4.7 Client Termination Policy

therapy is a time limited process with clear goals and a plan for treatment termination of therapy is usually influenced by the goals that are developed, changed, and/or achieved as well as the client’s ongoing treatment needs the duration of therapy will vary for each client, ranging from several weeks to months, or sometimes even a year or more the decision of when to terminate treatment is generally made with client and caregiver input and based upon the therapist/provider’s professional judgment, abilities, and needs however, there are also many factors related to the client and caregiver, that influences termination, including, but not limited to the client’s current (and perceived) level of functioning and symptoms manifested; caregiver’s level of distress and prioritization of therapy reason for seeking therapy; client/caregiver commitment to the therapeutic process; scheduling needs/compatibility; financial considerations for the family; client meeting insurance requirements for medically necessary treatment (clinical justification for dsm 5 tr diagnosis); justification for higher level of care; and need for more specialized treatment (out of the scope of experience and training for the therapist) ideally, terminating therapy should be a conscious and deliberate decision made between the client, client’s caregiver, and provider, with the child/adolescent’s best interest in mind in this case, sessions end when the client, caregiver and provider agree that treatment goals are met or that progress is no longer being made as caregivers may influence the frequency of sessions and duration of treatment for their child or adolescent, unplanned termination is not an unusual experience another factor to consider involves disagreement among a child/adolescent and their caregiver and/or disagreement between caregiver(s) and the provider regarding the child’s treatment if such disagreements occur, providers should strive to listen respectfully so that they can understand the caregiver’s perspectives and clarify any miscommunications or disagreements providers may be able to resolve such disagreements with the client and/or caregiver or decide to terminate the therapeutic relationship while remaining respectful and professional it’s important to acknowledge that a family’s commitment to therapy is largely influenced by not only the therapeutic rapport between the provider and child, but also the caregiver’s perceived working relationship with the provider throughout the therapeutic relationship, providers can encourage caregivers to discuss with the provider their concerns about treatment at any time, and, as appropriate, providers may ask for the caregiver’s feedback about their child/adolescent’s treatment and progress regular communication with the caregiver, whether it be at the beginning or end of sessions, responding to caregiver initiated communication in a timely manner, offering caregiver support sessions, or caregiver feedback meetings at predetermined intervals, can have a positive impact on the provider’s relationship with the caregiver and the continuation of treatment c aregivers may terminate the therapeutic relationship at any time even if a therapist and child desire to continue the therapeutic relationship, ultimately, it is the child’s caregiver/legal guardian who decides whether therapy will continue if either caregiver/legal guardian decides that therapy should end, providers should seek to honor that decision, unless there are extraordinary circumstances providers may terminate the therapeutic relationship at any time according to their professional judgment this decision may be related to caregiver behavior, such as failure to comply with clear boundaries regarding acceptable forms of client interactions and communication, frequent “no shows”, client non adherence to treatment recommendations, provider is uncomfortable or feels threatened by client, etc regardless of the situation, it is the responsibility of each provider to understand and comply with their own professional ethics and the statutes in their state related to client communication, and codes of conduct, particularly related to client abandonment and termination if a provider has any questions concerning these requirements, they are urged to contact their professional liability insurance carrier and/or their state licensing board if providers need additional non emergency support regarding a particular case, they may contact the director of community to discuss a referral for peer consultation through hopscotch after it has been determined that termination is the proposed course of action, it may be therapeutically appropriate for the provider to ask the caregiver for one or more closing sessions with the child to properly end the treatment relationship provider’s can attempt to help caregivers understand that apart from extremely unusual circumstances, it is generally not in the child/adolescent’s best interest to abruptly terminate therapy process for provider initiated termination if the provider decides to terminate the therapeutic relationship, they will 1\ explain to the client/caregiver in a timely manner, through approved methods of communication, why services with the provider are being terminated, and the effective date of termination 2\ complete all notes pertaining to the client and include reasons for termination 3\ cancel all upcoming scheduled sessions with the client within the hopscotch platform archive the client in the providers viewable caseload page within the hopscotch platform contact hopscotch customer support if the client/caregiver has requested assistance in finding additional care process for client/caregiver initiated termination if the client/caregiver notifies a provider that they wish to terminate treatment, or the client/caregiver no longer communicates with the therapist regarding scheduling future sessions after reasonable attempts have been made to contact, the provider will complete all notes pertaining to the client and include reasons for termination cancel future sessions scheduled for the client within the hopscotch platform archive the client in the providers viewable caseload page within the hopscotch platform contact hopscotch customer support if the client/caregiver has requested assistance in finding additional care