting experiments to explore those needs. I can envisage teams that still need testers adopting a needs-focused approach to driving testing. For example, putting into place various means by which to answer the question “how well does our product meet the needs of the people that matter to us?”.

Practical Applications

On a related note, some folks asked me about practical applications of Organisational Psychotherapy in their day-to-day work as testers. Here’s just a few applications which immediately come to mind:

  • Improving communication with the people that matter (i.e. developers, fellow testers, management, stakeholders, customers, etc.). I find NVC (nonviolent communication) skills and practice particularly useful in this context.
  • Clarifying what works and thus what to do more of (Cf Solutions Focus). This can improve team retrospectives.
  • Helping the people that matter (including ourselves) feel better about what we’re doing (Cf. Positive Psychology).
  • Understanding each other’s strengths, with a view to having the right people in the right seats on the bus (Cf. StrengthsFinder).
  • Eliciting requirements (if you still do that) (Cf Clean Language).
  • Building a community (such as a Testing CoP or a multi-skilled self-organising product team) (Cf Satir Family Therapy).
  • Improved cooperation with higher-ups (empathy, Transactional Analysis, etc.).
  • Dealing with blockers to changing/improving the way the work works.

Invitation

I’d love to hear if this post has helped put my recent Testbash session in context.

– Bob

Testbash Dublin

I’m just back from presenting an interactive session at Testbash Dublin. I enjoyed conversations on the topic of the session – Organisational Psychotherapy – as well as conversations around e.g. #NoTesting. Indeed, I noted a common theme running through many of the sessions from the more seasoned testers presenting: a grumbling low-key disaffection with the notion of testing as a path to quality.

No Testing

A number of folks engaged me in trying to better understand what I might mean by #NoTesting. Such conversations generally start out with “What do you mean by ‘testing’?”. My time in Dublin has allowed me to see through my discomfort in avoiding this question (yes, I generally choose to avoid it). I’m loath to get into semantic arguments from the get-go. I find they rarely lead to productive mutual exploration of such topics.

The bottom-line, is: It doesn’t matter one iota what I mean by “testing”. Whatever YOU mean by “testing”, that’s what I’m talking about when I mention #NoTesting. It’s an invitation for YOU to pause awhile to consider how life would be different if you stopped doing “testing” (whatever YOU choose to understand by that term) and did something else to address the same ends.

Ends Over Means

There’s an idea from therapy which might help you understand this perspective. In eg Nonviolent Communication (and some other therapies), human motivation is assumed to stem from attempts to get our needs met. That is, our behaviours and actions result from the strategies (means) we choose in order to meet our needs (ends). Any particular strategy affords us a limited palette of behaviours and actions. Aside: Often, we have little or no conscious awareness of either our ends or our chosen means.

“Testing” (whatever YOU choose to understand by that term) is a strategy you (or someone else) has chosen – almost always, implicitly –  for getting your or their needs met. And other folks’ needs, too, in the general case.

There are always other strategies (means, options) for meeting folks’ needs. Yet rarely do these other strategies receive any consideration. Maybe some of these other options offer a way to better meet folks’ needs. How would we ever discover that, without considering them, becoming aware of them, exploring them?

So that’s what I’m talking about with #NoTesting (amongst a raft of #No hashtags) – an invitation and reminder to actively consider whether your default means (strategy) are best serving your ends (needs), whether your first and automatic choice of strategy is the most effective way to attend to your – and other folks’ – needs.

– Bob

What If #4 – No Answers

What if we refrained from inviting answers, at least until we had sought our own? What if we refrained from providing answers, at least until someone had unequivocally asked?

“I don’t understand this” is a pretty common admission. Although not perhaps as commonly admitted as it is thought or experienced. And what do we do when our friends, peers, colleagues, loved ones make this admission to us? We jump to fill the void. To provide some answers. To help them in their understanding. Helping people to understand is a natural human reaction. But how helpful is it, really?

How often do we tell ourselves that we’re helping someone to understand, when we’re actually just helping them adopt our interpretation?

And what if we helped them to understand something and they came to their own understanding of it? An understanding at odds with our own? How would we feel then?

Personally, the joy I find in helping people understand something is as nothing compared to the joy I take in folks finding their own understanding. Even, and perhaps especially, when it differs from mine.

There are occasions when someone asks me directly. “Just tell me the damn answer!”. On these occasions I mourn for the loss of opportunity. For the lost chance to explore together. For the missed joy we might both have taken from finding answers together. And yet most times I’ll accede to the demand. Albeit with a heavy heart.

What if we refrained from inviting answers, at least until we had sought our own? What if we refrained from providing answers, at least until someone had unequivocally asked us? What if we just tried to listen, to hold the space, to empathise, and to do what we could to relate to people as fellow human beings, walking together for a while, as we each pursue our journeys?

NB. I’m not looking for answers here – at least, until you’ve found some of your own.

– Bob

Further Reading

What Is Clean Language? ~ Marian Way

Other Posts In This Occasional Series

What If #1 – No Management
What If #2 – No Process
What If #3 – No Telling
What If #5 – Continuous Improvement Is Useless
What If #6 ~ Agile Nirvana
What If #7 – No Work
What If #8 – Agile Never Happened

 

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