I have either not received final letters or specifically told the therapist not to send one, for fear of getting a letter like the above.

Unless they hand write the letter and it is totally personalized, they come across as form letters. I am sure when it comes to sending final letters many therapists discover that they had kind, intelligent female clients with whom it was an honor to work.

I think sending such letters may have more to do with state regulations or the ethical code of their professional organization than anything else.