Termination – A Rare but Reachable Goal
Helping Prescribers Honor Mastery, Foster Purpose, and Prevent Complacency
Clinical Vignette
Mr. W is a 50-year-old man who carried a diagnosis of opioid use disorder for two decades.
He’s now been sober for 10 years, serves as a peer counselor, exercises regularly, and mentors youth in his community.
He says:
“That life isn’t even me anymore.”
This is Termination—not just the end of a behavior, but the embodiment of a new identity.
It’s rare, but when it happens, it deserves thoughtful, affirming support.
What is the Termination Stage?
Termination is the final stage of the Stages of Change model.
In this stage, the individual:
Has no temptation to return to the prior behavior
Experiences full confidence and self-efficacy
Has integrated the new behavior into their identity
Uses past struggles to help others or deepen their life purpose
Most people never formally reach this stage, but it can serve as an aspirational north star.
Goal for the Prescriber: Recognize Mastery, Reinforce Meaning, Prevent Drift
Your role at this stage is to:
Honor their transformation without idolizing it
Help them reflect on meaning, legacy, and contribution
Reinforce systems of accountability and renewal
Watch for hidden complacency, substitution patterns, or grief around loss of identity
Tool: Identity + Purpose Reflection Map
Invite your patient to reflect on:
1. Who they used to be
“Tell me what you believed about yourself when things were challenging for you.”
2. Who they are now
“Tell me one word that describes you today.”
3. What they want to give back
“Tell me how you use what you’ve been through to help others or shape your future.”
This can be part of a closure session, annual check-in, or milestone celebration.
Common Pitfalls to Avoid
🚫 Don’t assume nothing else needs attention
🚫 Don’t minimize the emotional complexity of mastery
🚫 Don’t confuse Termination with perfection
Instead, treat it as a sacred point of integration—a time to deepen awareness, gratitude, and contribution.
Scientific Citations
Prochaska, J. O., Norcross, J. C., & DiClemente, C. C. (1994). Changing for Good: The Revolutionary Program that Explains the Six Stages of Change and Teaches You How to Free Yourself from Bad Habits. Avon Books.
Lapsley, D. K., & Stey, P. C. (2011). Identity formation in adolescence. Handbook of Identity Theory and Research.
McAdams, D. P. (2001). The psychology of life stories. Review of General Psychology, 5(2), 100–122.
Miller, W. R., & Rollnick, S. (2012). Motivational Interviewing: Helping People Change. Guilford Press.
Reflection Prompt
“Do I make space to honor my patients’ transformation—or do I quickly move on?”
“How can I celebrate without putting someone on a pedestal?”
“What does ‘freedom’ look like for this patient—and how can I support it?”