Topic: professional-ethics

Question: How does counseling end?
How does a counselor decide when to end counseling sessions or to terminate working with a client?

Answer (from Toni Teixeira, LCSWYour road to healing begins here):
Goodbyes can be hard.
Chances are most of the goodbyes you have experienced in your life have been
difficult. Saying goodbye to a therapist can be different. It can be an
opportunity to create a healthy ending in a positive relationship in your life.
If you work with a therapist who is skilled, then saying goodbye can be just as
transformative as the therapy itself. Ending therapy is also known
as “termination.” I know, “termination” doesn’t have a great ring to it!
However, it is what it is. It is an ending of the relationship as it existed.
It is reality cold and stark. Of course, when I talk to clients I don’t use the
word “termination,” I usually say “our goodbye.”  Under what circumstances does therapy usually
end? Therapy should end when a client does not need further assistance, is not
receiving any benefit from therapy, or might be harmed by continuing to work
with a particular therapist.In the best case scenario
the decision to move on from therapy and “say our goodbyes” happens when both
the therapist and the client feel like the client is ready to move on and move
up!  Ending the therapeutic relationship
should actually be worked on from the very first session. What I mean by that
is, there should be an understanding that the work we do together will have an
ending and that is a good thing because it means the client has gained the
skills to continue working on themselves independently. So the first session I
have with clients usually outlines a plan where the end goal is discussed and
we both have an understanding of the skills the client wants to learn or what
they hope to achieve. Now sometimes there are
situations where the therapist ends the relationship and the client may take
that personally, it is hard when any relationship ends and it might bring up
feelings of sadness, and fear or abandonment. Any good therapist will end the
relationship based on what is right for the client. What are some situations
where a therapist might end the relationship?If the situation the client
is dealing with is out of the therapist's scope of practice, the therapist may
end the relationship and refer the client to someone else. This is in the
client’s best interest. Another reason a therapist might end the relationship
is that the therapist is in a place in her life which prevents her from being
objective and helpful.  A therapist who
is going through a painful divorce may have difficulty working with a couple
that considering divorce. A good therapist may see that their judgement may be
clouded and want to refer the client to see someone else. This is good practice
and helps the client.If a client is actively
suicidal or actively using substances then the therapist may end the
relationship and refer out for a higher level of care. The client may need to
be hospitalized or may need an inpatient substance abuse treatment program.
Therapy may be terminated while they are being treated and may continue after
the intensive program is completed. 
Ending therapy should be a
time for connection and bringing together accomplishments, or reviewing the
next important step the client needs to take. It should not be an experience of
abandonment. A skilled therapist will help a client gain a new perspective on
closure. For some clients, it may be the one time in their lives when they get
a clean ending in a healthy relationship and they get to feel a sense of
control on creating that ending. Good luck to you!