Why Would A Therapist Stop Seeing A Client?

Reasons Why A Therapist Would Stop Seeing A Client

  1. Client Threatens Therapist 

    • Threats are never tolerated in therapy

    • Threats can cause lack of safety for both parties 

  2. 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 

  3. 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)

  4. 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.

  5. 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.

  6. 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

  7. 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, 

  8. 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

  9. 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)

  10. 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 

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Therapist Reflection: 11 Things I’ve Working as a Trauma Therapist