Termination in Trauma Treatment

Have you ever had a situation where you wondered if you should terminate a client, or maybe you wonder in general about termination in trauma treatment?

Termination can be a tricky situation and can create a lot to think through. Let me interject right here and say termination is not always a bad thing. You could be terminating because the client has accomplished their goals. We will talk more about that in a moment.

Over the years, I have had to make the decision to terminate clients, while some cases have come to a natural end. Through those experiences, I have come to develop a couple of things I like to think through before moving forward with a termination.

1. “Why am I terminating?”

Like I mentioned, termination doesn’t have to be due to negative reasons all the time. A couple of reasons I have had to terminate over the years are

  • lack of commitment to the process (i.e. frequent no-shows)
  • overbearing resistance to the healing process
  • client has reached their goals
  • client’s co-morbid diagnosis needs attention before trauma treatment can continue

2. “How do I want to terminate?”

I always want to ensure that I am not abandoning a client, so having referral options, if applicable, is important to me. I also like to be honest and open with my clients about my therapeutic opinion. These conversations can be nerve-wracking and intense, but I really try to model good self-regulation for my clients in the face of a difficult situation.

If I am making a referral, I always try to give three options to the client and encourage them to choose the one that best fits them.

If I am not making a referral and the client is done with treatment, I like to start talking about termination about a month and a half before I think the client will be ready. This gives us time to coordinate discharge plans and services, if any are needed.  

 3. “Have I processed the decision to terminate with my peers or professional consultant, especially if it is an unfavorable termination?”

Before I make my final decision about terminating a client for anything other than completion of goals, I always try to run the decision by another trauma treatment professional to make sure I am considering all aspects of the situation. This can be helpful in ensuring you are not allowing self-of-the-professional issues to negatively influence your decision to terminate.

If you are looking for professional consults, the Trauma Treatment Collective would love to support you in that way. You can learn more about Professional Consults here

I hope these points of consideration can assist you in navigating termination with your clients in the future.

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