Navigating Endings in Child Therapy: A Child-Led and Trauma-Responsive Approach

Endings are an inevitable part of child therapy.

Sometimes they are planned carefully and unfold gradually. Sometimes they arrive earlier than expected because funding ends, circumstances change, a family relocates or a therapist becomes unavailable. At other times, the decision to end therapy is made by an adult around the child, with the child having little influence over what happens next.

In whatever way an ending in a child’s experience of therapy comes about, it matters.

For children, therapy is not simply a service they attend. It is a relationship. It may be a space where they have felt seen, accepted and understood. It may be one of the few places where they have been able to communicate through play, creativity, movement or silence without needing to explain everything in words.

When that relationship comes to an end, children may experience a range of feelings, including sadness, confusion, disappointment, anger, relief or uncertainty. They may also appear unaffected, while communicating their experience indirectly through their play, behaviour or relationships.

As child and play therapists, we cannot prevent every ending from being difficult. We can, however, approach therapeutic endings with transparency, care and respect.

We can keep the child at the centre.

Reflections from my own transition

A few months ago, I had been preparing to finish working from my therapy clinic in Sandy Bay before moving to a space closer to home.

The transition has brought many layers of reflection. It has involved practical changes, personal transformation and experiences of parallel process. As I have navigated my own feelings about leaving a space that has held many important moments, I have also been thinking deeply about what the transition might mean for the children and families I support.

The move brought with it an unavoidable reality: not every child and family would be moving with me.

For some families, our work together had been relatively brief. For others, the therapeutic relationship had developed over a much longer period. Some families decided that the transition presented a natural opportunity to try something different or seek support elsewhere.

Although these decisions were understandable, I remained mindful that the children themselves had not always chosen to end their relationship with me.

Adults often hold the decision-making power around a child’s therapy. Parents, caregivers, funding bodies, organisations and therapists may determine when therapy begins, how frequently it occurs and when it finishes. Yet it is often the child who feels the emotional impact of those decisions. For me, knowing this is one of the hardest ethical challenges working with children.

This experience prompted me to think more intentionally about how we navigate endings in child therapy and play therapy, particularly when we want those endings to be child-led, trauma-responsive and respectful of the relationship that has developed.

Why therapeutic endings matter for children

Children experience relationships deeply, even when they do not communicate their feelings in the ways adults expect.

A child may not say, “I feel sad that therapy is ending.”

Instead, they might become more active or withdrawn during their final sessions. They may test boundaries, avoid talking about the ending, revisit earlier themes in their play or suddenly insist that they no longer want to attend.

Some children may ask repeated practical questions:

“Will you still be here?”

“Can I come back?”

“Who will use this room after me?”

“Will you remember me?”

These questions are often about more than logistics. They may reflect the child’s need for reassurance, predictability and confirmation that the relationship has mattered.

Children who have experienced separation, disrupted relationships, placement changes, family conflict, bereavement or other unexpected endings may be particularly sensitive to therapeutic transitions. An ending in therapy can activate earlier experiences of loss, even when the current ending is planned and safe.

This does not mean we should avoid endings or attempt to remove every uncomfortable feeling. Endings are part of life and relationships.

A thoughtful ending can offer children a different kind of relational experience: one in which change is spoken about honestly, feelings are welcomed and the relationship is brought to a close with care rather than disappearing without explanation.

In this way, the ending can become part of the therapeutic work itself.

Begin with the ending in mind

One of the most helpful ways to navigate endings in child therapy is to begin thinking about them from the start.

This can feel unusual. When we are focused on building safety, understanding the child’s needs and establishing the therapeutic relationship, it may seem too early to talk about finishing.

However, introducing the therapeutic frame provides children and parents with predictability. It helps everyone understand what therapy may involve, how decisions will be reviewed and how changes will be communicated.

Beginning with the ending in mind might include explaining:

• whether therapy is open-ended or time-limited

• how often sessions will occur

• when progress will be reviewed

• who will be involved in decisions about continuing or finishing

• how the child will be included in conversations about endings

• what a final session might look like

For example, a therapist might explain that they will initially meet with a child for ten sessions before reviewing the work with the child and their parent or caregiver.

Where possible, children should be given developmentally appropriate information about this arrangement. Rather than allowing the number of sessions to remain an adult-held secret, we can find child-friendly ways to make time visible.

This might involve using a calendar, a visual session tracker, objects in a jar or another creative representation of how many sessions are planned.

The purpose is not to create rigidity. Circumstances may change, and therapy may be extended or finish sooner than expected. The purpose is to reduce uncertainty.

When children have access to honest and understandable information, they are better able to develop a sense of what is happening around them.

Create a slow and considered transition

When circumstances allow, therapeutic endings should be gradual, planned and considered.

A slow transition gives the child time to understand that therapy is finishing, experience their feelings and communicate what the ending means to them. It also allows the therapist to notice changes in the child’s behaviour, play and emotional presentation as the final session approaches.

Depending on the child’s age, developmental needs and therapeutic approach, this process might unfold over several sessions.

You might begin by letting the child know that there are four sessions remaining. The following week, you might revisit this and make space for any questions or feelings. As the ending becomes closer, the child may choose how they would like to use their remaining sessions.

Children may want to:

• revisit a favourite play activity

• return to an important theme or story

• create something to remember the therapy

• look back at artwork they have made

• prepare a transitional object

• ask questions about the therapist

• practise saying goodbye through play

• decide how they would like the final session to unfold

A child-led ending does not mean placing responsibility for the entire process on the child. Children still need adults to provide structure, emotional containment and clear information.

It means creating enough space for the child’s preferences, feelings and communication to influence how the ending is approached.

Use natural transition points carefully

Natural transition points can sometimes provide a helpful frame for ending therapy.

These may include:

• the end of a school term

• the end of the school year

• a family relocation

• the completion of a planned block of sessions

• a change in funding

• a change of therapist or service

• moving from one therapy location to another

In my own situation, leaving the Sandy Bay clinic created a clear external transition point.

Natural endings can offer predictability, but they should not be treated as automatically simple. The fact that an ending aligns with a school term or a clinic move does not necessarily mean the child feels ready. It remains important to consider the individual child.

One child may respond well to knowing that therapy will finish at the end of the term. Another may feel heightened anxiety as the date approaches. A child who has recently experienced several other changes may need additional support, even if the therapy ending itself appears relatively straightforward.

This requires us to remain curious about the child and their experience:

What other endings has this child experienced recently?

What meaning might they make of this transition?

Does the child understand why therapy is ending?

What information do they need?

How can parents and caregivers support the transition outside the therapy room?

Work collaboratively with parents and caregivers

Parents and caregivers play an important role in supporting therapeutic endings.

They may need guidance to understand that the final phase of therapy is not simply an administrative task. It is part of the child’s relational and emotional experience.

Where possible, therapists can work collaboratively with caregivers to develop consistent, age-appropriate language about the ending.

This might involve supporting a parent to say:

“Your sessions with Ashleigh will be finishing in three weeks because she is moving to a different therapy space. You have not done anything wrong. You will have time to talk about it and plan your final sessions together.”

Clear language helps children understand that the ending is not a punishment, rejection or consequence of something they have done.

Parents can also be encouraged to make room for whatever feelings arise. A child may feel sad about finishing therapy while also being proud of their growth. They may feel angry with the adults involved. They may feel relieved, uncertain or ready to move on.

There is no single correct emotional response to ending therapy.

Our role is not to persuade children that the ending is positive. It is to help them experience their response as understandable and welcome.

When a final therapy session is not possible

Although we may advocate strongly for every child to have a final session, this is not always possible.

Therapy may finish suddenly because of practitioner illness, family circumstances, changes in funding, service closures or decisions made by parents or organisations.

There may also be times when a parent does not fully appreciate the importance of closure for the child and chooses not to return for a final appointment.

These situations can feel uncomfortable for child therapists, particularly when we know the child may experience the ending as abrupt or unexplained.

When a final session cannot happen, we can still ask:

What is possible?

How can I communicate that the relationship mattered?

How can I provide the child with some explanation or sense of completion?

How can I avoid leaving the child to assume that the ending was their fault?

During my transition from the Sandy Bay clinic, there were children with who I was unable to have the final session I would have preferred.

For those children, I prepared a personalised letter.

The letter included a photograph of me in the therapy space, a simple explanation of what had happened and reflections on the strengths and qualities I had noticed during our time together.

The language was tailored to each individual child and remained mindful of confidentiality, developmental age and the boundaries of the therapeutic relationship.

The letter did not replace the experience of an in-person ending. However, it offered something tangible. It communicated that the child had not been forgotten and that our time together had been meaningful.

Other possibilities might include:

• a brief video or audio message, where appropriate

• a transitional object prepared during an earlier session

• a certificate or written reflection recognising the child’s work

• a story explaining the change

• a phone or online goodbye, where clinically appropriate

• a message shared through the child’s parent or caregiver

• a supported transition to another practitioner

These decisions should be made thoughtfully and in line with professional ethics, organisational policies, confidentiality requirements and the needs of the individual child.

There is no perfect substitute for a planned final session. The aim is not to create a flawless ending, but to respond with care to the reality we are facing.

Making space for grief and loss

Endings naturally involve grief.

This can be true for the child, their family and the therapist.

Therapeutic relationships with children can be deeply meaningful. We may witness their vulnerability, creativity, courage and growth. We may come to know the ways they communicate without words, the themes they return to in their play and the small changes that might go unnoticed elsewhere.

When the relationship finishes, it is natural that we may also feel sadness.

Therapists can sometimes worry that feeling grief means they have become too attached or crossed a professional boundary. However, sadness at the end of a meaningful therapeutic relationship does not automatically indicate poor boundaries.

It may simply mean that we are human beings participating in relational work.

Professional boundaries do not require emotional detachment. They help us hold our emotional responses responsibly.

This means noticing our grief without asking the child to take care of it. It means finding appropriate spaces to process our feelings through supervision, reflective practice, consultation, journalling or our own therapeutic support.

Endings may feel particularly difficult when we have had little control over the decision, when the work feels unfinished or when we have not been able to say goodbye.

Supervision can help us explore questions such as:

• What am I feeling about this ending?

• What belongs to me, and what might belong to the child or family?

• Is there a parallel process occurring?

• What did I hope would happen before the work finished?

• What might I need in order to experience a sense of professional closure?

• How can this experience inform my future practice?

Reflecting on endings supports our growth as child and play therapists. It allows us to remain authentic about the emotional impact of the work while continuing to practise ethically and sustainably.

Endings do not erase the relationship

A therapeutic relationship can matter even when it does not continue.

Children may carry aspects of the relationship with them: the experience of being accepted, the memory of a predictable space, a phrase the therapist used or a feeling of being accompanied through something difficult.

We do not need to overstate our importance in a child’s life. At the same time, we do not need to minimise the relationship in an effort to make the ending easier.

The work mattered because the child mattered. A respectful ending acknowledges this.

It allows us to communicate:

“This relationship is finishing, and it was still real.”

“Our sessions are ending, and what happened here still matters.”

“You are moving on, and you do not have to pretend that you feel only one way about it.”

Approaching endings with the child in mind

There is no single script for ending child therapy.

A child-led and trauma-responsive ending requires us to consider the individual child, their developmental needs, their relational history, their family context and the circumstances surrounding the transition.

Wherever possible, we can:

• begin therapy with a clear and transparent frame

• talk about endings before the final session

• offer children developmentally appropriate information

• work collaboratively with parents and caregivers

• create opportunities for the child to communicate through play and creativity

• welcome a range of emotional responses

• advocate for at least one final session

• find thoughtful alternatives when a final session is not possible

• use supervision to reflect on our own experience of the ending

We will not always be able to offer the ending we would have chosen.

There may be uncertainty, sadness and unfinished feelings. There may be circumstances beyond our control.

In those moments, returning to the child can help guide us.

What does this child need to understand?

What would support their sense of safety and dignity?

How can I bring as much predictability and transparency as possible?

How can I communicate that the relationship mattered?

Thoughtful endings are not about avoiding grief or making every transition feel comfortable. They are about approaching change with honesty, care and respect.

For child and play therapists, this is part of our commitment to lifelong learning. Each ending invites us to reflect, grow and deepen our understanding of relational practice.

Most importantly, it invites us to continue holding children at the centre of the work, from the very first session to the final goodbye.

Reflecting on an ending in your practice?

Endings can bring up complex clinical questions and personal responses for child and family practitioners.

You may be navigating an unexpected ending, preparing a child for their final sessions or wondering how to respond when a family stops attending without notice.

Reflective supervision offers a space to slow down, consider the child’s experience and explore how you would like to approach the situation in a way that aligns with your values and professional responsibilities.

I offer individual and group supervision for therapists and practitioners working with children and families. These spaces are grounded in curiosity, authenticity, professional growth and a shared passion for supporting children well.

Until next time, take care.

Ashleigh