Lathma/Mental_Health_Conversation_Dataset huggingface dataset:
Question: I terminated my counseling relationship with a social worker several years ago. I am now realizing that I would like to begin counseling again. The social worker’s voicemail message says that he returns calls in 24 hours, but he hasn't called me back. I called him on the weekend and made it clear that I want him to call me back. Can he just ignore me?

Answer: Mental health providers should promptly return calls from current clients as well as from potential clients.  This is even true if the social worker (or counselor) is unable to make an appointment with the caller.  In that case the social worker should call you back to let you know that he is unable to schedule an appointment with you.In addition, mental health providers have an obligation to follow through with their own communication standards.  For example, if the social worker in this case has an outgoing voicemail message that promises returned calls within 24 hours, he has an obligation to follow through on that promise.All that being said, it is also worth remembering that mental health professionals are just people too. It is possible that he had an unforeseen emergency that kept him from from returning your call promptly.In the end, I agree with Sherry's advice. If you feel this social worker is not a good fit for you, you probably should trust your gut and find someone else who is a better fit.
Question: I terminated my counseling relationship with a social worker several years ago. I am now realizing that I would like to begin counseling again. The social worker’s voicemail message says that he returns calls in 24 hours, but he hasn't called me back. I called him on the weekend and made it clear that I want him to call me back. Can he just ignore me?

Answer: Yes, your former social worker should return your phone call.It is the professional ethic to do so and plain human decency to do so.If he doesn't, there is nothing you can directly do about the fact of his ignoring you.There are formal complaints you can make, which you can consider doing.What matters most is receiving social work service.Stick with looking for another social worker who is willing to help you.The self-doubts you mention may be worth examining.They do not, however excuse the social worker mishandling himself.
Question: I think I have depression, anxiety, bipolar disorder, and I have anger issues. I told my mom over and over again. She told me she would get me a therapist, but she never did. I just found out that my mom can't afford a therapist for me.

Answer: It can be difficult to get counseling if you don't feel supported by family members.  There might be a few options.  If you are in school, I'd recommend talking to a school counselor or school nurse.  They often will be able to help you access free or affordable counseling resources in your community.  In addition, depending on where you live, it's also often possible to call 211 for referrals to free or low cost counseling services in your area.I'd encourage you not to give up. You are on the right track.
Question: I have major depression, severe, PTSD, anxiety disorder, and personality disorder. I had an appointment with my doctor. I was very upset, and I shared with him about that particular drug.

Answer: Your doctor might be required to tell your psychiatrist - especially if your doctor is concerned about your safety.It was definitely a good thing that you told your primary care physician about what is going on.  I know that must have been difficult to talk about with him.  By having that conversation, you are helping your primary care physician and your psychiatrist work together to best support your health.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: There are typically three reasons why therapy is terminated:1) Client has met therapy goals2) Client is not progressing 3) Therapist is not a good fit for clientIn order to properly assess whether therapy is helping and what progress is being made, the therapist needs to have ways of consistently checking in with clients sessions-by-session to determine what is helping, what isn't, and where the client is at in relation to their original therapy goals. When a client has met their goals, that is a good time to end counselling sessions unless the client has new goals or simply wants to check-in periodically to make sure that they are still on track (sometimes referred to as relapse prevention). When a client is not progressing, and feedback has been taken and attempts have been made to make the therapy more helpful for the client but to no avail, than it is considered unethical to continue to work with the client. In these circumstances, referring out to another therapist who may be a better fit is a good idea.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: Hopefully both the client and counselor would together decide when to terminate counseling sessions. It's really helpful for the client to leave counseling with a solid sense of what he or she has accomplished in counseling, so it can be a good idea to spend some time acknowledging that in the last session or sessions. Sometimes, however, a client has needs beyond the scope of the counselor's expertise. That's a good time for a conversation about those needs and ideas of  how best to meet them, whether by adding in care with an additional mental health professional or transferring care entirely to a new mental health provider.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: There are different reasons why a counselor may seek to terminate with a client and these will each have different processes by which the counselor will come to that decision. Here are a few examples. The counselor may determine that the client's needs are outside what the counselor is competent to be able to work with. A person may have come to the counselor talking about a particular issue but either when they first met or as counseling progressed, it may become clear that the issue is in fact something different or that there is an additional related issue. If that issue is outside the competence of the counselor, the counselor should look for alternatives, the most common of which would be to terminate and refer. Beyond clinical issues, this could also come up around particular other related facts, such as the culture of the client or linguistic issues. This could also be the choice of the counselor if they know someone that they feel would be a better match for the client's issues. Another reason for discharge (and possible referral) would be if the relationship does not seem to be a good fit. No counselor is the right person to work with everyone. If the right level of connection is not happening, the counselor will often look first at what they are doing, might talk about it with the client and ultimately will admit that things don't seem to be working to allow the desired therapeutic process to work. A similar process would be followed if the counselor determined that the client might not yet be ready for counseling as evidenced by lack of engagement such as frequent cancellations, not doing any agreed on work between sessions, showing up late or being really guarded in session. The easiest situation to decide on is when a person has met their counseling goals and have nothing new that they are working on. While this is the easiest one to determine, it is also probably the hardest one for the counselor as they may be like the client in not wanting the relationship to come to an end. However, counselors know that this is part of the process. They will also determine this by regularly reviewing the treatment plan or by sending in the sessions that the work has come to an end. This type of termination maybe final or may be with the intent that the client will return later to address other things that have been identified but for which they are not ready to move into. All of these (and other) situations involves the counselor being open to the relationship ending, to monitoring how things are going, then engaging in self reflection, possibly talking with the client and then coming to a conclusion on which the counselor  follows through.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: From the very beginning of counseling sessions I emphasize that the work will and must end at some point.In counseling there is an arc to the process. A beginning, middle and end. I am always digging, searching and exploring. There comes a point where things come to there natural ending.I always leave an opening for continuing counseling in the future. At least as a check in.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: For most:  When the money/insurance runs out.When best:  When the job is done... and you're feeling much better.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: To be able to identify a clear ending to a counseling relationship, we must have a clear understanding of the goals and limitations of treatment.  Usually, during the initial evaluation, I identify my client’s short term and long term therapy goals.  As therapy progress, we verify goals on a monthly to a quarterly basis, depending on the frequency of the appointments.  Once the therapy goals have been met, there is a closing session, the counseling relationship is ended, and the client can stop attending sessions.  In some cases, the client can also establish new goals and determine if I am a good fit for their therapy needs or if they need a new provider, in which case I provide multiple referrals.The counseling relationship could also end due to other factors like noncompliance= when a client is not committed to the agreed treatment process, or when the client’s or a counselor violates the counseling relationship.  Either the counselor or the client is able to end counseling.  Although, as mental health providers we need to provide a reason for terminating our therapeutic relationship and referral options, as a client no explanation is needed, a closing session is highly recommended.  ¿Cómo termina la terapia?¿Cómo un consejero decide cuando terminar las sesiones de consejería o terminar de trabajar con un paciente?Para poder determinar el final de la relación del consejero, debemos comprender las metas y parámetros de la terapia.  Usualmente durante la evaluación inicial se identifican metas a corto y largo plazo con el cliente, y se discute con el cliente como esas metas serán alcanzadas.  Durante el proceso de terapia el consejero revisa las metas mensual o trimestralmente dependiendo de la frecuencia de las citas.  Ya que las metas de terapia son alcanzadas, hay una sesión de cierre y el cliente puede terminar la terapia.   En algunos casos el cliente puede identificar nuevas metas para la terapia y determinar si el mismo consejero u otro consejero le pueden asistir. 
La relación de consejería también puede terminar por no conformar o violentar los parámetros  establecidos para la terapia.   Tanto el consejero como el cliente pueden terminar la relación de terapia.  Como proveedores de salud mental los consejeros estamos obligados a proveer un razón para la conclusión del tratamiento y proveer referidos según aplique, los clientes no necesitan proveer una explicación, aunque es recomendable discutirlo en una sesión de cierre.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: It is usually time to end counseling sessions when it is clear to both the client and the counselor that therapeutic goals have been reached and enough improvement has been made that the client can continue without that support. There are exceptions to this rule, but for the most part this is when counselors begin termination. For some clients, this is an easy process that marks the achievements they have made in working through their emotions and difficulties. For some other clients, however, this is a difficult process in which they are losing a valuable support and are understandably anxious about what life will be like without the frequent meetings. Ultimately, termination is different for everyone, and there are many ways that termination can be healthy and helpful.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: As a therapist who believes in client self-determination above most other elements of the process, I want to as much as possible leave it up to the client to determine when they are finished. In the case of a termination because a client's distress has resolved, I might periodically check in with the client about how therapy has been going, and if we want to re-evaluate where we are.The more unfortunate situation would come about if I felt that I wasn't the best fit for the client. I would offer that in words, and ideas of therapists (with names) of who I thought might be a better fit and why. It still is up to the client whether to continue, however should they want to keep seeing me, a part of the work would be about that want (to see someone who professionally doesn't believe they can help as much as someone else.)I also find it perplexing when I hear a client (or on a personal level) tell me that their therapist said they "didn't need therapy." I don't know that I buy into that scenario all that much, because I do believe that yes, not everyone NEEDS therapy, but that everyone CAN benefit from therapy and I don't believe it is the therapist's job to deter someone from ever seeking out help of any kind.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: Ideally, termination should be a mutual process. It's not that the therapist kicks the client out at some point and says, "Okay, you're done." Rather, over time the client will decrease the frequency with which he/she comes to session so that it may start off as weekly, then decrease to biweekly, then perhaps once every three weeks, then once/month and so on. Throughout this process, the therapist and client should have had regular check ins about progress toward goals. If the client feels good about where he/she is in life, he/she might decide to suspend therapy for now. That being said, the therapist should make it very clear that if the client ever decided to return for "maintenance" therapy or a check in, he/she would always be welcome. There is no hard and fast rule to ending or a particular time period in which it must end. What matters most is that the client feels good about it and knows that the therapist will always be there should he/she wish to return.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: For a therapist, deciding to end counseling sessions or terminate working with a client is a thoughtful and intentional decision. One that is not entered into lightly. While there are many considerations counselors take into account, to help answer this question, I'll offer an example of two areas that counselor's take into consideration when ending counseling sessions:Does the client need different or more specialized care than the current counselor can provide? This requires the counselor to determine whether referring the client to another therapist or health care provider is needed.And, has the therapeutic relationship reached treatment goal(s)? While this question is specific to the counselor, I'd like to also add that a client, at any time, can end counseling.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: In general, I usually let the client decide when this should occur, sometimes with some clients it will be a joint agreement, but even in that case it should weigh mostly on what the client feels. In short, therapy ends when you feel your done.C
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: I will work with clients and continually review progress with them and determine if counseling is helping.  If a client appears to have less to talk about in sessions, appears more stable for a period of time and has reached therapeutic goals I will talk about termination.  Some clients however I may continue with on a monthly or bi monthly process to allow for check-ins to see how they are doing and if they need more help at that time.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: There are several reasons for a counselor to decide to end counseling.  A major reason to end counseling is if the counselor feels that he or she does not have the skills or experience to work with the client.  This may happen during the intake process or after working with the client for some time.  If the clinician feels that the client is not benefitting from the therapy, it is ethical to suggest that the client terminate the therapy.  The process of termination must not injure the client and, if necessary, the clinician may need to refer the client to other treatment modalities.  Another reason to terminate working with a client is if the client needs a higher level of care.  If the client has a crisis or is at risk of hurting himself or someone else, he or she may need a higher level of care.  In this circumstance, the clinician may need to involve outside services such as a crisis unit.  A third reason to terminate with a client is if the clinician feels that he or she cannot remain professional with the client relationship.  For example, if the issues that the client is working on bring up something significant for the clinician and the clinician feels that he is unable to separate that from the professional relationship.  In this instance, the clinician should refer the client to another therapist.  Finally, if the client has reached her goals for therapy and no longer needs treatment, the clinician and client should terminate treatment.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: Counseling ends when the client has received the maximum benefit from the therapist. Even if the therapist believes the client is not making progress, the client may feel they are improving and receiving a benefit. And the therapist may see a benefit and the client does not. It is best to have ongoing dialogue with the client to determine when termination is appropriate.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: In the best case scenario, it's a mutual discussion and decision. If not,  I've had the discussion initiated both ways, by me, when I sense the client has gone has far as they want, by lack of interest in accepting or completing homework assignments, missing or cancelling appointments, usually at the last minute, lack of participation during sessions.  Client initiates by asking me pointed questions about why the need for homework assignments,, by forgetting their calendar, or their checkbook :) , by suggesting that we make appointments over longer intervals (once a week to once a month, for example).  I rarely have had to terminate a working relationship--that's why I don't charge for the first visit, so we know if we are a good fit before we start working together.  Then I periodically ask whether the client feels we are making progress, moving in the right direction, talking about the most relevant issues etc.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: In my therapy practice the decision to end therapy is mutually made together with the patient.Otherwise, the person can end up with a sense of tremendous rejection and abandonment.The way you'll both know therapy is coming to a close is that the discussion will feel lighter and move easily.The person's mood will be better, they will smile more, sit in their seat in a more relaxed way, look more at ease, take better care of their appearance.One of the ways to end therapy is to gradually decrease the frequency of the sessions.Sometimes people who are in my practice start to come each three weeks, then monthly, then every three months.This gives a sense of security, friendliness, and casualness to the therapy, and de-medicalizes it as though the person was treated for a medical symptom and the symptom stops completely one day.Talk therapy is about life and life problems usually end gradually.I end my therapy in a way which mirrors the life process in which many interaction and situation problems show their effects gradually and show different effects over time.
Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer: Hi there, There are a number of reasons why a therapeutic relationship might end including, but not limited to the client reaching their goals, the client reaching a place of acceptance where they wish to remain or even a breach within the relationship.  The last aspect should likely be taken to supervision in order to be fully processed.  All of these things could happen, and usually happen organically (again, except for the last example). Your question, however, was about the counselor ending treatment. This is a bit more difficult and can be very nerve-wracking.  It may be beneficial to take this with you to supervision, as well.  It's important to understand why you feel the need to end or terminate with the client, as well. Do you feel that they would be better suited for another therapist, have they achieved their goals or is it something else?In regular, open-ended sessions, I try to make a point of checking in with the clients fairly frequently. In these check-ins, I use the time to ask the client how they feel about the sessions and if there is anything they wish to focus on more astutely.  I also ask if they have any immediate goals that they would like to prioritize.  In goal-oriented sessions, I check in more frequently to ensure that both the client and I remain focused and, should they wish to shift their focus, that they recognize it is part of my responsibilities to make sure we move back to the desired goal. Often, especially in longer term therapeutic relationships, we as clinicians can see that the client has reached their goal, however they are apprehensive about ending therapy.  This is actually a great place to go with them; why would they feel unable to handle issues in their external or internal environment without you? Often, having this open discussion can increase empowerment and mastery. That said, it could also highlight other issues which the client may have been apprehensive about going into within therapy and now, as the relationship seems to be ending, feels more confident in bringing these up. In the case where the relationship is a toxic one, terminating with a client may be the best option for both of you. It's a difficult conversation, but recall that part of the role of the therapist is to model that these discomforts can be managed. I hope that this brief response can assist you going forward!