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  #26  
Old May 09, 2019, 01:10 AM
starfishing starfishing is offline
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I'm not surprised. The therapist unilaterally ending therapy should be rare. Other than unusual exceptions, it should be up to the client to decide whether things are beneficial and whether to continue.
Thanks for this!
LonesomeTonight

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  #27  
Old May 09, 2019, 07:13 AM
Anonymous41422
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I highly agree with the semantics argument and with Budfox that there are many ways to get rid of problem clients that aren’t formal terminations. I’m guessing most experienced therapists know how to do this, though the % of time this is done... I couldn’t foster a guess. I strongly suspect this happened in my case though “I” technically quit. In many ways I think this makes sense because it leaves the client feeling at least partially in control.

I think the majority of therapies end in really normal ways - either the client feels good enough to move on, or things fizzle out. Termination isn’t anything I’d spend a lot of time worrying about as a new therapy client. That said, I think it’s important to remember that therapy isn’t “forever and ever” and life happens, therapists retire etc.

Would I believe a therapist who said they never formally terminated a client? I think so. Even with the ethical responsibility to refer out, ultimately it’s the client’s choice. Most therapists would probably stick with a client who would never see another therapist rather than let the client go without a therapist.
Thanks for this!
LonesomeTonight
  #28  
Old May 09, 2019, 09:32 AM
Anonymous56789
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I asked my therapist about this ages ago. He said there was only one person he had to let go over 30+ years.

Credentials do matter, so I disagree with those who assert that it does not. MD therapists (psychiatrists) often see more complex clients than other therapists, such as those with chronic psychosis.

I agree with those who think therapists may let a client go in more subtle ways. Those who are not up to the task of terminating a client could do things to drive the client away or try to convince the client to quit. Rather than the norm, I believe this would likely only occur with those who are unprofessional/ incompetent.
  #29  
Old May 09, 2019, 09:37 AM
Anonymous56789
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Quote:
Originally Posted by CartDown View Post
Don't therapists have to refer you to another therapist after termination?

It was comforting to hear he is not big on termination, but if things get stale, like if he believes I'm wasting my time, I'm afraid he won't tell me and it will be up to me to figure it out. And if I'm too slow to connect the dots, he may end up resenting me. I'm sure that sounds a bit ridiculous. I already feel like a fraud in therapy sometimes, so it stresses me out a bit.
Knowing he rarely lets anyone go, hopefully you have less to worry about now. You aren't the only one who needs reassurance about this as many who write here talk about abandonment fears.
  #30  
Old May 09, 2019, 09:38 AM
stopdog stopdog is offline
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Quote:
Originally Posted by PurpleMirrors3 View Post

Most therapists would probably stick with a client who would never see another therapist rather than let the client go without a therapist.
I don't think that it is a matter of a therapist sticking with anything. The therapist has no stake in it.
I also think this is a super bad plan in general- no therapy is not worse than bad therapy. Quite the opposite in my opinion.
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  #31  
Old May 09, 2019, 09:53 AM
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LonesomeTonight LonesomeTonight is offline
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Quote:
Originally Posted by octoberful View Post
I asked my therapist about this ages ago. He said there was only one person he had to let go over 30+ years.

Credentials do matter, so I disagree with those who assert that it does not. MD therapists (psychiatrists) often see more complex clients than other therapists, such as those with chronic psychosis.

I agree with those who think therapists may let a client go in more subtle ways. Those who are not up to the task of terminating a client could do things to drive the client away or try to convince the client to quit. Rather than the norm, I believe this would likely only occur with those who are unprofessional/ incompetent.

I said something similar to your last paragraph to my T, when he claimed that the client holds all the power in the relationship, because they can terminate at any time, while he ethically can't do so. I said that he could do things to make clients leave without terminating them. Like for me, he knows email is important to me. So he could choose to take that away (he said he never would) or otherwise not meet my needs. He could shame me. Insist on a particular psychological technique that I feel doesn't work for me. Etc.
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Anonymous56789
  #32  
Old May 09, 2019, 11:56 AM
Anonymous41422
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Originally Posted by stopdog View Post
I don't think that it is a matter of a therapist sticking with anything. The therapist has no stake in it.
I also think this is a super bad plan in general- no therapy is not worse than bad therapy. Quite the opposite in my opinion.
I suppose I was speaking on behalf of how a therapist might feel.

I do agree with you especially on the second point. I am immeasurably better with no therapy.
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Anonymous56789
  #33  
Old May 09, 2019, 12:49 PM
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LabRat27 LabRat27 is offline
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Doesn't that seem cruel?

Idk maybe it's naive, but I'd like to take my T at his word that he really thought terminating was in my best interests, even if it was ****ing stupid, and that it was difficult to do and he didn't want to but felt that he should.
He left the door open for if I finished DBT, but I kind of convinced myself that he was only saying that to try to make me feel less abandoned.
(Though he's the one who initiated us working together again so I guess maybe he did mean it)

ineffective therapy to get a client to quit seems super unethical. You're letting them pay you and using their time to provide what you know to be not what they need.
Thanks for this!
LonesomeTonight
  #34  
Old May 09, 2019, 04:22 PM
Anonymous56789
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Originally Posted by LabRat27 View Post
Doesn't that seem cruel?

Idk maybe it's naive, but I'd like to take my T at his word that he really thought terminating was in my best interests, even if it was ****ing stupid, and that it was difficult to do and he didn't want to but felt that he should.
He left the door open for if I finished DBT, but I kind of convinced myself that he was only saying that to try to make me feel less abandoned.
(Though he's the one who initiated us working together again so I guess maybe he did mean it)

ineffective therapy to get a client to quit seems super unethical. You're letting them pay you and using their time to provide what you know to be not what they need.
i agree its unethical but I can see situations occurring among those who at least try to practice ethically.

Like losing empathy, indifference. Telling clients they dont have the skills when in reality its their countertransference such as feeling helpless or their needs not getting met, like a need to save someone.

Their inability to keep their own stuff out of the therapy, where they are afraid to terminate. Afraid of client anger or suicide attempt. Even those who truly don't want to hurt someone.

There's no doubt in my mind this stuff does not happen infrequently.
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