Say what?

Let me start this by saying that therapists are human beings too. We get it wrong, just like anybody else. However, we have a responsibility to our clients to attempt to do good towards them, and not harm them.

Therapists, no matter the flavor, have boards and ethical guidelines that we must follow. These guidelines dictate how we engage our clients, how we cancel with clients, and most importantly, how we transition these clients if we can no longer meet their needs or if we feel that their needs have been met.

When we engage a client, we are legally required to let this client know what our practices are, what our fees are, and who holds our license. Failure to do this is unethical and inappropriate.

On the other side, we must also disengage in a like fashion. We must let a client know that we are disengaging from the relationship and this must be done after careful consideration. The relationship between the client and the therapist is important and must be preserved if at all possible. There are multiple reasons why a therapist may have to terminate with a client, perhaps they are changing jobs, or they feel that they don't have the expertise required to assist that client. Regardless of reason why, all effort must be made to provide the client with advanced notice of intent to terminate AND referrals to a new therapist who is qualified to provide the service to that client. It is not okay to good "therapists in Colorado" and give that list to the client. The therapist should let the client know that they intend to make a referral to a more qualified therapist. Then the therapist should obtain permission to discuss the client with potential therapists and then a conversation should take place. Preferably I would recommend accompaning the client to a session with the therapist if at all possible.

A letter in the mail is never the correct solution. Even if the therapist does not feel safe with the client, a phone call notifying them of the intent to transfer is preferred over a letter. Following up with a letter is good for documentation, but "breaking up" with a client over a letter is never good for either the therapist or the client.

In situations where the client is not returning for services, absolutely, send a letter terminating the sessions.

The same holds true for completing therapy goals. This should be a HUGE deal. There should be a lot of discussion before this happens. Here is my completion of therapy process with clients:

1. Goals review - this should be happening periodically anyway, but it is especially important at the end of therapy. If you sense that you're progressing with your therapy and you're good to go, ask for one of these sessions with your therapist. Go over the goals and complete the ones that have been completed. Adjust ones that need adjustment and then discuss if there are additional goals that need to be added.

2. Discussion that goals have been met and no new goals are needed. I like to send a client home that week to think over their goals and progress made and determine whether they feel they have reached the time when they can "graduate" from therapy.

3. Final session. This is the "YOU DID IT!" session and also the last session to discuss what to do if you feel you need therapy again, how do you come back, finding a new therapist if they are moving out of state or whatever. How to access emergency services, and finally, a survey or opportunity to leave a review for their therapist. THIS IS IMPORTANT! Therapists need to hear that they do a good job too!

Then and only then, can you terminate services with a client. Sending someone a letter that says "You have reached your goals, have a nice life" imagine how impersonal that feels and then imagine how that might trigger abandonment for a client.

Terminating a client relationship is a necessary part of therapy but it doesn't have to be traumatic.