What Does A Psychotherapist s Termination Letter Include?
If we are successful in our work with clients, our professional relationship with them ends. At that time, it is prudent to write a termination letter to formally document the end of that relationship. Here is a list of the things that should be included in that letter.
- Draft a statement that informs the client what termination of treatment is and that emphasizes that it is the client s responsibility to personally seek further treatment if appropriate.
- Include your client’s name (no “Dear Client” form letters).
- Identify the date when therapy began.
- Note the termination date.
- Relate the primary and secondary diagnosis or, if no diagnosis was give, relate the primary cause for treatment.
- Describe the reason for termination.
- Summarize treatment, including any need for additional services.
- If you feel further treatment is advisable or necessary, make that explicit in your letter.
- List three or more referrals or referral sources, including addresses and phone numbers.**
I wonder what else you think might ought to go in your termination letters?
**This information is taken directly from the book The Portable Ethicist for Mental Health Professionals: An A-Z Guide to Responsible Practice by Barton E. Bernstein, JD, LCSW and Thomas Harsell, Jr. JD.
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What are your thoughts on Affordable Care and insurance compensation to private practice folks, counselors, and social workers, ect. Mike
Hi, Mike! It s great to find your voice here! Hey, I m not sure what you are asking. Can you ask it differently?
Thank you so much Tamara. I have never written a termination letter and I see now it should be part of my routine when a client quits attending therapy. You are so helpful!
Welcome back, Linda! And, you are so welcome! I had an attorney tell me once that until that termination letter is written and sent, I could be viewed as the therapist on record. Not something that I really want to have happen 5 years after I ve last seen a client!
Frank Walker MFTI says
Good stuff. Nice to know what others put in their letters.
Should a diagnosis be part of it though. What about confidentiality?
What is going to be the impact of the ACA on counseling and social work income? Mike
Oh! Yes, get it now! Thanks for the clarification! I wish I could foretell the future, Mike, but I m waiting to see just like the rest of you guys!
Three years into The Affordable Care Act, I m really encouraged. We heard so many horror stories predicted about ACA but the truth is that many more people have protections and access to health care than even a year ago. I m sure that if I am the counselor or social worker that is struggling to make ends meet right now, I might question the potential impact of ACA But, for me. it was the right thing to do. Change is often difficult and even scary but we have needed to clean up health care for decades. It may not be perfect but it s one step in the right direction.
As for the impact on counselors and social workers, I rely heavily on the American Counseling Association and the National Association of Social Workers for monitoring the impact of legislation on the field of mental health. And, the Affordable Care Act is no exception.
I m curious, though, Mike. How are you and others anticipating the impact on the field?
Mike, here s how you can set up a gravatar if you are interested. It s really simple.
This post was most helpful, thanks for sending it out. I have concerns about providing specific referral sources; names, phone numbers, etc. In the past when I have had instance of terminating with clients it is often because of their failure to hold up to their end of the psychotherapy agreement (outstanding financial balances, no shows/cancellations, etc.) When this happens I consider it a disservice to the other therapists I am referring them to; to send a client that has acted like this. What are you thoughts on referring to websites, CSBs, etc. when terminating with clients?
Hi, Amber! I m so glad that you bring this up because I think there are many of us who feel that double bind. However, as mental health professionals, our first responsibility is to our clients even those that leave against medical advice. even those who frustrate us. even those who cheat us out of money. and even those who just quit coming. Unless you believe that they have successfully resolved their treatment goals with you and are not at risk to themselves or others, it is in their best interest and in your own best interest to have done everything that you know possible to do to provide resources for those clients upon termination. It s also important to remember that we aren t always the therapist who is a best fit for any given client. It s entirely possible that they may surprise even themselves by choosing to work differently with the next therapist.
My recommendation is to do what is in your client s best interest and in your own best interest. Trust your colleagues jundgments to screen for themselves.
HI Amber and Tamara:
Thanks for that exchange this was an issue I had not thought of, and I loved the response so simple.