Hello, My name is Karina and I'm a therapist in private practice. I recently had to terminate with a client after learning she was seeing two other therapists at the same time. 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 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 myself 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
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.
There are 2 general scenarios: 1) I think making therapy helpful and effective is very important to many clients, and I do not want to waste their money and time. When the treatment progress is stuck, we normally would 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 strength and progress, discuss what may get us stuck, and what may be helpful in the future. Then I will offer 3 referral resources for the client to contact for future treatment. 2) The client has made a lot of progress and recovered well. Sometimes the client is anxious and does not want to terminate. We normally will assist the client to pay attention to the progress, resilience, and strength, monitor their ability to use the coping strategies we covered, and work toward termination together. The real termination normally happens when a client feels more confident and ready to "graduate" from therapy. We will congratulate the client for getting better, and let the client know that he/she/they can contact us again in the future if any support is needed again.
The hardest part of my job is knowing when to say goodbye. We had a client who was not ready to do the work of recovery, and it was clear that our time together was not helping them. The decision to terminate therapy is one of the most difficult a professional can make, but it's a part of our ethical duty to the client. The factors that led to this decision were a lack of engagement and a lack of honesty. Our client was not being truthful with us or with themselves, and they were not making progress. I had to be honest with them about their progress. My job is not to keep a person in my program; it's to help them heal, and I knew that they were not ready to do that with us. We managed the process with empathy and a commitment to the person's well-being. I had an honest conversation with the client, explaining that my job was to help them heal, and that they were not ready to do that with us. I provided them with resources and a way to get help when they were ready. The process was tough, but it was in the best interest of the client. My advice is simple: the most loving thing you can do for a person is to be honest with them, even when it's hard. The most ethical way to manage the process is to always put the client's well-being before anything else.
I've had many experiences ending therapy with clients. Some factors that might lead to the decision include -client achieving their therapy goals and do not have new goals to move on to. -client need support beyond my scope of practice. -client moving to a different state or country. -therapist leaving the position/agency. To manage the process ethically, I give clients as much notice as possible, usually beyond the minimum few weeks. The last time I gave 2.5-month notice, so that we have plenty time to work together relationally, through feelings of unease or abandonment if they arise. I also helped clients identify short-term goals for the 2.5 months which gave clients a feeling of fresh start instead of dreadful ending. I helped everyone find the transition that meets their needs, whether that meant terminating or transferring them to a provider I trust.
At Pawland, we once had to discontinue a behavior therapy program for a dog because the treatment plan was no longer in the pet's best interest. Despite progress, the dog developed a medical condition that required veterinary intervention rather than continued behavioral training. Ethically, it was important to prioritize the pet's overall health and ensure the family was guided toward the right professionals. We managed the transition by being transparent with the owners, providing detailed records of the progress made, and coordinating closely with their veterinarian so the dog received comprehensive care. Ending the program was difficult, but ensuring the pet's well-being always comes first. Skandashree Bali, CEO & Co-Founder, Pawland | https://www.pawland.com
Terminating a client relationship can be challenging and requires careful handling. A common reason for ending such partnerships is a misalignment of goals. For instance, a business development manager faced difficulties with a client who had high growth targets but was unwilling to invest in essential resources or alter marketing strategies. Despite the manager's support and insights, the client's reluctance hindered the partnership's success, leading to the decision to part ways.
I've had to terminate with clients when the level of care I can offer them is not appropriate for their needs. As an individual therapist in private practice, my capacity is limited for clients with higher needs who might need more than weekly therapy sessions. I've had clients who need a higher level of care, and ethically, providing weekly therapy sessions did not meet their level of need. This led to terminating with the client and offering other resources for higher touch points of support.