Why start at the end? Because this is an area which frequently leads to complaints, with clients (or potential clients) expressing dissatisfaction about the manner in which their therapy ended.
Often the therapy ends before it has truly begun because the therapist makes an assessment and decides that they will not see the client. What particularly riles clients is when they have paid for an initial session only to be told that the therapist cannot help them.
But why should therapy be any different to other types of services? You will still be expected to pay a lawyer their hourly rate even if their advice is not something you want to hear.
It can be hard to tell a potential client you can’t help them. They may have put off coming to therapy until they have reached a point when they are very vulnerable. Telling them you can’t proceed is a rejection. But it is unethical to attempt therapy with someone when it is outside your expertise, techniques and scope of practice. How can you soften the blow?
It is not easy. It’s a good idea to try to put yourself into the client’s shoes. If your therapist ended the therapy, how would you want them to handle it? How would you like to be treated? It may be appropriate to offer an alternative therapist or service when it becomes clear that this would be in the client’s best interest.
We advise therapists to have a contract in place making your termination process clear. This could cover how long therapy should be for, if appropriate, and what happens to any notes/documents you hold for the client. As a general rule of thumb, the longer the therapy the longer the notice period for terminating therapy. But we know there are times when there may be an immediate need to end therapy – for example, in situations where the therapist’s and/or client’s safety is at risk.
What about those situations you must terminate therapy for personal reasons or because of your own physical and mental health? Do you tell your client that you are unwell? If you do, how much information do you divulge? What role can your supervisor play in helping you tell your clients? What support do you have in place to manage informing your clients (some of whom you may have had as clients for years)? Some UKCP colleges or member organisations require their members to have a professional will in place to cover such issues.
There are no hard and fast answers. Our best advice is to think of your client and always ask your supervisor and organisational member or college for support.