In Summary:
- Ending therapy can trigger grief, anger, confusion, or attachment-related reactions in clients.
- Responses may vary by attachment style: anxious clients may cling or protest, avoidant clients may withdraw, and trauma histories can intensify reactions.
- Psychologists should give clients ample notice (ideally several sessions or months) to process the ending and reduce distress.
- Termination can be reframed as a therapeutic opportunity – helping clients normalise endings and build resilience.
- Explanations for endings should be brief and factual, ensuring clients don’t feel rejected or responsible.
- Ethical obligations include arranging continuity of care, supporting referrals, and maintaining secure, accurate records.
- Integrating discussions of endings early in therapy and regularly reviewing caseloads can make transitions smoother and healthier.
Concluding a therapeutic relationship with a client can be fraught with ethical, emotional and psychological complexities. However, with the right approach, it can be a constructive process. Dr Catherine Hart MAPS, clinical psychologist, shares her strategies.
Therapeutic relationships inevitably come to an end. Sometimes this is because therapy has reached its natural conclusion; in other cases, psychologists may need to conclude treatment for personal reasons, such as taking parental leave, stepping out of private practice or relocating overseas.
Ending therapy can be a complex process, including the legal and logistical requirements that are involved. However, the ethical, emotional and psychological elements can be equally as complex, and are often unpredictable. The client may experience grief, anger or even confusion.
Despite this mix of complex emotions, the goal should be a clinically sound ending, rather than a purely transactional one, says Dr Catherine Hart MAPS, clinical psychologist, director at Succoris Psychology Partnerships and 2024 APS Supervisor of the Year.
That is, an ending that is planned, collaborative, provides time for processing and enables continuity of care. How can the psychologist take steps to ensure that? Dr Hart shares her strategies.
What emotional, psychological and relational dynamics might arise?
“It’s really normal for the client to experience a range of strong emotions, including anger, grief and feelings of abandonment, and they’re all valid,” says Dr Hart.
Unexpected reactions may arise, too – and transference, particularly in the form of the reactivation of earlier attachment injuries, is often top of the list.
This may cause the client to project previous experiences of abandonment, rejection or betrayal onto the psychologist, she says.
“Clients might tell you, ‘I’m being left all over again, like I was when my parents divorced', or something along these lines,” says Dr Hart.
The psychologist might also notice clients playing out insecure attachment styles.
For example, those with an anxious-occupied style might demonstrate protest-style behaviours, from clinging to the psychologist to making threats.
“[Clients] may say things like, ‘I wish I’d never started working with you’, or ‘I knew I shouldn’t have trusted you’,” says Dr Hart.
Avoidant clients, in contrast, might behave dismissively, withdraw or even show signs of relief. In some cases, their emotional response may surface at a later time, such as in the form of complaints or attempts to re-engage with the psychologist.
In some cases, previous experiences, such as trauma, could intensify the client’s response.
For some clients, the conclusion of therapy may increase emotional dysregulation and a fear of abandonment, as well as the client’s tendency to move through cycles of idealising, then devaluing the psychologist.
Other clients may experience feelings of self-blame or hopelessness might dominate.
What strategies can the psychologist employ to manage these dynamics, while meeting ethical obligations?
Ultimately, the psychologist’s goal should be to “minimise the negative effects [of concluding the relationship] on clients and safeguard the continuity of services”, according to 4.7 of the Psychology Board’s Code of Conduct, which will come into effect on 1 December 2025.
One of the most helpful strategies is providing the client with as much notice as possible, as required by 4.7.d of the Code.
“Giving the client at least three or four sessions to think about it is ideal,” says Dr Hart.
“This is especially important if it’s a long-term relationship. If you’ve been seeing someone for a couple of years, then you ideally want at least a couple of months to work through it.”
In contrast, leaving abruptly can amplify the client’s distress, and further intensify symptoms, particularly anxiety and self-blame.
“Once a new client came to me because they’d turned up to their previous therapist’s office one day, and the therapist was gone. The office was closed; the furniture had been removed. The client had no idea what had happened, and processing that was difficult.”
The longer the notice, the more time the psychologist has to employ other strategies.
For clients who experience strong emotions or reactivation of attachment injuries, the phasing out may present a therapeutic opportunity.
“If the ending is done well, it can be a chance to heal – an in-the-room, in-vivo experiment to work through what the experience is bringing up for the client,” says Dr Hart.
This might include supporting the client to normalise endings, and to see the potential for more choice and opportunity – by reframing the situation, asking pertinent questions and creating avenues for choice.
“You’re not necessarily going to spend your whole life with the first person you meet. You have a relationship for a while, then it changes.
“You might say: 'We’ve done some good work together; now, you’re ready to move onto the next chapter of your journey. How can I support you as you move on to someone else?'”
How much should the psychologist explain?
Where the ending of a relationship is due to changes in the psychologist’s employment, health or other factors, it can be helpful to provide an explanation. But how much should the psychologist reveal?
The trick is to ensure the client doesn’t feel responsible or rejected, while keeping the focus on them.
“It’s important to keep it pretty brief and factual wherever possible,” says Dr Hart. “You might include [some basic information] about the situation that is causing you to pause or finish practice. For example, you could say, ‘I have some health concerns that I need to address.’
“However, if you include too much detail, you could cause the client to worry, which might detract from their needs. If the discussion becomes about you, and what’s happening to you, the client has no space for their own reactions, because you’re taking up all the room.”
Managing referrals, handovers and records
In addition to minimising harm, the psychologist is ethically obliged to make reasonable plans for the continuity of service to clients, including helping the client locate alternative appropriate practitioners, according to 4.7.c of the Code.
A handover might play a powerful role in helping the client to see the phasing out of the relationship as not a termination, but a continuum, says Dr Hart.
“This [can be framed] as the next level up of the client’s therapy – not an ending or a replacement.”
Key to success is putting agency and choice firmly in the client’s hands, from asking them what to include in a referral to inviting them into the room for the handover.
“How much does the client want you to share? I ask the client directly and give them [as well as the new psychologist] an ending letter to keep.
“This is a transitional object that captures all the amazing stuff the client has done, and all the progress made. It might include the client’s qualities and strengths as you see them, the themes of your work together, and areas they may still need to address.”
Ensure that you comply with your record keeping obligations in line with the APS Professional practice guidelines on record keeping.
How might the psychologist react, and what strategies can they employ?
Looking after the client’s best interests is the priority. However, being mindful of your own self-care is also important.
“It’s really important to validate our experience,” says Dr Hart. “We might go through a range of emotions related to our own issues being activated, and it can be unpredictable.”
These emotions might include guilt for letting clients down, and a sense of loss for the work left unfinished, especially if the termination occurs suddenly. At the same time, relief might arise, particularly if the phasing out results in a more manageable caseload. However, this relief might then bring up more guilt – about feeling relieved.
To manage these reactions, the psychologist should acknowledge the possibility of countertransference and engage in reflection.
“Ask yourself: 'Why am I responding this way? What does it mean? What personal work do I need to do?' It’s important to be honest. Reflection, journaling, talking with trusted colleagues, and supervision can all help with normalising the experience.”
APS’ self-care for psychologists course is designed to equip you with effective practices to look after your own mental wellbeing.
What can psychologists learn for future practice?
For Dr Hart, the possibility of an ending should be raised in all relationships with clients from the beginning.
“In my early sessions, I try to normalise that [the relationship] won’t go on forever and ever – that we don’t know how circumstances will change, that maybe we’ll work on a particular chunk of work, then you’ll outgrow me. Open-endedness can be difficult for clients.”
A useful technique is setting up six-monthly review sessions. These give the client the chance to review what they’ve achieved and what they’d like to work on next.
In addition, both the client and the psychologist have an opportunity to decide whether to continue.
At the same time, psychologists could benefit from reviewing their caseloads regularly.
“It’s difficult because most of us are contractors. If we don’t take on work today, there might not be a guarantee of work tomorrow, and we don’t necessarily know what we’ll be doing in six months. This can make it hard to feel okay with doing less,” says Dr Hart.
That said, where possible, the psychologist should be honest about their capacity and set boundaries for themselves.
“How do you structure your caseload? Do your expectations meet reality? Should you sign up a client for twice weekly therapy if you’ve got no bandwidth? Should you take on new clients if you know you’re planning on extended leave in six months?
“It can almost be a badge of honour to be busy, but if you burn out, you won’t see anybody.”
If a psychologist does decide to step back for the right reasons, then they should do what they can to try and feel at peace with it, says Dr Hart.
“It’s totally okay and acceptable – a transparent, ethically motivated decision is what we should be aiming for.
“As long as we can give the client honesty and [where possible], a bit of warning, and if the ending can be handled well, it can be profoundly healing. It can be a normal, healthy step that respects the client’s autonomy."
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