In graduate school they teach future counselors how to terminate with clients. I've never really liked using the word, terminate, in the same sentence with clients. Not only does it bring to mind images of the governor of California as a vengeful robot, but it's also the root of the word exterminate. I guess it would not sound as professional to teach a course on How to Say Goodbye, or How to Move On to Another Therapist, or How to Know When You've Done Enough.

I've only had the opportunity to address termination issues with three clients. The last two were bittersweet, but positive, because they had progressed through treatment and finished. It was hard to say goodbye, to say that our work together was over. However, I was left with the distinct feeling that they were going to be okay, especially because both had very supportive and stable families.

Thursday night was difficult. Since last October I have been meeting with an 8 year old client, I'll just call him Juan. On the drive to his house I never know what awaits me which I like because it's always a challenge. But there's some lingering sadness on that drive over, because I know his history. Abandonment, abuse, neglect... most likely from the time he was born until not too long ago.

It took us a while to build rapport. During the first visits, everything would be calm and then he would suddenly become angry and yell or swear at me. He would scream, "I hate you, you didn't bring the right crayons, they're ugly!." I would ask him to lower his voice and not swear at me. Over the next few months he was able to tell me what he was angry about rather than throw things, break things, or yell. We were making progress and not without some bumps along the way. Over the past two weeks it seems that his behavior is more erratic than ever, and it has become clear that he needs more intensive treatment than I can provide. Ideally, termination takes at least 3-4 sessions so that the client has the opportunity to process it fully. I suppose that happens in private practice. Ours took 1 and 1/2 sessions on Thursday night.

I started the session saying, "Remember how we talked about getting a new counselor?"
"Yeah, so?!?" I could tell he was already becoming angry.
"Well, she's coming here next week so that she can meet you."
He put his head down and shouted into his chest, "Good! Because I don't care about you! Actually, I hate you! I really hate you!"
"Are you going to hate me forever? That would be a shame... How angry at me are you right now?"
"I hate you."
"You sure seem angry."
"I'm sorry, I don't hate you, I'm sorry I screamed at you."
"I know you don't hate me, but I bet you're real angry with me, and thanks for telling me you're sorry."
"Yeah, I'm angry. The new counselor, will she be nice to me?"

He continued to cycle in and out of anger, sadness, and curiosity. His real life seems to mirror the chaos within him. Our session was abruptly interrupted by a squealing siren that seemed to get closer and closer. A marshall police car arrived, its siren blaring, with the client's uncle handcuffed in the backseat. He had been driving around in an unsafe car and they there to impound it. No one seemed too surprised or concerned with the arrival.

We resumed the session and said our goodbyes. Before I left we played a game of tic-tac-toe and Juan asked if he could give me a hug goodbye. I left knowing that he would be receiving the treatment he needs, but also left wondering what will happen to him. What will become of this boy is five years? Ten? I found myself praying (which has been significantly less frequent these days) on the way home. I prayed that God would intervene in this little boy's life in a major way, to give him the hope and strength to rise above all the horror that he has known.