Navigating Client Dismissal: A Guide for Therapists
At some point in their careers, most therapists will face the difficult task of ending a therapeutic relationship. There can be many valid reasons for doing so—repeated no-shows, inappropriate behavior in the treatment space, a client’s ongoing lack of participation in their home care, or simply the absence of progress despite consistent treatment efforts.
Whatever the reason, it’s essential to approach client dismissal with professionalism, clarity, and care. Communicating the decision clearly—whether verbally or through a formal letter—is key. There are several important elements that should be included in that conversation or correspondence.
1. Clearly State the Termination of Services
Begin by informing the client in no uncertain terms that you will no longer be accepting treatment appointments from them. Clarity here is important to avoid any misunderstandings. Here are a couple of examples:
“After providing continuing treatment related to your condition over the last 6 months, and seeing no progress towards a resolution of your symptoms, I am referring you to (insert name of therapist), who I believe may be better suited to provide you with more effective treatment. I would be pleased to provide them with a copy of your treatment notes upon your written request. Going forward I would request that you seek ongoing treatment from them, or another therapist of your choosing.”
“After your most recent no-show for a booked appointment, your sixth such occurrence in the last year, we are removing your ability to continue booking appointments at our clinic. We encourage you to seek out a new therapist and encourage you to approach future therapeutic relationships with professionalism and respect.”
2. Explain the Reason(s) Without Being Defamatory
Be concise and specific about why you are ending the therapeutic relationship. This explanation should be respectful and non-defamatory, especially in cases involving inappropriate behavior. Below is an example of how such a message might be worded:
“The reason I/we will no longer be providing massage therapy/manual osteopathic therapy treatment is due to inappropriate behavior that occurred during your appointment on [INSERT DATE]. This behavior is not acceptable in a therapeutic setting. We encourage you to approach future therapeutic relationships with the professionalism and respect they require.”
3. Offer a Referral (When Appropriate)
In many cases, it is good practice to provide the client with a referral—either a general suggestion to search for a new therapist through professional association directories, or a specific recommendation if you believe another practitioner may be a better fit. However, in cases of inappropriate behavior, a referral is not necessary.
4. Seeking Legal Guidance for Written Dismissals
If you choose to issue a dismissal in writing, it’s strongly recommended that you consult a lawyer before sending the letter. If you don’t currently have legal counsel, remember that CMMOTA Members have access to Legal Guard® through their Professional Liability Insurance Policy. To learn more about this benefit, please visit this page.