End of Therapy Policy & Procedure
Purpose
This policy outlines the circumstances and procedures under which therapy may be completed, discontinued, or terminated by either the client or the clinician. It ensures ethical practice, transparency, continuity of care, and clear communication regarding the end of the therapeutic relationship.
Scope
This policy applies to all clients engaged with Renee Louise Psychology, regardless of referral type or funding.
Definitions
Completion of therapy indicates the client’s clinical goals have been met, is generally a collaborative decision, and ideally a planned final session is booked.
Discontinuation of therapy indicates the client disengaging from therapy before clinical goals have been met. This may occur due to unforeseen circumstances, such as an abrupt change impacting client ability to attend sessions.
Termination of therapy is when either the client or the clinician chooses to end the therapeutic relationship due to a problem, such as determination that the client-therapist fit is not conducive to therapeutic gains.
Policy Statement
Renee Louise Psychology is committed to ensuring that the conclusion of therapeutic services is managed in a planned, ethical, and client-centred manner. The end of therapy will be conducted in a way that upholds client safety, dignity, continuity of care, and professional boundaries, and is consistent with the Code of Conduct for Psychologists, relevant privacy legislation, and organisational values.
Therapy may be concluded where goals have been met, services are no longer clinically appropriate, the client chooses to discontinue, or where continuation of therapy is not possible or appropriate. In all circumstances, Renee will take reasonable steps to ensure clients are informed, supported, and provided with appropriate transition or referral options to minimise risk of harm.
Rights to Terminate Therapy
Client Right to Terminate
Clients have the right to terminate therapy at any time. It is strongly recommended that clients discuss the decision to end treatment with Renee, in order to ensure a safe and planned completion of therapy.
Clinician Right to Terminate
Renee has the right to terminate services for you. Reasons that Renee may terminate services are outlined under ‘Clinician-Initiated Termination of Therapy’.
Circumstances for Ending Therapy
Collaborative Completion of Therapy
It is the aim of Renee to see you through your therapy journey to its completion, for as long as your presenting difficulties remaining within Renee’s scope of practice. At various intervals of time, Renee will suggest a progress review; it is recommended that you also suggest a progress review if you feel this is indicated.
Completion of therapy is ideally a collaborative decision, and planned, with a final session spent reviewing progress over time, reflecting on the therapeutic experience, and is an opportunity to provide resources and direction for re-engagement or engagement in other services in future.
Client Discontinuation
It is assumed that a client remains under the care of Renee Louise Psychology until therapy is mutually agreed to be completed, or therapy is terminated. Unforeseen circumstances may require therapy to be discontinued prior to clinical goals being met; for example, client relocation, a new job that does not allow time for appointment attendance, or a change in finances.
A client may notify Renee of discontinuation of therapy due to unforeseen circumstances, at which time best efforts will be made to achieve a collaborative therapy completion.
If a client does not attend treatment for a period of 3 months and has no future appointments booked, therapy is considered discontinued. After 3 months of no therapeutic engagement with no future bookings, the client’s file will be closed, unless the client has discussed alternative arrangements with Renee.
Clinician-Initiated Termination of Therapy
Renee is committed to providing safe, ethical, and effective therapy. However, there are circumstances in which Renee may need to terminate services. These include:
Non-payment of session fees, including unpaid cancellation fees.
Multiple late cancellations or repeated cancellations that prevent therapeutic progress.
Inability to accommodate the client’s availability within current scheduling constraints.
Displays of aggression, threatening behaviour, or inappropriate communication directed toward Renee.
Attendance while intoxicated or under the influence of substances during a session.
Presenting concerns outside Renee’s scope of practice, competence, or professional boundaries.
Lack of engagement with or suitability of the therapeutic interventions that Renee offers.
Poor therapist–client fit, where the therapeutic relationship is not conducive to effective treatment.
Procedure for Completion, Discontinuation or Termination of Therapy
Assessment and Discussion
Collaborative completion
When in-session discussion is available, Renee will review your original goals for therapy and presenting difficulties with you, along with any original assessment results, and prompt a discussion around the status of those goals and difficulties, provide a review of comparative assessment results, and enquire regarding any outstanding difficulties or goals that may have arisen since commencement of therapy.
When treatment goals have been met, a recommendation will be made to complete therapy. Concerns from clients about completion of therapy will be addressed and planned for accordingly. At times, it may be relevant to offer reduced frequency sessions for relapse prevention (e.g., monthly sessions).
An option exists for clients to book in as-needed on an ad-hoc basis following completion of therapy, for general support. These sessions are available as private sessions only (i.e., Medicare rebates are not available for such sessions).
Client discontinuation
Where available, discontinuation of therapy prior to clinical goals being met will be approach as above, with an additional focus on identifying outstanding difficulties and therapeutic goals, resources for independent engagement where appropriate, and referral options.
If a client has discontinued without providing advice of the intention to discontinue, at least one attempt will be made from Renee to re-engage a client in services, via email or SMS. Renee will contact the client to notify of upcoming discharge, providing the opportunity to re-engage in services.
Client and clinician-initiated termination
Where appropriate, available, and safe, Renee will:
· Discuss concerns with the client,
· Offer the opportunity to discuss the difficulties as a part of the therapeutic process,
· Provide feedback about the issue affecting therapy, and
· Explore whether the difficulty can be resolved before termination is initiated.
Notice Period and Transition Support
If therapy is terminated by Renee for reasons other than safety concerns or non-payment, she will:
Provide a 4-week continuation period during which the client may continue to attend scheduled sessions.
Offer referral options and resources to assist the client in finding an alternative service.
Notify the referring medical doctor of the termination and clinical reasons where appropriate and professionally justified.
Documentation
Renee will document:
The reasons for completion, discontinuation (when known), or termination,
Any attempts to address the issue with the client,
Recommendations provided,
Notifications to the medical doctor/s, and
The closing summary in the client’s file.
Immediate Termination
Renee reserves the right to refuse further service effective immediately in the following situations:
Safety concerns, including aggression, threats, harassment, or intoxication.
Non-payment of fees, including any outstanding balances.
In such cases, Renee may end therapy without providing additional sessions.
Immediate Actions
If safe and appropriate, written notice will be provided.
Referral information will be offered where possible and appropriate.
The referring medical doctor will be informed with the reasons for termination, and if there are concerns about client safety.
Post-Conclusion Procedures
Notification of Referrer
For clients with a referring medical doctor, the medical doctor will be informed when:
The client has completed or discontinued therapy, or
Therapy has been terminated (either by client or clinician), including the clinical reasons why.
File Closure
After termination:
The client’s file will be closed and archived according to legal and regulatory requirements.
Renee will advise the client of the file closure via email, along with relevant information about how to access services in the future.
Any future engagement will be treated as a new episode of care, requiring updated documentation.
If a file closure has occurred due to clinician-initiated termination, Renee has the right to refuse any future treatment.
Communication to Clients
Clients will be informed of this policy:
In the informed consent form
Verbally as needed throughout treatment.