Growing a Practice

What to Do When a Client Fires You as Their Therapist

Headshot of Ben Behnen
March 28, 2024
March 28, 2024
Ben Behnen
Marriage and Family Therapist Intern

“Thanks for nothing,” he said to me, his words saturated with sarcasm. 

The woman next to him was looking down, her hands twisting in her lap. My heart was pounding, my mind desperately grasping for something to say.

The man scoffed and shook his head, “I’m out of here.” He got up from the chair across from me. I awkwardly half-stood to reach for the door but he got there first and yanked it open. 

I looked back to the woman who let out a sigh, “I’m sorry, I guess this isn’t working for us. Thanks for trying.”

I tried to reply but words were failing me, so I simply nodded as she sulked out. I heard an agitated huff from the man down the hall.

With the two of them out of my office, I closed the door and sank to the floor. My face burned and my eyes misted over. A chasm opened in my gut. I wanted to disappear.

Being fired by a client is a rite of passage as a therapist. Sometimes it’s dramatic, emotional, and “little t” traumatizing like my own experience with this couple. 

Often, though, it’s quiet and without any fanfare. Regardless, being fired is difficult and can lead to serious self-doubt and imposter syndrome, especially when you’re just starting out as a therapist.

That said, there’s a lot you can learn from your own firing experiences, as well as from what other therapists have learned, to help you avoid some unnecessary missteps.

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Reasons why clients fire their therapist 

A natural first question that arises when you get fired is, why? We are meaning-making creatures so our first impulse is to try to understand.

Unfortunately, this often also leads to spiraling and ruminative anxious thought loops. 

Let’s try to avoid that and talk about a few of the most common answers to the big why question.

Not a good fit

The first might be that you were simply not a good fit. It is commonly known that the therapeutic relationship is the number one factor for client success in therapy, so if your client feels there is something off, this could lead to a firing. 

What “good fit” means is often murky. It could be as seemingly benign as a different sense of humor or something more serious like a lack of trust. We’ll discuss later how you might better assess your relationship with your client and avoid unnecessary termination and internalization.

Not reaching their goals

The second answer to the why question is that your client is not reaching their goals. Some clients know exactly what they are looking for and if they feel they are not getting there (or getting there quickly enough) they may decide to move on. 

Other clients do not know exactly what they want from you, they just know something is wrong. If their vague sense of being unwell isn’t improved on, you might get the ax. Regardless, we’ll get into the importance of clarifying goals early on to avoid these types of firings.

Not ready to do the work

The third answer could be that the client is simply not ready to do the work of therapy. Oftentimes folks think they want to work on their problems but once they start digging deeper into them, they’re surprised by how painful and draining the work truly is and decide to stop. And that’s okay. 

Therapy is not easy and it would be unfair to expect everyone to be up for the task. It’s nothing against your client and nothing against you. It just means they are not ready at the moment.

Not able to pay

The fourth and final answer is that therapy became too expensive. This is tragically common. Insurance changes, they have a baby, a global pandemic drives a surge in inflation—whatever it might be, finances often get in the way of clients continuing care. 

This is a frustrating one because often there is nothing that either you or your client could do to change things. If you have the option to adjust your rates, it can be tempting to do so. Before doing this, though, you need to take care of yourself and have clear boundaries around how much you need to make to stay financially secure.

What to do when a client fires you as their therapist

Knowing what to say to a client that wants to end their therapeutic relationship with you can be difficult. I certainly was lost for words when that couple stormed out. You and I cannot control what our clients say or do, but we can try to improve how we show up for them. Even when it seems they are done. Let’s go over a few suggestions.

Check in with yourself

First, you want to check in with yourself. What do you feel when a client indicates they want out? Where does your mind go first? As best you can, try regulating any distressing feelings (e.g. embarrassment, shame, fear) and redirect your attention to what your client may be feeling and thinking. 

Start an open conversation

Start an open conversation about what they are feeling with curiosity. The goal is not to persuade them to continue seeing you. Rather, you are discerning whether the care they are looking for is something you can honestly offer or if they need a different level or expertise in care. 

What I’ve found most common is that clients feel uncomfortable asking for something different in therapy. Opening a conversation to how their treatment is going with genuine curiosity empowers them to voice their concerns and builds further trust with you. Again, we’ll talk later about how to avoid this sort of hiccup in the first place.

Don’t over-promise

Don’t over-promise what you can offer. When I was just starting as a therapist, I often felt pressure to be anything and everything for my clients. 

I had one client who wanted me to give them a detailed timeline for how treatment would progress for them. Despite this being our first session, I felt pressured to give them what they wanted and stammered through a timeline chalk full of therapeutic jargon and ridiculous promises of progress. To no one’s surprise, they stopped showing up after a few sessions. 

It's vulnerable when you cannot offer what a client wants. But you are not a miracle-worker. Every clinician has limits and it’s better to be upfront about them.

Offer to make a referral

Be sure to offer to help them find someone else. You may not be the best therapist for them but you can still help them by finding a better fit. This doesn’t mean spending hours of your time playing matchmaker. It could be as simple as checking in with a few colleagues or doing a search on Psychology Today with their presenting concerns and insurance. 

Putting in a little extra time helping them find someone else communicates your care for them as well as hope that they can still find the help they are looking for. 

Take a pause

Checking in with yourself is often difficult (sometimes near impossible) to do in the moment. That’s okay. Give yourself a few minutes after seeing clients and before you transition into whatever comes next in your day to check back in with those feelings and thoughts. 

Be open to whatever may come, not trying to change or manipulate anything. Just observing what comes and extending kind curiosity toward it. Allow yourself to feel the sting of shame or the pit in your stomach of fear and continue watching until it slowly fades. 

I often found myself suppressing or running away from these feelings but that only makes them grow over time. Instead, doing a short meditation like this has helped me process the difficult emotions, feel less anxious about them in the future, and go on with my day carrying a little more ease.

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What to do when a client ghosts you as their therapist

Some clients don’t give you the option of a conversation. Rather than voicing their concerns, they simply stop showing up. What do you do then?

As we talked about before, we’re not in control of our clients and their care is their responsibility. It’s easy to overthink a client ghosting you. I’ve done it myself. 

I had one client who had been consistent for almost a year doing weekly sessions. One week he no-showed his appointment, so I sent a quick email saying I hoped he was doing well and asked if he would like to reschedule. No reply. My mind spun with everything I said and did during that last session, trying to pinpoint what I did wrong. 

A few months later, I saw he was on my schedule again. I was a little anxious before the session, wondering what it was I did that may have caused the break. It turns out he unexpectedly started a new job that he was excited about and missed his last session because it was his first day. All that worrying over nothing.

If a client ghosts or starts no-showing sessions without communicating with me, my general rule of thumb is to try getting in contact once through whatever medium of communication we use most. It tends to be a quick email letting them know they missed an appointment and asking if they want to schedule again.

If I still don’t get a response, then I send a termination letter to their address on file letting them know I will cancel any further scheduled appointments and close their file with me (something that is not permanent should they want to schedule again). 

One last consideration would be whether you have concern about risk of suicide. Ideally you want to handle this in-session with clients and develop a plan before any client struggling with suicidal ideation leaves your office. Being direct about suicidal ideation can be difficult, especially early on as a therapist, but it is the best way to protect your client and yourself. 

Helping your client develop a safety plan where you are not their first emergency contact ensures they have someone more accessible to help them in a time of crisis. Identifying who they will contact and how also empowers them to contact you if they need help rather than leaving any false assumptions that you will instinctively know something is wrong and contact them.

How to fire a client as their therapist

Typically your client will be the one who ends treatment but there are rare occasions where you as the therapist may choose it is best to end your therapeutic relationship. This is different from graduating your clients. Graduating tends to be a natural and mutual progression toward the ending of your therapeutic relationship after treatment goals have been accomplished. 

Terminating therapy as the therapist, though, is one-sided in the sense that you are the one instigating the conversation about ending treatment. There are a few occasions where this may be appropriate.

One such occasion may be for clients who become too attached to you as their therapist. I have seen this with clients who make great progress but do not reduce the frequency of our times meeting. I find myself grasping at straws during sessions and the conversation seems to shift away from clinical topics to chitchat. 

In these cases, it may actually be clinically harmful to keep meeting at the same frequency as it reinforces the narrative that our clients need us to be okay. In therapy we are trying to empower our clients to be happy and healthy by their own efforts, newfound skills, and repaired relationships.

When this happens, I tend to highlight the progress they have made and gently ask how they would feel about reducing session frequency. Some take this in stride and are empowered by the validation of their progress. Others react with fear and concern, which is okay because now we have something clinical to discuss again. Either way, you break up the stagnation and help your client address uncomfortable but necessary emotional blocks.

A more difficult occasion where you may have to terminate treatment is if your client is not respecting the boundaries of your therapeutic relationship (e.g. frequent tardiness, failing to make payments or set up a payment plan, making sexual advances, verbal/physical abuse).

In most cases, you can start by making the boundary crossing clinical. Communicating to your client how their actions affect you gives your client the opportunity to reflect on behaviors that likely are negatively affecting their life and relationships in a safer setting. These often are powerful interventions.

However, your safety is important, too. Being a therapist does not mean you need to tolerate abuse. On the contrary, doing so would perpetuate a message to your client that it is okay to abuse others. If you are early on in your career (or have not taken the time to consider your own boundaries) it may be helpful to discuss with a supervisor or colleague what is acceptable and unacceptable behavior in a therapeutic relationship. 

In general, it is best practice to be direct early about expectations and boundaries and firm when it comes to your own safety.

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How to prevent being fired by a client as their therapist

Some firings and ghosting simply cannot be prevented. No matter what, your client is in control of their care and choices and has the right to end treatment whenever they would like. 

That being said, there are practices and principles we can use to reduce unexpected (and sometimes unnecessary) firings and termination.

Set expectations upfront

The first, which we have alluded to, is being direct about expectations and hopes from the get-go. One question I ask near the beginning of every intake is, “What are you hoping for from me and our time together?”

I used to avoid this kind of question because I worried my client might say something I could not offer and risk disappointing them. Over time, though, I’ve learned that it is best to talk about expectations early because it sets the course of therapy in a productive direction and avoids wasting you and your clients time if their expectations are ones you cannot meet.

Check in throughout treatment

The second practice is to check in with your client on how therapy is going throughout treatment. Some therapists use a post-session evaluation they give to their clients that asks questions like “How satisfied are you by treatment so far?” and “Has there been anything we have not talked about that you would like to?” This empowers your client to share their true feelings without the pressure of verbalizing them.

I tend to check in about once a month with my clients about how treatment is going. We’ll talk about progress they have made so far, any concerns or unspoken feelings they may have about treatment or me, and how they feel about the frequency of our sessions. 

I also encourage client’s during our intake to voice any concerns they may have throughout our therapeutic relationship. Again, viewing your relationship with your client as a clinical intervention opens the door for powerful and relevant change to occur.

Seek supervision and case consultation

The third practice to reduce unexpected and unnecessary termination is thoughtfully using supervision and case consultation. Every therapist has blind spots so it’s crucial to get a third party perspective, even for clients who you feel things are going well with. 

Presenting cases as neutrally as possible (or better yet, recording your sessions with your clients permission) allows for your supervisor or consult group to illuminate areas of concern that you may be missing. It’s vulnerable being open about the way we approach treatment but it's best for your growth as a clinician as well as your client’s continued healing.

Go to therapy yourself

The fourth and final practice is going to therapy and doing the work yourself. It was not until I started therapy that I fully realized how much my own fears and insecurities were obscuring my clinical vision. 

My therapist helped me see how I was avoiding conversations about expectations and boundaries that needed to be had because I was scared of letting down my clients or upsetting them. This was a crucial step in my journey of becoming a confident and more competent therapist. 

There may be some unintentional ways that you are contributing to a client prematurely discontinuing treatment. It does not mean you are a bad therapist, it just means that, like the rest of us, there may be some unresolved issues that could use care and attention.

You are not a bad therapist if a client fires you

I never did see that couple after they walked out of my office. Sometimes I wish I could go back and handle that situation differently. 

I try not to judge myself, though, because I know there are always growing pains along the path of becoming a therapist.

Every therapist has struggled with the aftermath of a firing. You are not a bad therapist for going through what we all have. Learn what you can from the experience and keep going.

Ben Behnen is a therapist who loves helping other beginning therapists. He's getting close to attaining his license in marriage in family therapy and is using his experience and love for writing to help other beginning therapists on their journey to licensure. You can follow him on LinkedIn or subscribe to his free newsletter.

This post is to be used for informational purposes only and does not constitute legal, business, or tax advice. Each person should consult their own attorney, business advisor, or tax advisor with respect to matters referenced in this post.

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