Every therapist has had the experience where a client discontinues treatment by not appearing for a scheduled appointment and then not responding to follow up calls inquiring about the client’s overall status.
Termination Of Treatment
Every so often, clients with whom I’ve had this experience re-contact me, sometimes years later. When I’ve asked about how things ended, I’ve usually received a fairly matter-of-fact, calm description of a certain turn of events that were occurring in the client’s life at the time. Usually, it’s been a rush of various events that together overwhelmed the normal personal organizational skills.
How It Works Now, And Then
In their return to work with me, several of these clients have talked about their prior way of terminating. While I appreciated their claims that no ill will accompanied their actions, I generally (and often privately) accept that something was not right with the treatment. Maybe things will become clearer in the new treatment experience.
Even if there’s no detectable ill will on either side of the relationship, I certainly feel a loss and hurt, and accept that the client wanted to send that message for a reason. I accept that this is part of the work I have chosen. There’s learning and growth in this for me, and I privately review what did and did not go well in the relationship.
Ill Will
At other times, I am virtually certain there is ill will or disappointment. I know that recent or earlier mistakes of mine left their mark, only to result in the experience of a sudden cut-off type of termination. There would have been much more learning had the confrontation been direct and specific, and that’s where a big part of the loss lies. I don’t get to learn all that I could, much less express my regret for my errors.
Taking Difficult Feedback
A benefit of my training and professional development over the years has been an ability and willingness to accept very difficult feedback about my work. Some of this has come directly from clients. Some of it has come from clinical supervisors, some from my colleagues with whom I consult. I take the feedback very seriously, but I don’t take it personally. That doesn’t make it an easy experience, but I know it’s necessary. I usually encourage clients to provide this feedback during therapy (“Was today’s appointment helpful?“), as part of my overall approach, but that’s slightly off-topic.
Uncomfortable Intimacy
You don’t want a therapist who can’t tell you this stuff in an open way. It’s not the most advantageous subject to bring up in a blog, but I think it’s necessary. Let me add here that I’ve had many wonderful experiences saying goodbye to clients. Some I’ve seen again in the office, most not. However that goodbye goes, it’s an indispensable part of the therapist’s experience.
No matter how long a professional practices, or how much he or she learns and grows, there will always be clients who are not happy with him/her. It’s a mark of personal development to be able to speak to one’s discontent or hurt directly, and I am sorry when that does not occur. Leaving in silence is OK, not leaving in silence is better, dealing with difficulty when it occurs is the best of all.