| Abstract: | This paper examines three central concerns for the short-term therapist at a time when therapy is widely available free of charge in the community, in a model that has been called ‘ serial life-span therapy’. Issues of referral-on, topping-up or extending contracts are experienced as dilemmas or as temptations, depending on what therapists believe their clients need and what their clients may demand of them. Short-term therapy has become accepted in many contexts, with therapy no longer used as a once-and-for all solution to clinical problems, but as a serial method over time which includes topping up and re-contracting. After an initial agreement of brevity, depending on the client's disturbance levels at assessment and on availability, there may be the need for referral-on at the end of a brief contract, when clients may be offered a different, long-term service, or they may be recommended to return later in life for more, if and when this becomes necessary. Flexible contracts rather than rigid rules about the termination of therapy are being practiced in many contexts, depending on ‘what works’ and how methods can be adjusted to new evidence. There is danger of collusion or control, and this can lead to therapeutic dilemmas, which involve taking acceptable risks, or to therapeutic temptations, which are due to the desire for narcissistic gratification, benefiting the therapist rather than the client in terms of power or Eros. Being able to let go of clients and manage issues of loss, grief and greed requires a measure of maturity in the therapist that aims for good-enough results rather than striving for perfect endings. |
