Exploring How Therapists Manage Endings in Therapy for Adults with an Intellectual Disability

Student thesis: Doctoral Thesis


Background: Endings in therapy are viewed as a multi-faceted, complex, and significant aspect of the therapy process. Research suggests that the way in which endings are experienced can influence the view of therapy as a whole, as well as therapy outcome. Despite the significance of the ending phase, there is relatively little empirical evidence exploring endings from therapist and service user perspectives. The literature that does exist focuses on the general population, and suggests that the ways in which endings are managed impact on how the ending is experienced by both service user and therapist. This study aimed to explore how therapists manage endings for adults with an intellectual disability, an area which thus far has not been empirically investigated.
Method: This study utilised a multi-method approach, using online surveys and semi-structured interviews. The methods of analysis were thematic analysis of online surveys, and IPA of interviews. 31 therapists completed online surveys, and eight therapists took part in interviews.
Results: The online surveys offered three superordinate themes: ‘Preparing for a therapeutic ending’, ‘Providing a therapeutic ending’ and ‘Post-ending issues’. In addition, five superordinate themes were extracted from the interview data: ‘Recognising’, ‘Readying’, ‘Reframing’, ‘Reflecting’ and ‘It’s not all hearts and flowers is it, really?’. The multi-method approach allowed for a broad and deep understanding of how therapists manage endings, and convergence between the two methods highlights research rigour.
Conclusions: The results in this study provide a broad and deep understanding of how therapists manage endings for adults with an intellectual disability. The results are consistent with the general population literature on endings, although some nuances are identified. The implications for clinical practice are outlined, alongside potential areas for future research
Date of Award2020
Original languageEnglish
Awarding Institution
  • Teesside University
SupervisorAsh Summers (Supervisor) & Dave Dagnan (Supervisor)

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