How does referral/termination work?

I'm fairly certain that a referral is in my future. I know that they send their records to the new T. but what exactly happens? Do you see new T. only after you have completely terminated with ex-T? Is there a transition period? Just trying to prepare myself and decide if I want to keep going or just end therapy completely. I'm taking a 7 week break (If I can actually go through with it) so hopefully I will have some clarity by then.

Sending records over is definitely not a given. You would need to request that in many cases and not all Ts will do that. The last T I saw prior to my current one would not share records for example, and not all therapists keep much in the way of records, though it depends a lot- those who rely on billing insurance have some incentive to keep at least basic records.

Some Ts prefer you to quit them prior to seeing the new one, others will allow a limited transition period, but that's less common in my experience. (Keep in mind, you can be terminating with one therapist and begin seeing another- you don't need permission, and you don't need to tell your current T, though I understand that may be the way you wish to go.)

A good new therapist will make time for you to process the loss of the old one if you wish to do that. You mentioned looking for someone relationship oriented, so within that type, it shouldn't be an issue.

She does keep records - she types during my sessions. I also keep a journal of our sessions which would be helpful for them to read.

I am curious who my T. would recommend so I would want to ask during the process.

I'm thinking it might be good to stop seeing current one and reassess whether I even want to continue therapy. It might be better to go back after a break of several months. It all depends on how this goes. If it's peaceful and somewhat on my terms, then I would probably take a break. If I feel even more hurt, then I would probably transfer to another one to help me process it all.

Got it! Yeah, sounds like you'd need a month or two to settle into your life without therapy, time to truly adjust and see how you feel.

I know my termination was different, but...

I do think Leah is right. Your T can't send over your file to a new T w/o your permission. That would be a breach of confidentiality.

And Ts are supposed to give you 3 referrals when terminating. So they can do a search on psychologytoday.com, find 3 names, and those are their referrals. That's what my T did She even gave me a male referral even though she knew I would never see a male T. So ask your T about the referrals, if she knows them, etc.

Best of luck.

Last year, I had a positive termination with a therapist (the others were either neutral or negative). I had decided that I wanted to try a different type of therapy which my therapist of many years was not trained or comfortable doing. We did an overlapping transition, which worked for me. It was still painful, but it was also very good.

I think different therapists, different clients, different situations are handled different ways. In the end, it's your therapy, you are actually in charge (at least in terms of defining if and how records are transferred, if you decide you want referrals, etc.).

Seems to me the answers to these questions should be up to you. Is your current T terminating you, or vice versa?

Right now she is heavily considering referring me. I'm taking a 7 week break without her knowledge. If I'm better I will leave on my own. I want to leave vs her abandon me. And I already feel good about it like I've got control again. My transference was keeping my mom issues alive. I need a break and don't want to be consumed by them. I have sessions scheduled every two weeks but will cancel them until the last one at end of September.

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I wonder why she wants to unload you. Maybe you don't want to get int to it…

Does she use the euphemism "referring you"? That seems like a clever way of saying abandon.

I hope it is truly more in control you're feeling, because otherwise, knowing that new info that she's "heavily" considering referring you out, it starts to feel more like you might possibly be preemptively cutting the cord to maintain a sense of control? It sounds tough, I am sorry. Good to know that other things in your life are going well.

I'm so sorry Soccer Mom. I know how painful this has all been for you.

I've been making my own rules around scheduling sessions lately, and it is surprisingly liberating. I'm in an angry phase with my therapy, and I feel disconnected from my T and mentally checked out of the process. I may end up outright quitting, but I've been sticking around mainly to see what T is going to do to try fix things. I've been pretty disappointed so far. Turns out, I'm 'just a client' after all... Transference is SO CLEAR with some distance. It's like... What the heck was I so attached to? Difficult to explain.

Anyway, unless you are in a really bad place, maybe test out how no therapy at all feels. I switched and ended up in the same situation with someone else. I think I'm one of the minority that is negatively impacted by therapy.

I think she gets frustrated with the transference. We once had an entire discussion over abandon vs referring. Her feeling was abandon means letting me go with no resources. Like leaving a child on the side of the road. When referring, she would be supporting me until I got to a new T. Logically I see her point but....

Yes, I have thought about that but I feel empowered. I put away all my therapy books, deleted notes from my phone, changed her name in my phone to her business name, etc. I feel like I'm back in control - not my emotions or her. And, if I can make it that long without her, then I may realize I don't need therapy right now. In that case, I would be leaving her on my own accord and feel good about my decision vs her deciding the time frame, etc. I need to remind myself that I lived without her before just fine and can do it again.

I almost feel like being in therapy brought up issues that hadn't really been a problem before. And, I held onto emotions too long. I would get upset about something and try to stay in the moment until therapy so she could see how they affected me. VS letting them go and telling her how I made it through. I was too negative.

A referral is something you ask for/want. If you are not getting along with this T then I would probably not ask for one from them? Termination is something you and your T discuss together, if you want to quit you say something like, "I would like to terminate 2 weeks from now, I'm moving to deepest dark Africa. . ." and it is like any other work/professional termination of services. You clean up as many loose ends as you can and away you go. Or, you just quit/don't go back, etc. Records and stuff with therapy are only the insurance/medical records governed by HIPAA, not your T's notes she takes for herself, those are hers for her purposes like your journal is yours. Usually if you want a new T to talk to a previous T you ask previous T during the last session if new T can contact her or not and they call/talk on the phone if that's what each wants to do/agrees to. A new T probably doesn't want much from an old T; they'll have their own experience of you and how they feel they can help you, etc.

I just realized today I don't think I would want my records to follow me. I would want new T to come to her own conclusion without any preconceived ideas. And a fresh start. I always have my therapy notes if she needs a history.

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I've never had a therapist ask for notes from a past therapist, nor have I had a pdoc do so. They always reached their own conclusions. Only down the road after I had been established with them for some time did they consult with each other, and only then with my permission.

There is certainly a difference. But isn't the difference rather slight? I guess it depends on the extent of the support. But if you experience it as abandonment, then isn't it abandonment?

I think it is much too easy for a T to drop a C. There is no oversight, no audit process, no reporting to any governing body.