I had the opportunity to advise a colleague on how to terminate therapy for one of her clients. This particular case was sensitive and complex. The therapist was worried about the client’s reaction and potential feelings of abandonment.
As I asked my colleague questions about the client, the therapeutic relationship, and her feelings regarding the situation, it became apparent that the therapist also had feelings regarding what she needed to do.
Let me explain further. The therapists’ code of ethics is “do no harm,” meaning we are to terminate therapy when we feel the therapeutic relationship may be compromised. We refer clients out when we do not have enough knowledge or expertise on a particular issue. We sometimes have to be the voice of reason when a higher level of care (i.e., hospitalization) is required.
One area I do not think is discussed enough is when the reason for termination is a therapist’s limitations. In my colleague’s case, she is experiencing some serious health issues requiring her to emphasize her health. In other words, whatever energy she has will have to be geared towards her healing. My colleague feels guilty she has to let this client and others go. She is also experiencing frustration because this client is nowhere near termination.
My advice to her was, to be honest with the client and explain why she cannot continue seeing her. She also needs to start preparing her for termination with plenty of time left for processing feelings and summarizing the work done. Another option for the client is for her to continue therapy with another therapist. My colleague can assist by helping to find another therapist that can be a good fit. It will not only provide a continuum of care, but it may also model a healthy and caring process in saying good-bye.
Finally, we therapists need to turn to each other when dealing with these types of issues. It helps process our feelings regarding our clients, our difficult cases, and our options. I was happy I could assist my colleague in finding clarity and the strength she needed.
QUOTE OF THE WEEK
“If your compassion does not include yourself, it is incomplete.” Jack Kornfield