Dear Therapist:

Hi, I look forward to your column each week because you always have such insightful answers and opinions.
My therapist recently terminated my therapy with her. My psychiatrist as well has abruptly ended my treatment. I was not informed of the reasons as to why they stopped seeing me, and they did not give me closure either. I was wondering if this is a common thing for therapists and doctors to do. I was also wondering if I am legally entitled to proper closure as well as answers as to why I was abandoned by my mental health clinicians. These were people I trusted, and the betrayal and confusion are difficult to deal with. I’m obviously hurt as well. 

Thanks so much for taking the time to answer me. 

Response:

Having both your therapist and your psychiatrist terminate treatment at the same time could be a coincidence. However, the fact that neither one gave you a reason for termination is troubling. Additionally, it is unprofessional for any practitioner to “abruptly” end treatment without a full transition plan. This would include identification of a new provider, discussion of issues related to termination, and collaboration with the new provider.

Theoretically, there are situations in which it would be inappropriate for a therapist to disclose certain issues related to termination. This would be similar to a caveat within records release. Although patients are entitled to their full record, certain information can be omitted if it would be harmful for the patient to see. However, I have trouble justifying a scenario in which a therapist would simply terminate without providing any information as to the reason.

Perhaps your therapist feels that the reason for termination is obvious. If the therapist believes that a problem or action arose in session that is clearly the reason for termination, they may assume that you understand why therapy was discontinued. Or if there has been a progression over time in  a negative direction, this may be clear to the therapist—and the obvious reason for termination. Although these might slightly explain the therapist’s actions, they do not negate your right to be afforded the opportunity to understand the factors that led to your therapist’s decision to terminate the therapy process.

Closure is a tricky thing. It has become a household term, relating to anything from a simple conversation to a traumatic death. Certainly, you have the right to end your relationship with your therapist (as well as that with your psychiatrist) on as positive a note as possible. You should feel that you were a part of the decision-making process, even if ultimately the decision is theirs. You should be able to understand what it was that led them to their decision. Did they feel that they don’t have the expertise necessary to help you? Did they feel uncomfortable around you? If so, why?

Although you may never receive the answer that you seek, I hope that you find the right therapist and psychiatrist. In addition to helping you deal with your presented issues, they can help you to achieve closure from your previous therapeutic relationships—even if those involved are not willing to.

-Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Woodmere, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 516-218-4200

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