Termination: A crucial aspect of psychotherapy
Termination is, perhaps, unfortunately, a key skill that therapists at a counseling practice need to master if they want to operate successfully. The termination may result from the end of a long and trusting relationship with a client or from something more complicated, including numerous no-shows or simply being a bad fit.
While clients can terminate their relationship with a therapist at any point and for any (or no) reason, this process is slightly more complex for therapists. Knowing the right time to terminate therapy and how to navigate communications well will protect both the client and the therapist and ensure no ethical boundaries are breached.
This guide will explain how termination ethics work and outline exactly how and why you should end therapy with a client. These skills will enable you to look after your and your client's health, hopefully contributing to personal growth and developing positive, trusting relationships even after ending therapy.
Ethics around the termination of therapeutic relationship
Just like in every other aspect of therapy, termination has ethical considerations you must be aware of. Ethically, the counselor must prepare clients for the termination process and decide when they are no longer benefiting from the therapy.
This means that counselors should consider termination even from the very first session. Regardless of the relationship between counselor and client, it is often likely that feelings of disappointment, loss, and finality accompany the termination period.
For the client to be as well prepared for this as possible, it is necessary that the termination of therapy process is transparent and the therapist actively counsels them through the next stages on a positive note.
Termination of the psychotherapy process can be highly triggering for certain clients, particularly those who have experienced trauma or loss, so the exact termination methods used by a counselor will vary for each case.
Ultimately, an ethical termination is honest, considerate, and based on the reasonable understanding that a client is not benefiting from therapy.
If a therapist makes this decision early in the therapeutic process, they should maintain professionalism by referring the client to a more suitable mental health care option.
The ideal time to send a therapy termination letter to your client
Therapy termination occurs differently depending on the clients, but it is often a good idea to officially signify the end of a therapy relationship with a termination letter. This may seem excessively formal, but terminations can sometimes go wrong, and these letters will help protect both the therapist and the client. While some therapists will choose to send a termination letter to every client, this may not seem like the best option for you.
Nevertheless, there are certain situations in which you definitely should use termination letters, including:
- When you are terminating a client who hasn't shown up to their appointment and isn't rescheduling.
- When you are terminating a client based on a fear for your own safety or health, and so you do not wish to have an in-person appointment.
- When you are terminating a client because you believe you are a “bad” fit and won't be able to address their needs adequately.
- When you are terminating a client who has had past issues handling rejection.
Process of laying the groundwork for the termination process
It is important that termination has been introduced to the client carefully, and you don't just surprise them with this massive decision that they feel they have been left out of.
Prepare clients for termination from the start
When you first meet a client, part of your counseling treatment plan should involve explaining that therapy is time-limited. Successful therapy relationships always have an endpoint; if clients know this, they will be better prepared to deal with termination.
Knowing that termination will eventually happen also introduces the understanding that the full termination phase of therapy is good, especially when the client can no longer benefit from the therapist's expertise and has most likely achieved their goals.
Set therapeutic goals to mark a “finish line” for therapy
Therapists should create objective goals with their clients that help focus the counseling guide. These should be documented and shared with the client, either with hard copies or via counseling software. When each goal is achieved, it is important to acknowledge this so the client can visualize and celebrate their improvement.
While these goals will inevitably change as the client develops and grows, they can help serve as a guideline for the final objective of the client's treatment.
How to terminate therapy with a client: step-by-step process
When the end date for therapy is in sight, the majority of each session will essentially focus on termination. We have outlined the different considerations you need to be aware of so that this process can occur as effectively as possible.
1. Gauge readiness for termination
If a client has achieved the goals in their treatment plan, it is time to think about termination. When this becomes clear, you should raise the possibility of termination with your client and assess whether they feel positive or negative about stopping therapy.
Different factors will contribute to these emotions, and if your client is feeling particularly negative or fearful, it may be a good idea to adopt a fading-out approach and slowly reduce your therapy sessions.
If the termination results from a poor fit or interpersonal issues, you should talk to your client about a referral. To ensure transparency, this conversation is honest upfront and includes details about relevant pricing updates.
2. Review gains made in treatment
During termination, it is important to identify and acknowledge a client's achievements within therapy. It would be best to ask them to review their advancements and compare their progress from the first few sessions to the final session.
Reviewing treatment goals and gains made in their ongoing treatment needs will allow clients to visualize their progress and accept that they are ready to stop therapy.
3. Create a mental health maintenance plan
The biggest issue surrounding termination is a fear of relapse. To combat this, you and your client should construct a mental health maintenance plan that outlines different methods and strategies the client can use.
This documentation could be included in an online counseling guide, making it accessible to clients even after the termination of the therapeutic relationship.
Mental health counseling termination letter sample
PDF version: https://content.highmarkprc.com/Files/EducationManuals/QualityMgmtToolkit/sample-termination-letter.pdf
Final thoughts on therapy termination
Understanding client terminations can be tricky for counselors, but it is necessary. You may deem termination necessary for several reasons, and you must be as transparent through this decision-making process as possible.
Provided you follow ethical guidelines and are honest and upfront with your clients, there is no reason why you won't be able to conduct a smooth termination process of your therapeutic relationship.
Hopefully, this article has provided you with enough information that you can focus on improving your terminating therapy skills and getting positive reviews from both your past and present patients!
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