Getting fired sucks. But usually, we associate that with a job. Unfortunately, there are times that your therapist also “fires” you. This post explores some of the reasons your therapist might fire you, how I’ve dealt with situations like these, and what to do next.
Reasons for Termination
There are many reasons your therapist might fire you. Legal and ethical requirements demand it in certain situations, while other situations involve more of the therapist’s judgment.
In the United States, states set their own rules and expectations for therapists licensed in their state. There isn’t any national licensing, and therapists frequently only get licensed in their home state. Because of this, therapists can only work with clients in states where they hold a license.
If you move, your therapist can no longer work with you without putting themselves at risk of practicing without a license. Some states allow for a transitionary period immediately following your move, but ultimately, your therapist will either need to help you transition to another therapist or she will need to get licensed in the state you move to. (Licensing costs money and takes time. It isn’t feasible to get licensed in too many states.)
This is changing though. Soon, LPCs in many states will benefit from the Counseling Compact. This will make it easier (and hopefully more cost effective) for therapists to practice in states outside their home state. Only a handful of states have approved the Counseling Compact though, so widespread acceptance will take time. (As of the time of writing this post, Texas has not yet introduced legislation to accept the compact.)
Sometimes, your own behavior results in your termination from your therapist. Different therapists have their own rules. But in general, you can expect that any physical aggression or threats towards your therapist will lead to termination. Usually, your therapist should review these expectations during your intake. But you can always ask if you don’t remember or she didn’t cover it.
Your Therapist Can't Help You
Sometimes, your therapist just can’t serve you the way you should be. The reasons for this vary. But it often relates to training, experience, or scheduling. As an example, if your therapist isn’t comfortable treating people with suicidal thoughts, she will likely refer you to someone who is. If you need a form of therapy in which she is not trained, she will also refer you out.
Usually, therapists avoid facing this by screening clients prior to intake. However, sometimes things come up or aren’t addressed during screening and they are discovered later. Don’t take being terminated for reasons like this as “there’s something wrong with me” or “I can’t be helped.” Each therapist specializes in different things, so ethically, then need to refer you to someone who can provide you appropriate care.
You Stopped Coming
In most cases, your therapist will fire you if you have not attended a session in a certain period of time. The length of time varies by counselor or counseling practice. Some therapists allow clients to restart after termination for inactivity, but others do not.
Personally, I terminate clients after 1 months without scheduling a session. However, if clients talk to me first about taking a break, I extend this period on a case by case basis. Also, clients who would like to come back after they’ve been terminated because they weren’t attending sessions have that option if I have availability.
You're "Not Progressing"
Your therapist might also discharge you because you stopped progressing. Sometimes, insurance requires therapists to discontinue treatment when the client is no longer showing outward benefit. Other therapists interpret their ethical obligations in a way that requires them to discharge clients who don’t progress even if they are paying themselves.
This reason should be something that your therapist discusses with you before it happens. You should have the ability to voice your own thoughts before it happens. You and your therapist can also talk about changing things up, taking a break, or how you have been progressing in ways she doesn’t see.
Unfortunately, there may also be times that your therapist discusses all of those things with you and discharges you without any options for you.
You Are "Too Attached"
While many therapists believe attachment is healing, others view it as a problem. Sometimes, a therapist feels uncomfortable with attachment because of her own issues. And unfortunately, your therapist may not recognize this about herself.
My Therapist Fired Me
Personally, I’ve had a couple experiences when my therapist fired me. The first was after I had canceled a session and then contacted her about rescheduling. She never called back to reschedule. This confused me because only a few weeks before I had wanted to leave and she convinced me to stay.
A few months ago, the therapist I’d seen for 1 year already fired me. I needed to move out of state, and unfortunately, she wasn’t licensed in that state. I am still sad, and I miss her. But I’ve noticed a lot of times I think about what she’d tell me. That comforts me even without talking to her. I also have hope that someday I’ll be able to see her again.
I've Had to "Fire" Clients
There have also been times I’ve had to fire my own clients. Some of these clients were mine when I worked for a clinic and was required to terminate clients after certain circumstances.
I’ve also had times I had to fire clients when I get to make the rules. Usually, this resulted from clients not scheduling for an extended period of time or they moved. But there have also been times when I wasn’t trained or equipped for the clients needs.
I hate firing clients. I feel inadequate when I can’t meet my clients needs. And clients who disappear, I worry about. And when I am forced to fire a client, either because of insurance or because I’m told to by a boss, I feel sad. It would be great if clients always had the choice when they start and end therapy.
Feeling the Pain
Getting fired by your therapist hurts. It’s not fair. The end of this relationship can create grief the same as any other relationship. You might question yourself and what you could have done differently. Or you might cry about it, multiple times. No matter what your pain feels like, you’re entitled to feel it. Your pain is valid and a normal response to loss.
So what do you do after your therapist fires you? Well, first, take whatever time you need to grieve. At first, you might want to never see another therapist again. But seeing another therapist can help you to process the grief. Whether you choose to see another therapist or not, you don’t have to stop working on whatever brought you to therapy in the first place. Find whatever works for you.
Losing your therapist sucks, and your grief is real. Take whatever time you need to grieve. Then find ways to continue your healing, whether that’s seeing another therapist or trying something else.