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Posted

Although the Ethical Framework for the Counselling Professions does not specifically look at the aspect of unexplained endings and how to manage them it does address various issues such as the practitioner's self-care and ensuring that the therapist is competent to work with the client and that they are interacting with other services when appropriate. Below is a list of reasons that a therapist might end therapy and how they can do so whilst following the ethical framework of the BACP.

 

4.1 It is the practitioner’s responsibility to work within their competence (Ethical Framework, commitment 2) and to demonstrate accountability and candour by ‘monitoring

how clients experience our work together and the effects of our work with them’

 

4.2 When the client is not benefiting from your work together, or they are not likely to benefit from it, or is likely to be harmed from it, the practitioner needs to ensure they

demonstrate accountability and candour: ‘that clients are promptly informed about anything important that has gone wrong in [their] work together, whether or not clients are aware of it, and quickly taking action to limit or repair any harm as far as possible.’ (Commitment 6b) This may mean ending the work prematurely.

 

4.3 Practitioners who work for organisations need to ensure that their contracts or agreements with the organisations that they work for are clear in respect of how the

client’s needs are appropriately addressed if they cease working for the organisation whilst the client is having sessions. It is important that this information is shared with the client when making the therapeutic agreement.

 

4.4 Practitioners in private practice will need to consider forming their own policies in respect of what will happen to their clients, should they no longer be able to work.

 

4.5 Possible circumstances that may interfere with the practitioner’s ability to provide ongoing care to clients could be due to retirement, illness, changing work patterns,

changes to governance or funding of agency, disability, and even death. It is the practitioner’s responsibility to put clients first by: ‘making clients our primary concern

while we are working with them’ (Commitment 1a). The practitioner therefore needs to make arrangements to ensure that their clients’ needs will be addressed and that the clients will not be abandoned should they, for whatever reason, be unable to work with them. Again, normally this is something that should be shared with clients during the contracting process or the start of therapy.

 

In the event of the practitioner being incapacitated or dying it is good practice to ensure that a clinical will is made by the practitioner to cater for all the clients and to minimise the impact on them. This would normally involve agreeing (with both the person, and the client) that another trusted person could contact each client (and or agency) in a situation where the practitioner is no longer able to do this. This person would normally be a nominated person from a particular agency, or for private practitioners, the practitioner’s supervisor, line manager, or an experienced colleague.

 

4.6 BACP members commit themselves to work to professional standards and ensure that their wellbeing is ‘sufficient to sustain the quality of the work’ (Commitment 2d). So practitioners need to monitor their own health, and practice self-care to minimise the effects of stressors in their professional and personal lives. They should seek assistance from professionals and colleagues to ensure that these stressors do not lead to decreased clinical competence.

 

Members of BACP are also committed to ‘Build appropriate relationships with their clients by: communicating clearly what clients have a right to expect from us.’ (Commitment 4a) so it is crucial to share all information that may impact on the person’s decision to enter into the therapeutic relationship. This includes issues relevant to termination, absences, and

procedures for ensuring that clients’ needs between treatment sessions are discussed and agreed with the client in the first session.

 

4.7 Practitioners do not have a duty to treat clients indefinitely and they do not need the clients’ permission to end the therapeutic sessions. However, they do have an ethical obligation to act consistently with the client’s best interests in mind. It is important that they take necessary actions to ensure that their clients are informed and any ongoing therapeutic needs are sufficiently met if they decide or have to end the relationship prematurely.

 

Conclusion:

It is best practice that the ending stage of the therapeutic process is planned jointly between the therapist and the client. However, ‘life doesn't present us with neat helping

relationships which end on a cue.’ (Frankland and Sanders, 2006). In the event of an unexplained ending, if the therapist has worked in an ethical way throughout the therapy and made contingency plans for this kind of event, the impact on the sudden ending will be minimised for both parties.

  • 4 months later...
Posted (edited)

Thanks for posting this -- I didn't notice it when it first appeared. It's good to know there are at least some written guidelines, but I suspect that they are, sadly, often not followed.

Here's a link to a 2014 Guardian story about how therapy can be harmful: https://www.theguardian.com/society/2014/may/26/misjudged-counselling-psychological-therapy-harmful-study-reveals. Sadly, I haven't been able to locate any signs that the results of the study discussed in the link have been published anywhere, but did find another web article at https://www.sheffield.ac.uk/news/nr/preventing-adverse-effects-of-psychological-therapies-1.376074

I had previously come across the website http://www.supportingsafetherapy.org/ linked in the post. It sounds like something that everyone considering therapy should read. Not perfect, but at least there are some people out there aware of the possibility of harmful therapy and trying to help prevent it

Edited by Mary S
corrected typo

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