Termination in 16-session accelerated experiential dynamic psychotherapy (AEDP): Together in how we say goodbye.

Abstract

This article explores key aspects of the termination process in a 16-session treatment protocol of accelerated experiential dynamic psychotherapy (AEDP). AEDP theory and its empirical support are described; interventions used throughout termination are demonstrated with verbatim clinical exchanges; and potential challenges faced during termination are addressed. Congruent with AEDP's healing orientation, termination is reframed as completion and launching: Although treatment ends, the change process begun in therapy can continue, as does the therapist's care for the patient. AEDP interventions during termination include (a) relational strategies to foster connection and undo aloneness; (b) the highlighting of patient resilience and the celebration of growth; (c) affirmative work with defenses around loss; (d) coregulation of patient's emotional experience; (e) experiential, bodily-rooted affective strategies to process and transform negative emotions; and (f) thorough exploration and processing of ensuing, vitalizing positive emotions and in-session experiences of change-for-the-better (i.e., metatherapeutic processing), to expand these and promote enhanced well-being and flourishing. Therapists aim to (a) elicit and process emotions related to the completion of treatment; (b) celebrate patients' affective achievements; and (c) convey trust and confidence in an ongoing transformational process, predicted to yield not only diminishment of symptoms and suffering but also upward spirals of flourishing. AEDP suggests that in providing patients a new, positive attachment experience of togetherness as therapy ends, termination offers a unique opportunity to disconfirm patients' earlier attachment-based expectations, revise inner working models, and help patients grow in self-confidence as they face, accept, and thrive in the wake of loss. (PsycInfo Database Record (c) 2020 APA, all rights reserved).