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ABSTRACT: The termination stage has always been recognized as an important aspect of the clinical intervention process. Careful attention to that stage is even more critical in the current practice environment of short-term intervention and demands for measurable outcomes. Bowen's family systems theory, while well established in the field of clinical practice, does not incorporate clear directives for the practitioner about the ending stage of intervention. Still, its major concepts for assessment and intervention suggest a range of termination activities that can affirm and summarize a family's gains. In this article the authors offer a variety of ending strategies for use within family systems theory.
KEY WORDS: clinical practice; family systems theory; family therapy; psychotherapy; termination.
Whether or not a practitioner manages the ending of a clinical intervention well can make the difference between successful and unsuccessful outcomes for the client. If treatment gains are not consolidated the progress made during intervention may not persist. The topic of ending clinical intervention, while recognized as important, receives relatively little coverage in practice texts and supervision, however, because the earlier phases of assessment and intervention are considered to require more knowledge and skill. The need to attend carefully to endings is critical, however, now that clinical intervention increasingly occurs in the context of short-term relationships. Accountability to third-party payers and clients has become a driving force in the social services field. Practitioners must provide their services in a manner that more clearly reflects structure, a short-term focus, and attention to measurable outcomes.
Since its introduction in the 1960s and 1970s, family systems theory has been an influential and widely utilized theory of family assessment and intervention. The theory provides a comprehensive conceptual framework for understanding how emotional ties within families of origin (including extended family members) influence the lives of individuals in ways they often fail to appreciate and may tend to minimize (Bowen, 1978; Kerr & Bowen, 1988). Family systems theory is unique in its concern with multigenerational family processes.
Surprisingly, the major proponents of family systems theory do not clearly address issues related to ending intervention. There may be two reasons for this lack of attention. Family systems theory emerged during a time when family therapy was conducted primarily by private practitioners not typically...