4 Best Practices for Ethically Terminating Therapy With Clients
Ending therapy ethically is a critical aspect of mental health care that requires careful consideration. This article explores best practices for terminating therapy with clients, drawing on insights from experienced professionals in the field. From managing multiple therapist scenarios to empowering clients through therapeutic graduation, these expert-backed strategies prioritize client welfare and navigate the complexities of treatment decisions.
- Ethical Termination Due to Multiple Therapists
- Empowering Clients Through Therapeutic Graduation
- Prioritizing Client Welfare in Treatment Decisions
- Navigating Stalled Progress and Successful Recovery
Ethical Termination Due to Multiple Therapists
Hello,
My name is Karina, and I'm a therapist in private practice. I recently had to terminate a therapeutic relationship with a client after learning she was seeing two other therapists simultaneously.
I was immediately concerned about the potential for harming the client, especially when I learned from her that she was seeing multiple therapists to avoid getting too close to any one therapist. After consulting with a colleague, I realized another ethical risk was client abandonment.
The way I handled this ethical dilemma was to first provide the client with ample psychoeducation on why multiple individual therapeutic relationships at the same time can be harmful. Then, I made it clear that I am available to continue seeing her, provided I am the only individual therapist she is seeing at the time.
Ultimately, the client was not able to commit to seeing only me for individual therapy. So, I offered her several termination sessions and then ended the therapeutic relationship.
Please let me know if there is any more information I might provide that's helpful for your article.
Thanks,
Karina
Empowering Clients Through Therapeutic Graduation
Of course. In our facilities, a common scenario for termination arises when a client has met their therapeutic goals. I had a client working through anxiety-driven clutter. We reached a point where the tools became second nature and the distress was significantly reduced. The work had shifted from processing emotions to practical organization, an area where a professional organizer would be a more appropriate guide.
I managed this by discussing the progress transparently over several sessions, framing termination not as an end, but as a graduation. We reviewed the journey, solidified a maintenance plan, and I provided referrals to trusted professionals. The key is to ensure the client never feels abandoned, but empowered and equipped to continue their journey independently.
Prioritizing Client Welfare in Treatment Decisions
Hello, my name is April Crowe, LCSW. I am a Therapist at The Paramount Wellness Retreat in Connecticut. We would like to contribute to your article! Here are the links to our website, staff page, and my LinkedIn:
https://www.paramountwellnesscenters.org/
https://www.paramountwellnesscenters.org/contributors/
https://www.linkedin.com/in/april-crowe-a7b47219/
Here are our responses to your query:
Terminating counseling with a client should be handled with care and understanding. Factors leading to termination may include lack of progress despite multiple interventions, need for specialized treatment, and ethical responsibility to realize helping a client may be beyond the scope of your skillset. Continuing without improvement can risk great harm to the patient by delaying access to appropriate care. In accordance with the APA Ethics Code, therapists must avoid practicing beyond their competence and ensure client welfare. To manage this ethically, the counselor must communicate to express concerns and highlight strengths while acknowledging limitations. Termination should be framed as a joint decision and invite the client to reflect on their needs. The counselor should provide referrals to the client, including professionals that fit the client's needs. It can be beneficial to provide transition support and/or closure to the client to help reflect on their experiences, reinforcing their strengths, and affirming their resilience, to help them move on to a better fitting treatment plan.
For example, a client had been working through anxiety and depression for over a year. Over time, the client showed minimal progress despite consistent attendance and good therapeutic rapport. We noticed that the client was struggling with other issues, beyond just the anxiety and depression, such as medication management, trauma, and substance use. We then acknowledged that the needs of the client went beyond the scope of their current expertise, and the client required more intense and specialized care. With this, we ethically informed the client and provided referrals for their needs. Initially, the client was disappointed but appreciated the transparency and referrals. Shortly after, the client connected with a specialized trauma program, where they began making significant progress. In this case, client termination was handled in a way that prioritized the client's best interests, respected autonomy, and upheld professional ethics.
Navigating Stalled Progress and Successful Recovery
There are two general scenarios:
1) I believe making therapy helpful and effective is very important to many clients, and I do not want to waste their money and time. When treatment progress is stalled, we typically process and discuss it in the session, and try to adjust the treatment plan. If it still does not work, then we will move toward termination based on a mutual decision. I normally summarize the work, empathize with the client's strengths and progress, discuss what may have caused us to become stuck, and what may be helpful in the future. Then I will offer three referral resources for the client to contact for future treatment.
2) The client has made significant progress and recovered well. Sometimes the client is anxious and does not want to terminate therapy. We typically assist the client in paying attention to their progress, resilience, and strengths, monitor their ability to use the coping strategies we covered, and work toward termination together. The actual termination normally occurs when a client feels more confident and ready to "graduate" from therapy. We congratulate the client for getting better and let them know that they can contact us again in the future if any support is needed.