Mod12-Effective Conclusions of Interactions and Healthcare Services

Importance of Effective Conclusions

• Conclusions occur regularly in healthcare yet receive little structured attention.

• Effective conclusions:

  • Strengthen the collaborative therapeutic relationship and demonstrate respect.

  • Reinforce empowerment and Person-centred care (Pagano 2015).

  • Require equal preparation time to that of the opening interview (Moss 2017).

  • Ensure optimal use of the allocated appointment/service time and funding.

• Common reasons for closure:

  • Achievement of session goals or overall treatment goals.

  • Completion of funding/time allotments or treatment plan timeframe.

  • Staffing changes, scheduling limits, or unexpected/unplanned death.

• Regardless of reason, both the professional and the Person must be prepared (Beesley et al 2018).

Features of Effective Conclusions

• Planning begins at the start of every interaction; introductions set expectations (Ch 3).

• Continuous application of core communication skills (listening, questioning, non-verbal awareness, summarising, clarifying) underpins effective concluding.

• Two core micro-skills dominate the closing phase:

  • Summarising

  • Condenses and re-states key points in a clear, concise overview.

  • Demonstrates active listening and gives the Person a chance to correct misunderstandings (Dougherty et al 2015).

  • Aids memory retention and focus on all—not just isolated—information (Healy 2018; Henderson 2019).

  • Clarifying

  • Removes ambiguity by explaining meanings or asking probing questions (Stein-Parbury 2017).

  • May utilise open questions (Ch 4) or direct explanation; empowers mutual understanding.

• Non-verbal cues (body positioning, eye contact, facial expression) also signal closure and must align with verbal intent (Holli & Beto 2017).

• Provide contact details so Persons can reconnect for questions or further care.

• Maintain awareness of the session purpose to manage remaining time and tasks (Moss 2017).

Preparing to Conclude or Finalise

• Endings vary in emotional weight depending on length and intensity of the therapeutic relationship.

• Western cultures often avoid endings; individuals under stress seek continuity (Shulman 2016).

• Positive closure mitigates reluctance to end and supports empowerment.

• Healthcare professionals must plan “goodbyes” whether after a single call or months of care.

Concluding Initial Meetings or Single Interactions (Face-to-Face or Telephone)

• Sequence:

  • Introduce yourself and confirm it is a convenient time.

  • Obtain permission to discuss role and interaction purpose.

  • Explore Person’s prior knowledge and healthcare experiences.

  • Identify focus and limits of this specific interaction.

  • If questions fall outside scope, arrange a referral and document it.

  • Provide a 5–10 minute time warning: “We have about 5\text{–}10 minutes left…” (Friess 2011).

  • Invite final comments/questions: “Is there anything else you’d like to discuss before I go?”

  • Summarise key discussion points and clarify next steps or referrals.

  • Supply contact details; thank the Person and express pleasure in the meeting.

  • Use congruent non-verbal signals to end.

Concluding Individual Treatment Sessions (Within an Ongoing Program)

• At program outset, collaboratively formulate overarching goals and session-by-session objectives.

• At each session’s start: remind Person of today’s focus.

• Near session close: give a time cue (e.g.

  • “We have 10 minutes remaining.”) to guide wrap-up.

• Emphasise achievements or progress—boosts optimism for future sessions.

Concluding Healthcare Services After a Period of Care

• Triggers: stabilised condition, achieved goals, depleted funding, or time limits.

• Emotional dimensions:

  • Sense of loss for both Person and professional (Egan & Reese 2019).

  • Possible reliance on therapeutic relationship → harder separation.

• Strategies:

  • Provide early notice: “In two weeks we’ll have your last session…”

  • Ask Person to prioritise final concerns: “What do you want to achieve in these two sessions?”

  • Acknowledge accomplishments; encourage reflection on challenges overcome.

  • Manage distress: allow time for emotion; introduce support staff if needed; follow up later when appropriate.

  • Express appreciation and recognise Person’s contributions (Holli & Beto 2017; Moss 2017).

Concluding Services Due to a Life-Limiting Illness

• Often occurs in palliative care contexts (Palliative Care Australia 2018).

• Must remain fully Family/Person-centred, age-appropriate, and values-based.

• Core requirements:

  • Effective, empathetic, timely communication (Henderson 2019).

  • Pain and symptom management (WHO 2006).

  • Cultural competence: honour rituals/practices around dying (Entwistle et al 2018; Pringle et al 2015).

  • Integration of psychological and spiritual support.

  • Support family needs; offer bereavement counselling when indicated.

• Professional self-care:

  • Anticipate own emotional response and bereavement; seek supervision or counselling as needed.

Components of an Effective Conclusion (Checklist)

1. Clear verbal notification that the session/period of care is ending.

2. Comprehensive summary of content, goals, and outcomes.

3. Time for questions and clarification.

4. Identification and discussion of achievements and treatment effects.

5. Expression of enjoyment in working with the Person.

6. Expression of appreciation for the Person’s engagement.

7. Provision of contact details (practitioner and/or service).

Chapter Summary & Practical Takeaways

• Always verify the Person’s understanding—ask them to summarise or reflect.

• Monitor both your own and the Person’s non-verbal cues; adjust if anxiety or confusion emerges.

• Provide written summaries or handouts when information density is high.

• Ensure the Person leaves knowing what to do next and when/if follow-up is available.

• Person-centred care dictates openness, completeness, and timeliness of all end-of-care information (NSW Health 2011).

• Concluding well is not an optional courtesy but a core professional obligation that sustains trust, autonomy, and quality care.