codes of ethics re: termination

Does anyone else notice that in the codes of ethics for various therapy groups, the text re: termination is so brief and vague, that it seems entirely meaningless? Example:

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1.10 Marriage and family therapists assist persons in obtaining other therapeutic services if the therapist is unable or unwilling, for appropriate reasons, to provide professional help.

1.11 Marriage and family therapists do not abandon or neglect clients in treatment without making reasonable arrangements for the continuation of treatment.
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My T did the minimum -- gave me some warning, then list of referrals. Then when I reached out at various points later, because I was in major distress and crisis and because subsequent Ts were either not working out or were even marking things worse, she began to push me away, scold me, then ignore me.

And the other Ts mostly argued that this was indeed ethical. It feels like a form of "gaslighting" by the collective therapy world. It's all for your own good they say, T did the right thing, if you are having trouble it's all about you the client.

And there was an assumption on part of ex T that as long as i was seeing someone bearing the title "therapist" I would be fine, as if each of them has magical powers that will fix whatever harm was done by their colleague, rather than ex T herself facing the harm head on with me and bringing the therapy to some organic and safe closure.

Without some detailed guidelines to refer to, isn't it a free for all?

It is a free for all. They don't answer to anyone and can get away with a lot of unethical behavior. It's really sad and tragic for the clients who are treated poorly.

What's up with this code of ethics? Can I read it somewhere?

I have seen therapists band together against clients. Some of them are even dumb enough to put it in writing which makes it fun for me.
And yes - it is very very common for those guys to label and blame the client no matter what the therapist did or did not do to protect themselves and each other.

I believe you and I think it is totally disgusting behavior on their part. I don't understand why people go into this "healing" profession and then proceed to destroy and ruin people's lives. YUCK.

Agree. It needs to be regulated. Reading stories on here makes me realize that bad therapy causing pain is way more common than I would have thought before. These people who we pay to rifle in our lives and hurt us at our most vulnerable-- even punish us for being sick, which is why we are there in the first place. I already tend to think that a lot of it is quackery, but now I'm convinced it can actually be commonly and actively hurtful. But maybe that's because I'm hurt.

I am in same boat and share your view about the prevalence of damaging therapy, and the quackery question. I did not feel this way before last year.

One of the most crazy-making and absurd outcomes of my harmful therapy experience and termination is that the basis of termination was referrals from my old T and the idea that another T would save me. And yet, try getting another T to acknowledge that therapy itself might have caused harm, which would be the first order of business for someone who had just gone thru something traumatic, be it therapy or something else. And I mean really acknowledge it fully.

I know what you mean. I didn't even get any referrals. And then you have people tell you to just go find another therapist to deal with the bad therapy/therapist. Really? I was terrified it would happen again. I am terrified of therapy in general even though I still see someone. I will NEVER disclose or trust again like I did with the horrible therapist.

People tell you you're "wallowing" in what happened and to just move on and whatever, but it's NOT THAT SIMPLE. Is it that simple to get over child abuse or rape or domestic violence? If we struggle getting over those things are we "wallowing?" I know I have to move on with my life and I have, but it still FREAKING hurts and it has damaged me in ways that no one else could damage me. Ideally, yes, it would be great to just move on and not think about it, but there are reasons why I went to therapy in the first place. Mostly it's because I don't figure these things out and I don't cope very well with emotional pain and life in general. If I could just get over things I wouldn't have needed therapy in the first place. UGH. So frustrating.

It sucks. It all just sucks and there is no justice.

I think the problem here really is you can't force someone to provide you services. Once a T decides to terminate the logic on their end is either that they aren't helping you, or that they don't want to help you. Either one and it makes all the sense to them to cut you off, the fact that it bothers you just points to the fact that you need therapy, which was the case before they saw you at all. I'm not saying it's right or wrong, just that this is the way it is. I work with clients... I've fired clients before... I'm not a therapist mind you, but in my case it's usually people who I can't stand working with or who stop paying me. I'll provide copies of what we've done and a referral if they ask. I can't imagine being forced to continue working with anyone or anything once I've decided not to...

It's not about firing someone or choosing not to work with them. It's about doing it in a humane and ethical way. And unless the therapist has been threatened by the client that should go beyond just providing referrals. It's wrong and it's damaging. Therapists work with people all the time they don't really want to work with. It's the nature of the job.

If therapists really care about people then they need to suck it up and deal with their prejudices. (I'm not sure any of them really care at all though.)

My termination wasn't much of a termination. Not much worse could have happened. I don't think it's fair she has the upper hand. I can't even have access to my files because of the SI (plus how do I ask if I'm not supposed to contact her). I think the system is unfair. Ts can document whatever they want to. And when they terminate, they get to walk away intact. My T mailed me referrals after the termination. One was a male! I have a fear of men. Proves she tried real hard to help me. And to define ethical, all they have to prove is that they can longer help you and are no longer beneficial. Really? A T can decide that at any time. They can sabotage you just to get rid of you.

I am in the middle of filing a grievance, but I know the facts on paper show she was ethical (if they had a transcript of verbal conversations I'd have a ton more proof). But people for the most part seem to believe that she did in fact abandon me. I can tell by how long they stick to guessing at why I was terminated and whether or not they try to figure out if I did something wrong.

But it sucks. I never really believed that a T could do something like this to their clients. I read about it, but thought I was one of the lucky ones...till 5.5 weeks ago

It sounds like you are saying therapists cut people off because they can't stand them or they stop paying. Just more typical blaming of the client that I see here over and over. Of course it is all our fault. We're horrible, awful people who no one can stand to be around. Right. Of course. I get so sick of this.

Actually if you read what I wrote I said "Once a T decides to terminate the logic on their end is either that they aren't helping you, or that they don't want to help you." I don't see how you could fault my logic there. Then I went on to say I personally typically only fire clients I can't stand or that stop paying me.... I'm sure I would also fire someone I couldn't help, but I work in a different field than a therapist and I usually know who I can and can't help immediately and refer those I can't.

I don't know why everything needs to boil down to "blame" on this site. Do I think Budfox is "to blame" for his termination, no, not in a million years. I remember his posts about what happened, it's unfortunate. I was merely trying to point out how the situation must look and feel to his therapist, who IMO came to the conclusion she wasn't helping him. I think that seeing all the perspectives might help him process this in a healthier way, ie yes, it is very painful to go through, however it doesn't necessarily mean his ex-T doesn't care about him or intends to or even wanted to abandon him.

If you're not a therapist then what you're saying you do with clients is irrelevant to therapy termination. It doesn't make any sense bringing that into the discussion.

I have seen so many people here say they have the perfect therapist and then later get badly damaged by that same therapist. This happens over and over and over. Sometimes therapists just suck.

And there is LOTS of blame here on this site because no one wants to believe a therapist could do something like that.

^^Thanks for this. I figured that my T's colleagues would rally around my T even though he was morally, legally, and outrageously UNETHICAL. I expected it! But you know what? They will all have to live with the lies they created to bail out a bully of a T. They will have to live with that. I have to carry my own cross for the mess he created on my end.

I'm not a therapist but that doesn't mean my opinion on termination is irrelevant. You cant force someone to do a job, period, therapy or ditch digging or whatever it may be. That was my point, that would be slavery.

I don't think therapist bashing is going to help any of us get better. There are certainly times when it's warranted, when a therapist abuses patents etc, but to blanket every failed therapy with this kind of blame isn't right. Sometimes two people just don't work out, and no one needs to be to blame for it.

In Budfox's case he fell for his therapist, which many of us do, and then after some time she decided it wasn't working. In my mind she wanted to help him by terminating. She could have continued to take his money for a therapy that wasn't progressing, I would see that as being worse. I've read of many people being strung along for years and years in therapies that weren't going anywhere, being financially abused so to speak by therapists. I just think it all comes down to perspective, and the right perspective here is to see all the sides. In my mind, just guessing, I think his therapist had his best interest at heart. She is human too, maybe the termination was a mistake, maybe not... but neither party needs to be to blame really, it just didn't work out. That's just life a lot of the time.

The reason therapists bear the blame, for me, is because they set the game up, keep info from clients, label clients, experiment on clients and do not explain the whole thing to clients.

I totally agree. And they have codes of ethics to abide by (supposedly) which is why they can't just drop people willy-nilly.

I'm not therapist bashing. I just state truth. The whole "system" needs overhauling. Too many people end up getting more damaged in therapy than they were when they went in.

Also, I didn't say your opinion wasn't relevant. I said bringing up what YOU do with clients in a profession that isn't therapy is not relevant. Big difference there.

Same here. I can't see disclosing or being vulnerable like before. I guess one good aspect is that I have since done a lot reading and networking, and I am now informed and can protect myself should I do therapy again.

Yes it is very alienating and distressing to be told to get over it. There is a saying “Be kind, for everyone you meet is fighting a battle you know nothing about.” Applies here. I would have told people to get over it, until I went thru it. Therapy is unique I think in its capacity to cause pain, though I know it can help too.

But other "services" do not put the client's emotional and psychological well-being on the line. Therapy is different, unique. And the power imbalance requires the one with the power to wield it with utmost care.

And if anything requires utmost care it is the decision to cut someone off cold turkey who has formed an attachment or dependence, and might have come into the process already in real distress. In my case I was suffering from chronic illness, depression, sudden loss of family members, and social isolation.

It is true that a T might legitimately find themselves in a situation where they can't help. But continuing in some fashion, or tapering off, or taking a break MIGHT be the lesser of two evils compared to abrupt termination. Also, if the T cannot handle it or does not want to, then they have failed. It is their job and they are paid for it, and this should be acknowledged as part of termination and transition.

If a surgeon cut you open and got to the core wound or disease, and then said they could not go any further, it would be malpractice, because it is assumed they would not have opened the wounds in the first place if they were not equipped to handle it. Human emotions are bit more complex than that, but seems a fairly apt analogy.

I think there are only so many ways to terminate someone ethically. It's been said before and I believe it to be true, that ending therapy is kind of like breaking up with a partner. In the end it is in both parties best interest because if both people don't believe it will work, it won't.

I agree it needs to be done as humanely as possible. To me this means in person, with enough notice to find a new T. I've read a lot of posts here that describe some pretty awful terminations, but unfortunately unless it amounts to abandonment, there isn't much you can do about since the definition of abandonment is pretty weak. Like Petra said, if a T doesn't think their service is helping you then they most likely aren't the right T. Unless there is a concrete issue that a t can point to as the reason they aren't the right person for the job, then I agree they tend to blame the client. It's unfortunate, but just like a breakup, both parties usually think the other is at fault when the truth is really somewhere in the middle.

To me right now, the whole psychotherapy industry seems vaguely exploitative. Especially anything "transference-based." I tend to think it's pseudoscience at best and cruel at worst. But then again, I am speaking from my own hurt.

In my case, I was never actually terminated, and I'm struggling with the fact that she said I'm "too sick for her to help," hurt me, but still wants my money and claims to want to help me. No termination there but it still seems seriously unethical, especially since she knows I have a horrible fear of abandonment. How is that not exploitative?

I'm not blaming my T. I think she is a victim or casualty of the process too in a way, though to much lesser degree than I was. I see this as much about inherent flaws in therapy as about her failure.

I have seen this from her perspective. Took a while, but I think I see it quite clearly now. Did this help me process this better and feel less pain -- yes by about 10%. I do think she cared about me, probably a lot. I think she is a good person, but probably insecure and a bit narcissistic and she couldn't handle the failure. She wanted to be away from it as much as she wanted to help me.

But this is more about the decision to terminate, whether that really IS the best option, and then just as importantly how is it carried out. In my case the devil in the details. Many many things were said that subtly deflected responsibility onto my shoulders and turned my reactions and perceptions inside out. And there was no plan for transition. Just some referrals and good luck. And when I contacted her, which was me enacting a transition because she failed to, she began scolding and blaming and telling me what was good for me, rather than having dialog. So then I doubted whether her apparent compassion and caring was an act, and now the real T was emerging. It was like a mother telling a child no when the child was desperately seeking attention.

Part of the harm was this harrowing doubt and confusion. This process was infantilizing, pathologizing, disempowering, and more.

A therapist should clearly lay out his or her termination policies on the very first day of therapy. It's not something most clients want to hear about or deal with and it's a scary thought, but it should be very, very clear. I think it should even be in writing.

My therapy was terminated not because it wasn't "working," but because I refused to do something he demanded I do. He knew I would not do it because we had talked about it before and he knew I was not ready, but he demanded I do it anyway or he wouldn't see me again. (By the way, he ALWAYS said he would never force me to do it. He said he would help me with it and he said he would never give up on me.)

It's not about therapy not working. It's about ending it in the most humane way possible. I know there won't always be ideal terminations, but what happens to a lot of clients is horrible and damaging and needs to be acknowledged by licensing boards more often. Of course things don't always work out and of course it isn't always ideal to continue therapy, but many therapists are so clueless and hurtful about termination that people end up worse off than ever. It needs to be discussed all along and clear that one day therapy will end and there should be clear policies about it.

YES, yes, yes. Inherent flaws in therapy. It's a screwed up process. I don't know what the answers are, but something is terribly wrong in the mental health care system and especially with therapy.