{"id":6831,"date":"2026-07-14T23:33:12","date_gmt":"2026-07-14T23:33:12","guid":{"rendered":"https:\/\/bridgeproject.co.uk\/?page_id=6831"},"modified":"2026-07-14T23:36:38","modified_gmt":"2026-07-14T23:36:38","slug":"endings-and-transitions","status":"publish","type":"page","link":"https:\/\/bridgeproject.co.uk\/index.php\/endings-and-transitions\/","title":{"rendered":"Endings and Transitions"},"content":{"rendered":"\t\t
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Learning objectives: <\/b>\u00a0<\/span><\/p>

In this guide you will learn to:\u00a0\u00a0<\/span><\/p>

  • Collaboratively structure the intervention within a time-limited framework, using clear contracting, goal-setting, and phased planning to support engagement and prepare the young person for a meaningful ending.\u00a0<\/span><\/li><\/ul>
    • To explore and normalise endings, using anticipatory conversations to help young people process loss and transition.\u00a0<\/span><\/li><\/ul>
      • Use therapeutic tools such as ending letters, shared understanding maps, and staying well plans to consolidate progress and support continuity beyond therapy.\u00a0<\/span><\/li><\/ul>
        • Support transitions and discharge by scaffolding onward planning, validating responses, and promoting reconnection with life outside services.\u00a0<\/span><\/li><\/ul>

          Time-limited working<\/b>\u00a0<\/span><\/p>

          • As previously outlined, this intervention uses the principles of cognitive analytic therapy, which is a time-limited intervention. To manage the young person\u2019s expectations, the duration of treatment is agreed from the beginning. We aim to convey that endings are a natural part of life by acknowledging that we are working together for a specific period in a young person\u2019s life. It is not essential that all 16 sessions are attended; many young people may conclude earlier.\u00a0<\/span><\/li><\/ul>
            • The advantage of time-limited working is that the ending is anticipated from the outset. Some young people may not feel ready to end or feel they have not reached their desired goals. Exploring hopes and expectations early can help manage this and support young people to see that goals can take different forms. We might ask: what<\/span> would you like to feel different at the end of this work<\/span><\/i>, or, <\/span>what you like to be able to do when you leave here?<\/span><\/i> \u00a0<\/span><\/li><\/ul>
              • It could be helpful to assess the value of counting down sessions or whether it is more supportive to work in blocks; for example, it can be helpful to map out the \u2018phases\u2019 of the intervention, including shared understanding and learning new skills. The young person can have ownership of their own experience in the intervention, including the ending, by explicitly exploring what they want to have achieved by the end of your time together.\u00a0<\/span><\/li><\/ul>
                • Remember: the intervention supports the work and development that happens outside sessions, helping reduce longer-term dependence on services.\u00a0<\/span><\/li><\/ul>

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                  *Video 10: Endings*<\/b>\u00a0<\/span><\/p>

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                  Concluding the intervention <\/span>\u00a0<\/span><\/p>

                  • It is important to notice the emotional impact of an ending in therapy. There can be a dip in mood, or a re-emergence of symptoms as the young person is confronted with independence. This is a valid emotional response in an intervention and it can be mitigated by allowing space to process and grieve the ending in sessions. When developing a shared understanding of the young person\u2019s life and difficulties, we can explore possible responses to endings (see module on shared understanding). For example, young people who have developed strategies to keep others close by going to extremes may experience a return of earlier symptoms or behaviours to hold on to the service. Conversely, a young person who strives to be perfect to feel seen may not acknowledge difficult feelings in response to the ending, aiming to be a \u2018good patient\u2019.\u00a0<\/span><\/li><\/ul>
                    • An ending letter is shared between the young person and practitioner in the second-to-last session. The young person is invited to contribute or write a goodbye letter in response. This letter provides a summary of the work completed, reflects on progress which is made during sessions, and serves as a reminder of the therapeutic journey which the young person can revisit. It may also reflect on the therapeutic relationship and any ongoing goals.\u00a0<\/span><\/li><\/ul>
                      • By marking ongoing tasks, the clinician shows confidence in the young person\u2019s ability to move forward or transition to new services without continued support, whilst acknowledging the limits of the work.\u00a0<\/span><\/li><\/ul>

                        Ending letters<\/span>\u00a0<\/span><\/p>

                        While there is no fixed format for a goodbye letter, Corebridge (2019) offers a helpful summary. This may includes:\u00a0<\/span><\/p>

                        1. An introduction to the purpose of the letter.\u00a0<\/span><\/li>
                        2. A summary of the context, objectives and work that has taken place in the intervention.\u00a0<\/span><\/li>
                        3. A summary of the shared understanding of the young person\u2019s difficulties.\u00a0<\/span><\/li>
                        4. New coping strategies or new patterns of relating learnt.\u00a0<\/span><\/li>
                        5. Predictions and acknowledgements about what may be difficult going forward.\u00a0<\/span><\/li>
                        6. The practitioner’s personal reflection on the therapy and the therapeutic relationship.\u00a0<\/span><\/li>
                        7. Any plans for follow-up appointments.\u00a0<\/span><\/li><\/ol>
                          • Young people who have ended with the service will have the opportunity to attend a three-month follow-up appointment to reflect on the experience and process of the intervention. This also provides an opportunity to share how things are going since concluding the work.\u00a0<\/span><\/li><\/ul>

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                            *Video 11: Endings and transitions*<\/b>\u00a0<\/span><\/p>

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                            Transitions<\/b>\u00a0<\/span><\/p>

                            Many young people with symptoms of personality disorders may present with anxiety about endings. The techniques discussed in this approach can help reduce feelings of abandonment and rejection. For many young people, further scaffolding is required around transitioning into new health services, systems, or vocational settings.\u00a0\u00a0<\/span><\/p>

                            What is a transition?<\/span>\u00a0<\/span><\/p>

                            In healthcare, transition is the process of preparing, planning, and moving from young people\u2019s services <\/span>to <\/b>other forms of support. This may include adult or community mental health services, third sector organisations, education, employment, or residential care. The Scottish Government\u2019s Transition Care Plan (TCP) (2018) helps outline needs, preferences, and concerns from young people ahead of the move. The best practice is to begin this process early and collaboratively. As this intervention we offer is time-limited, the practicalities around transition planning will take place in the latter or ending phase of the intervention e.g. appointments 10 \u2013 16.\u00a0\u00a0<\/span><\/p>

                            Guiding principles for transition to adult services, education or third sector services <\/span>\u00a0<\/span><\/p>

                            To transition a young person to other services, below are some guiding principles:\u00a0\u00a0\u00a0<\/span><\/p>

                            • Consider the rationale or need for additional support.\u00a0<\/span><\/li><\/ul>
                              • Identify what support is needed, based on strengths, needs, context, and the intervention journey.\u00a0<\/span><\/li><\/ul>
                                • If it is appropriate to transition to adult services, prepare and educate young people about differences from child or adolescent services and consider how this might be experienced by the young person.\u00a0<\/span><\/li><\/ul>