A Guide to Psychology and its 
                     Practice -- welcome to the «Termination of Psychotherapy» page. Click on the 
                     image to go to the Home Page.

Termination
of Psychotherapy

 

Website Menus

Page Contents: Introduction / How Long Should Treatment Take? / Reasons for a Client to Terminate Treatment / The Manner of the Termination / Termination by the Psychotherapist / Legal Aspects of Termination

 

 
IN order to appreciate—and understand—life fully, you must come to terms with death. And, just as beginnings and endings are integral to life, they are also central to human psychology. Consequently, once psychotherapy begins, its ending—its termination—becomes a vital presence in the psychotherapy.

In regard to the termination of psychotherapy, you might be surprised to discover that the critical issue in most cases is not the reason for termination but the manner in which the termination occurs.

But first, before considering the issues related to termination, let’s consider the matter of how long treatment might take.

 
How Long Should Treatment Take?

The length of treatment depends on the nature, the severity, and the extent of the emotional wounds that have afflicted you—and those criteria in turn affect the strength of your resistance to change, which in turn affects the length of the treatment. For example, someone who experienced a lack of parental involvement and guidance in childhood, but who had supportive friends and teachers throughout childhood would likely be receptive to changing old patterns of thinking and behavior and so might need anywhere from a few weeks to a few months of weekly sessions of treatment. In contrast, someone who experienced repeated parental abuse throughout childhood, who lacked a supportive social network throughout childhood, and who experienced continued emotional trauma as an adult would likely develop strong defenses resistant to facing the pain of the abuse, resistant to changing behavioral patterns, and resistant to relinquishing the desire for revenge on the abusers. Overcoming those resistances could take several years of weekly treatment.

Therefore, considering that the length of psychotherapy is not a fixed length, we can start to consider when and how to terminate the treatment.

 
Reasons for a Client to Terminate Treatment

Unless psychotherapy begins under a specific legal contract, such as the purchase of a complete treatment program, we can state one general principle about the course of treatment: If you begin treatment voluntarily, you may terminate treatment at any time, for any reason.

The best reason to terminate psychotherapy would be that you have come to understand your life and its unconscious motivations to such an extent that you no longer need a psychotherapist to guide you. If you began psychotherapy feeling as if your psychotherapist were almost a god, you end psychotherapy realizing—as the psychoanalyst Jacques Lacan taught—that your psychotherapist is no more necessary to you than any other person. This isn’t an insult; it just means that you have more or less “dissolved” all your illusions about finding your identity in other persons.

  

There can also be less admirable reasons for terminating psychotherapy. For example, some people might start psychotherapy because they are unemployed and feel depressed. After a few sessions they might find a job, start feeling better, and decide to quit psychotherapy. Maybe they didn’t really come to terms with the unconscious basis of their depression, but if they want to stop psychotherapy, they have the right to do so.

  

The psychotherapist might not think it’s a good idea for someone to leave psychotherapy and might even note in the client’s chart that the client terminated psychotherapy Against Medical Advice (AMA). But AMA is just a legal device to protect the psychotherapist in case of a future lawsuit, so that the psychotherapist can say to the court, “But I warned the client!”

Nevertheless, regardless of what your psychotherapist thinks, you can do whatever you want. It’s your life.
 

  

Then there are pragmatic reasons for terminating psychotherapy, exemplified by those cases when a client, having been in psychotherapy for a while and having done good hard work, receives a job offer in another city or state and decides to move. Or maybe the client has made good progress in psychotherapy, feels more confidence, and decides to go back to school—but no longer has the time for psychotherapy. Or maybe financial issues prevent the treatment from continuing. These are not necessarily “foolish” decisions, even though the client might still have unresolved psychological conflicts. The point here is that not everyone wants to, or can afford to, pursue psychotherapy to the point of deep unconscious healing. For some persons, “good enough” may be good enough.

There are also unfortunate reasons for terminating psychotherapy. Through good work clients can find relief from their initial symptoms, but then they might also start to encounter some deeper unconscious issues that frighten them. So they find reasons to leave the treatment. The reasons may seem pragmatic, but they really are excuses for the clients to run and hide from their own unconscious.

There can also be safety reasons for terminating psychotherapy. For example, a psychotherapist might make a serious clinical mistake (not just an unpleasant interpretation), and a client might believe that trust has been broken. If the client makes an effort to speak about the problem within the treatment but isn’t given a competent explanation, there may be no other option than for the client to terminate treatment for his or her own psychological safety.

  

Note that if your psychotherapist does something illegal or unethical—such as try to have sex with you—then you would be well advised to terminate psychotherapy and make a consumer complaint to the psychotherapist’s licensing board.

  

 
The Manner of the Termination

The only way to terminate psychotherapy honestly is to talk about it. So take at least one or two sessions to review your treatment before leaving. Remember how your life once was. Recognize what you’ve learned and how you’ve grown because of the psychotherapy. Recognize also what still needs to be done. Assess your weaknesses. And then look ahead to anticipate future problems and plan strategies to cope with them.

Ways to avoid a proper termination:

If you simply stop coming to sessions and don’t return your psychotherapist’s messages, for example, that’s hiding, not terminating.

  

If you get involved with a new “lover,” for example, and find psychotherapy to be inconvenient for your dating schedule, that’s running, not terminating.

If you get angry at your psychotherapist because of transference and quit psychotherapy rather than deal with your feelings within the psychotherapy, that’s bolting, not terminating.

But if you have terminated the treatment honestly and politely, you also have the option to return to treatment again in the future—either for a one- or two-session “tune up” or to work on deep issues still unresolved.

 
Termination by the Psychotherapist

There can also be times when psychotherapists must terminate treatment.

Psychotherapists in training who work in an agency may leave the agency at the end of an internship, and treatment with all of their clients will have to be terminated, sometimes prematurely.

  

Sometimes psychotherapists who work for an agency will decide to leave the agency to go into private practice. Things can get sticky here because if a psychotherapist tries to take any clients from the agency into the private practice, the agency might claim that the psychotherapist is “stealing” its clients. So the psychotherapist has to be very careful about how everything is presented to clients. Nevertheless, clients are free to do what they want.

Sometimes psychotherapists will have countertransference issues that can interfere with the treatment. Psychotherapists may have to consult with peer professionals to discuss their cases, and it may be decided that circumstances ethically require the termination of treatment to protect a client’s best interests.

  

Countertransference problems will be minimized if psychotherapists have had intense training in psychodynamic psychotherapy or psychoanalysis. For example, a client and psychotherapist may have opposing political views, and the client may have a tendency to argue politics; but if the psychotherapist has the expertise to keep the treatment focused on the underlying emotional issues—rather than get caught up in surface arguments—then the psychotherapist’s personal feelings need not become a problem.
 

  

Sometimes psychotherapists will realize that the psychotherapy has moved into an area that requires expertise they do not have, and trying to continue psychotherapy without proper training or supervision would be an ethical violation.

Sometimes a managed-care company will decide that treatment must be terminated. This is usually done for practical business reasons that have nothing to do with the client’s welfare, but psychotherapists on the case can lose their jobs for not following orders, even if it is not in the client’s interest to terminate the treatment. Psychotherapists in such a position should seek legal advice immediately, lest their licensing boards take action if their clients file complaints.

Regardless of the reasons for a psychotherapist needing to terminate the treatment, psychotherapists are bound by ethics to treat their clients with due respect and consideration in all things, including termination. The reasons for termination should be discussed fully and honestly. Clients should be given enough advance notice so that their emotional reactions can be carefully processed.

  

If the client-psychotherapist relationship is an issue contributing to the need for termination, then any block to the client and psychotherapist working together effectively may prohibit a full processing of the termination itself.

  

Finally, a suitable referral to another psychotherapist should be made, if necessary.

 
Legal Aspects of Termination

If your psychotherapy was not entirely voluntary—that is, if it were court-ordered, for example—then premature termination will be a violation that will cost you dearly. But in any other case there shouldn’t be any legal problems. Just remember these points:

Even after psychotherapy has terminated, you still hold the privilege of confidentiality. Your psychotherapist cannot reveal anything about your treatment without your permission. Your psychotherapist will also have the legal obligation to retain your treatment records (or “chart”) for quite a while, according to state law. For example, California law (Health and Safety Code section 123145) requires that records be kept for a minimum of seven years, but this law does NOT APPLY to private practice settings. Hence psychologists in CA are referred to the Specialty Guidelines for the Delivery of Services by the American Psychological Association which recommends that full records be maintained for three years after termination and that summary records be maintained for an additional 12 years.

  

You may request that your treatment records be sent to another qualified professional. Note that your original psychotherapist has a legal right to the chart itself, so only copies of the information in your chart will be sent.

If a person dies while in psychotherapy, or after psychotherapy, privilege—including the right to see the psychotherapy records—usually passes to that person’s estate. In such a case, professional legal advice may be needed.

 

 
Clinical questions about the termination of psychotherapy can be found
on the Questions and Answers About Psychotherapy page.

 
 


No advertising—no sponsor—just the simple truth . . .
 

If this website has helped you, then
please help support this website


 

 
Additional Resources

CA Law:
Legislative Council Website —the official site for California legislative information. Search their database for any law you can think of.
CALIFORNIA CIVIL CODE —Table of Contents
CALIFORNIA HEALTH AND SAFETY CODE —Table of Contents
CALIFORNIA EVIDENCE CODE —Table of Contents
CALIFORNIA PENAL CODE —Table of Contents
CALIFORNIA WELFARE AND INSTITUTIONS CODE —Table of Contents

Related pages within A Guide to Psychology and its Practice:
Choosing a Psychologist
Confidentiality
Consumer Rights and Office Policies
Fear of Psychotherapy
Legal Issues
Psychology: Clinical or Counseling or ...?
Psychology and Psychiatry
Questions and Answers about Psychotherapy
Reasons to Consult a Psychologist
Types of Psychological Treatment
 
CONTACT ME
 
INDEX of all subjects on this website
 
SEARCH this website

 



FOR THE SAKE OF TRUTH this website about the practice of Clinical Psychology does not accept any advertising.

Therefore, if my work has been informative and helpful to you, please send a donation in appreciation, even if it’s only a few dollars, to help offset my costs in making this website available to everyone without advertising.

 
Gratitude is joy to the heart!

 


Raymond Lloyd Richmond, Ph.D.
San Francisco
 
Credentials
 
Contact Me


 

Psychology is a complex subject, and many issues are interrelated. And so, even though you may find a topic of interest on one particular page, an exploration of the other pages will deepen your understanding of the human mind and heart.

Psychological Practice
To Become a Psychologist
Choosing a Psychologist
Confidentiality
Consumer Rights and Office Policies
Honesty in Psychological Treatment
Legal Issues
The Limits of Psychology
Managed Care and Insurance
Other Applications of Psychology
Psychology: Clinical and Counseling
Psychology and Psychiatry
Questions and Answers about
   Psychotherapy

Termination of Psychotherapy
Types of Psychological Treatment
 
 
Clinical Issues
Becoming a Nonsmoker
Depression and Suicide
Diagnosis in Clinical Psychology
Dream Interpretation
Fear
Fear of Flying: Information
Hypnosis and “Negative” Hypnosis
Medical Factors Affecting Psychology
Medication Issues
Psychological Testing
Questions and Answers about
   Psychotherapy

Reasons to Consult a Psychologist
Repressed Memories
The Psychology of “Stress”
Trauma and PTSD
Types of Psychological Treatment
The Unconscious
 
 
Social Issues
Adolescent Violence
Anger
Family Therapy
Forgiveness
The Psychology of Terrorism
Sexuality and Love
Spirituality and Psychology
Spiritual Healing
 
 
Personality and Identity
Death—and the Seduction of Despair
Identity and Loneliness
Personality
Sexuality and Love
Trauma—and PTSD
 
 
Stress Management
Autogenics Training
Hypnosis and “Negative” Hypnosis
Progressive Muscle Relaxation
The Psychology of “Stress”
Systematic Desensitization
 
 
Fear of Flying
Aviation Links
Basic Principles of Aircraft Flight
Fear of Flying: Information
Fear of Flying: Treatment
Hypnosis and “Negative” Hypnosis
Systematic Desensitization
 
 
Self-help
Anger
Autogenics Training
Becoming a Nonsmoker
Progressive Muscle Relaxation
Questions and Answers about
   Psychotherapy

Systematic Desensitization
Trauma Support Groups
 
 
Personal Information
Consultation Information
Contact Me
Education and Affiliations
Feedback Form
Introduction
Privacy Policy of this Website
 
 
HOME
 
SEARCH

 


There is no advertising on this website.


 
 

Throughout this website, my goal is simply to help you realize that although life can be painful, unfair, and brutal, it doesn’t have to be misery.
 
The practice of good clinical psychology involves something—call it comfort—which does not mean sympathy or soothing, and it certainly doesn’t mean to have your pain “taken away.” It really means to be urged on to take up the cup of your destiny, with courage and honesty.

 

 

Comments

 

 

 

    

his is a FREEWILL WEBSITE with NO ADVERTISING. If you find this page to be informative and helpful, please send a donation to this website in gratitude, as a “down-payment” on the success of your hopes!

 


 

A Guide to Psychology and its Practice

www.GuideToPsychology.com

 

Copyright © 1997-2022 Raymond Lloyd Richmond, Ph.D. All rights reserved.
San Francisco

 

All material on this website is copyrighted. You may copy or print selections for your private, personal use only.
Any other reproduction or distribution without my permission is prohibited.

 

 
Donate

No advertising and no sponsor—just the simple truth.