Why Would A Therapist Stop Seeing A Client?
Reasons Why A Therapist Would Stop Seeing A Client
Client Threatens Therapist
Threats are never tolerated in therapy
Threats can cause lack of safety for both parties
Not Paying For Sessions
Money and fees are part of the therapeutic relationship and should be discussed in an honest and direct manner
The therapist should have a written policy in their informed consent paper for clients to review and ask questions prior to beginning therapy
Frequent Cancellations
Consistency is necessary toward effective therapy
Canceling often delays therapeutic work, whether intentional or unintentional
Therapists who accept insurance do not get paid if a client cancels a session (insurance does not pay for missed/canceled sessions)
Client Needs Higher Level Of Care
Client needs to be seen more than once a week due to suicidal ideation, homicidal ideation, self-harm, eating disorder, and/or substance use
This can include: Inpatient Program (IP), Partial Hospitalization Program (PHP), and Intensive Outpatient Program (IOP)
Therapists in outpatient therapy see clients usually once a week max. An exception to this would be a psychoanalyst who sees clients 2-4 times per week.
Needs A Specialist
Therapist lacks special training, experience, and knowledge to help client, which can cause harm, render therapy ineffective, be a waste of time, etc.
Examples include: OCD, ADHD, PTSD, personality disorders, eating disorders, substance use, etc.
They Meet Their Goals
Client achieves all their goals they initially wanted to work on and do not have new goals
They feel better
They see results
Countertransference
The therapist’s own feelings about the client from previous relationships and experiences which interferes with the client’s therapy and poses significant harm to the client
Examples include: Erotic feelings toward the client and acting on them,
Dual Relationship
The therapist realizes their client has a relationship with someone they know like a friend, family member, classmate, work colleague, etc.
Boundaries are there to protect both client and therapist
When boundaries are loose and therapy is not a professional relationship anymore, it can be harmful because the therapist has the power and can use this to exploit the client
Loose boundaries can also lead to enactments, engaging in transference, and engaging in countertransference
Client Is Not Getting Better
Therapy isn’t effective for whatever reason. This can include the therapist lacking training, experience, or skill in working with the presenting issue/concerns.
It could also include other issues like the client needing a higher level of care (e.g. more intense treatment than what is being offered)
Client Is Being Harmed
Therapy is actually harming the client in that the therapist holds more power than the client and this is being used in a manipulative manner
Perhaps the therapist is using therapy for their own needs (rather than the client’s), therapist is breaking the boundaries of a professional relationship and entering into a friendship or romantic relationship
What Should Therapists Do Before Ending Therapy With A Client?
Reviewing their code of ethics
Review client’s symptoms to see if the therapist has training, experience, and ability to keep seeing the client
Discussing their feelings and thoughts about a client to their supervisor or colleague for consultation so it doesn’t interfere with and hinder treatment
What Is Client Abandonment?
Ending therapy with a client abruptly without coordinating care and offering referrals to other providers (especially when they are in need of services due to suicidal ideation, homicidal ideation, etc.)
When a therapist takes on a client and works with them, they are professionally responsible for the client
How Do Clients Heal From My Therapist Firing/Ending Therapy With Them
Discussing it with their new therapist
Allow them to feel all their feelings
Share their feelings with their support system