Most certainly well being of a client is the first priority.

But therapist is entitled for some safety on the job. Clients throwing furniture around and acting otherwise violent makes t unsafe. Alone in a room with aggressive client. Does their life have value too or just clientele's?

The way this client is described she might need to be hospitalized plus she isn't getting any better, perhaps talk therapy isn't effective method with clients in distress and she isn't responsive to CBT either.

T is being observant and honestly admits that he is unable to help her he is not competent on treating this particular patient and referral to more appropriate therapist might be the best. Client doesn't want to stop seeing current t despite the fact that she isn't getting any better and in fact remains suicidal. Should t continue seeing her just because she doesn't want to stop or because she cries or throws things around? It doesn't sound like good enough reason. It isn't helping her to keep seeing this t.

Somewhat cold tone of an article might be off putting if it was meant for distressed patients. But it's a case study for professionals. Yeah it is bad writing. But it's not meant to make clients feel better, it's written for professionals not for clients

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