Abrupt therapist termination — how to respond?

March 23, 2022 9:52 AM

My wife and I recently began seeing a couple's therapist, "Susan." After four sessions, my wife and I would agree that progress has been slow, but therapy has helped us communicate more clearly and respectfully with each other. BUT...

Two weeks ago, on the afternoon of our latest therapy appointment, the practice manager called me out of the blue to say, "Susan thinks couple's therapy is not a good fit. Continue individual therapy and try back later."

I was blown away by the abrupt and impersonal termination, and I replied that I would appreciate a personal note from Susan, who could explain her decision and provide us guidelines about what to pursue individually and how to know when couple's therapy would be a good fit for us.

After two weeks of not hearing back, I emailed the practice manager yesterday, who said:

"Susan suggested that you continue with individual therapy and take a break from couple’s therapy. Susan does not have any additional individual therapy goals other than the ones that you have set with your personal therapists. In a couple of months and when you have met some of your individual goals, we can revisit couple’s therapy again."

I feel this reply is inadequate, but how should I respond?

My inclination is to write Susan a letter, outlining my concerns and questions:

• Susan's sudden termination feels like we've been abandoned
• We are unable to appropriately manage our therapy (individual or couples) without Susan's explanation of why she feels she cannot help us right now.
• In the future, given the intimate nature of therapy, a personal note delivered with advance notice would be highly advisable in contrast to an impersonal same-day termination delivered via the practice manager.

(By the way, since Susan is operating in a pre-licensed capacity, I would CC the letter to her supervising therapist.)

Does this approach sound appropriate and adequate? Any other angles we should consider?

Ultimately, I'm not optimistic for much of a reply, and my wife and I have recovered from the sting of the event. Mainly, I feel it's important to call out what I consider nonprofessional behavior in the hopes that future clients receive more compassionate treatment.

posted by anonymous to Human Relations (24 answers total)

Oh my God no. Susan does not have the obligation you seem to think she has. One of the reasons she doesn't is that in an abusive relationship, suggesting patients stop couples therapy in favour of individual therapy is crucial. "I'm recommending you and your gaslighting ass get off my couch so your wife can get actual help with you out of the room" is not something a therapist is going to say, let alone write.

Not I am not implying either you or your wife are abusive.

Discuss this with your individual therapists.
posted by DarlingBri at 10:00 AM on March 23, 2022 [38 favorites]

I think the purpose of individual therapy is to uncover possible underlying issues that each person may be experiencing but aren't expressing in the company of their partner. It allows for each person to let their guard down a little more with a therapist one-on-one; especially if one or the other doesn't want to offend their partner, or perhaps has deep shame or fear due to previous trauma, and hasn't previously told their partner about it - especially if their partner might trigger trauma memories or responds in ways that makes the other feel uncomfortable. If progress has been slow, the therapist likely wants to see if there is something unspoken that is retarding progress. Just do the individual therapy for a while, and don't pry into what each of you are discovering about yourselves in private.
posted by itsflyable at 10:03 AM on March 23, 2022 [3 favorites]

Chiming in that I think this is acceptable practice, and you don't need to have any further communication with Susan or Susan's office.

I can think of a few situations where there might be weird issues at play (for example, an evangelical Christian couples therapy approach with issues of orientation or polyamory or something).

But aside from that, I think that Susan's office and Susan have communicated with you effectively. The strongest possibility is that there is something Susan believes will prevent effective couples' therapy that she does not want to discuss with both of you present (and may not want to discuss individually, but leave to individual exploration in individual therapy.) Since her obligation is to both of you and to your relationship, she really can't give a reason that she thinks won't be helpful to either of you.

She's behaving professionally in terminating your joint therapy. It's not the same as individual therapy where it might be important to give an individual closure and information - it's just not the same kind of professional relationship.

It sounds like you are experiencing some emotion about this (the sting) and that you want information and control over Susan's decision. Those are really great things to bring to your therapist. I would go cautiously about discussing this a lot further with your wife, in case whatever it is could damage your wife's growth (not saying it would, but that you might want to apply the 'first do no harm' principle to this situation, just in case.)
posted by warriorqueen at 10:15 AM on March 23, 2022 [10 favorites]

I disagree with the commenters so far: while it's not strange for a couple's therapist to recommend termination and personal therapy instead, it IS very strange that Susan would not even send a personal note herself - not even by email! - let alone offer the standard face-to-face termination session with you both. I don't understand why a therapist would flee from clients like this, communicating only through an intermediary, unless you behaved threateningly or abusively towards her.

Regardless, though, her decision is her decision. You're not entitled to any personal notes or contact from this therapist against her will. So let go of your demands and expectations on that front. While you may wish to report her to her professional board or her supervisor, that is separate from being able to demand to speak with her or communicate with her. You can't compel her to interact with you. You should stop trying.

All of these things are true at the same time:

- Susan is fully within her rights to do what she's doing
- AND you should stop demanding to communicate with her
- AND Susan is behaving strangely and unprofessionally by communicating with you only via her intermediary unless she has reason to think you are dangerous.

You can also reassure yourself that Susan's actions probably are about her, not about you. You may never know why exactly she acted like this. And that's okay. Coming to terms with this situation is a good subject for your individual therapy.

What you are entitled to from Susan are your medical records. Request these records from her office (not Susan directly). These will be formal therapy records, not her personal notes, don't expect them to be informative about her reasons for abrupt termination beyond what you already know. But she is legally obligated to provide these notes to you upon request, and it will contain some sort of assessment/case notes that you can take to your individual therapist who may be able to decode them and explain it to you as far as they understand.

It is also possible that your individual therapist may be able to contact Susan and ask her for more information in order to help you better meet your individual therapy goals, if you provide a written release allowing Susan to speak to your individual therapist. It's possible that Susan will refuse to speak to your individual therapist but again, that's her prerogative and also rather unusual behavior that's likely about her and not you.
posted by MiraK at 10:36 AM on March 23, 2022 [29 favorites]

I think you (the OP) are right to be upset. I would be upset, too. I understand the points people have made in the responses above – but I think that at the very least, Susan could have communicated with you better (like replying to you personally when you requested it) and could been much more gracious and warm in her messages. Her brusque termination – and the manner in which it was conveyed to you – seems unkind at best, unprofessional at worst. For what it's worth, I probably would contact her supervisor, if I were in your shoes.
posted by JD Sockinger at 10:37 AM on March 23, 2022 [15 favorites]

I am not a therapist nor have been in couples therapy, but I agree with the OP that something seems off here:

on the afternoon of our latest therapy appointment, the practice manager called me out of the blue

At the very least, the time to drop a client isn't the same afternoon as their next appointment, no? Seems rude if only because people have busy lives, and no doubt schedule other things around therapy appointments.

"In a couple of months and when you have met some of your individual goals, we can revisit couple’s therapy again."

If I was told that, I would also feel annoyed that no specific goal had been mentioned. It would not make me want to ever see this particular therapist again.

To the OP- I wouldn't contact Susan, but I'd contact her supervising therapist. I'd keep it short, fact-based, with as little emotion as you can. I probably wouldn't say I felt abandoned, but more focus the last minute cancelation/unclear and impersonal communication as a problem.
posted by coffeecat at 10:47 AM on March 23, 2022 [7 favorites]

In your shoes, I would be pissed off, frustrated, and confused. I would feel like I had been treated less kindly than I deserved.

But frankly, sending Sternly Worded Letters to unkind people rarely does any good. And complaining to Susan's supervisor may not change much either, unless there's a specific rule of her profession that she's breaking here. (I'm not a therapist, so I can't speak to that.) But this isn't a restaurant where you can throw your weight around and try to bully a waiter by threatening to get them fired. Susan works for herself, and within the laws and regulations that apply to her, she can set her own tone for interactions with clients.

It's probably worth letting this go, or processing it with your individual therapist.
posted by nebulawindphone at 10:54 AM on March 23, 2022 [9 favorites]

I think Susan is really out of line. I agree that you are right to be upset. Susan should have told you this herself, and I would not go back to her if I were you. It's also clear you aren't going to get more information from her, and I think you just need to accept that. I also agree that talking to your individual therapist would be your next step - that therapist may talk to Susan and find out why Susan thought individual therapy is not appropriate.

I also agree with coffeecat that contacting the supervising therapist would be appropriate here - not "I'm trying to get Susan in trouble," but I'm trying to understand what happened. Susan isn't willing to talk to you, and you have every right to find out why you were terminated abruptly without any kind of reasonable explanation.
posted by FencingGal at 10:56 AM on March 23, 2022 [3 favorites]

I think the therapist should have talked to you about this in a session and maybe helped you set some goals. You obviously find this disconcerting and distressing. But, you can't make the therapist see you, and might not trust them at this point.
posted by theora55 at 11:04 AM on March 23, 2022 [1 favorite]

Since you are interacting with another professional therapist who probably know more about being a therapist than most of us, maybe that would be a good person to ask about this.
posted by amtho at 11:09 AM on March 23, 2022 [4 favorites]

I'm a therapist, and a termination session when possible is considered ethical practice. I think that if this was Susan's decision and if she was able to call you or provide a termination session, that would have been proper course here. Abruptly ending treatment and not communicating directly is not best practice at all, irrespective of the reasoning (unless there was some kind of safety issue).

It is possible that Susan's supervisor made this decision for her and did not allow her to call, or that Susan felt ill-equipped to handle this.... or maybe a possibility she was fired?
posted by bearette at 11:19 AM on March 23, 2022 [32 favorites]

FWIW, here are some mundane not-abuse reasons for cutting off couples therapy and sending you back to individual: "You disagree about the goal," "you aren't both committed to the process," and "this isn't really a communication problem — one of you just needs to make a decision." I know people who've been fired by couples therapists for all those reasons.
posted by nebulawindphone at 11:28 AM on March 23, 2022 [11 favorites]

To the OP- I wouldn't contact Susan, but I'd contact her supervising therapist. I'd keep it short, fact-based, with as little emotion as you can. I probably wouldn't say I felt abandoned, but more focus the last minute cancelation/unclear and impersonal communication as a problem.

This. Susan may be behaving professionally in choosing not to give her reasons, but her transition — particularly the last minute notice — lacked the basic courtesy you’d expect from anyone.
posted by Tell Me No Lies at 11:36 AM on March 23, 2022 [4 favorites]

I think the tone of the communication is not appropriate to the circumstances, but I would certainly assume Susan has no control over that as the decision would have gone through her supervisor and then the practice manager and any correspondence should be directed to those people and the director, if that's not the supervisor. If Susan actually did anything wrong, they can handle that internally.

But you probably shouldn't expect anything different to happen. They may improve some internal process because of it, but you won't likely get anything else out of them.
posted by Lyn Never at 12:05 PM on March 23, 2022

I consider this unprofessional. I would be very angry if a therapist treated me this way. She at least owes you a final meeting.

Some people have suggested that Susan may have been fired, or that the decision was out of her hands. If that's the case, then the practice is lying to you. You were given reasons ("Susan thinks couple's therapy is not a good fit"). Those reasons are inadequate, but they imply something that would be untrue if Susan was fired, in over her head, needed a break, etc.

The practice should have at least given you a wind down therapist -- with another therapist if not with Susan -- to explain, give you a chance to ask questions, and keep your relationship on track with this change. I would agree that you should write a letter to the practice explaining that you feel you were treated unprofessionally. It will be good for them to get that feedback.
posted by Winnie the Proust at 12:37 PM on March 23, 2022 [6 favorites]

You said two things I want to point out: Susan's sudden termination feels like we've been abandoned
That sounds really tough. Also, I'm noting you said "we" but who is feeling this way? You or your wife or both of you?

We are unable to appropriately manage our therapy (individual or couples) without Susan's explanation of why she feels she cannot help us right now.
It's unusual to me that you are using "we" when discussing individual therapy. But, I want to point out, you can use individual therapy to discuss the feeling of abandonment. I'd say your individual therapist is a perfect person to discuss all this with, and they can probably give you insight into what they regard as Susan's professional obligations.
posted by bluedaisy at 12:58 PM on March 23, 2022 [6 favorites]

You’re getting brushed off. I won’t read into the therapy inside baseball stuff, but your therapist is telling you they do not want your business by communicating in that manner. I would ignore them and try a different therapist. If weird stuff happens again, maybe it’s you? Maybe couples therapy is hard.
posted by Geckwoistmeinauto at 1:05 PM on March 23, 2022 [3 favorites]

I suspect there is more to the story (and indeed, you and your wife would have inside info we're not privy to), so I'm just responding here to the surface of what you've told us: if NEITHER of you have been told in previous appointments, or even hinted at, what goals you might be seeking in individual therapy, I'd see reason for your confusion.

However - the likelihood that neither of you really have any idea regarding your individual issues is a bit... unrealistic.
posted by stormyteal at 1:35 PM on March 23, 2022 [1 favorite]

the likelihood that neither of you really have any idea regarding your individual issues is a bit... unrealistic.

I strongly disagree with this assessment. One of the reasons a couple may go into therapy in the first place is that things are going wrong and they don't know why. Clarity can be very hard to come by when you're in the middle of the mess.
posted by Tell Me No Lies at 2:56 PM on March 23, 2022 [4 favorites]

Since she is pre-license it is entirely possible that her supervising therapist had their weekly or monthly meeting with her directly before your therapy and said “yeah, you need to cut these people loose.” I would drop it and respect the boundary you have been given, which is “do work with individual therapists and then revisit.” It could very well be that part of what needs working on is respecting boundaries even when you wish there were more information about that boundary.

But really, I would assume there was an administrative snafu or snag that prevented her from being able to cancel with you in a more timely manner and let it go. You’ve already got your answer.
posted by Bottlecap at 3:04 PM on March 23, 2022 [3 favorites]

I'm a therapist (IANYT), and here's what stands out to me:

Having the practice manager call you rather than reaching out herself strikes me as odd. Likewise, not following up when you requested clarification. This makes me wonder if A) Susan isn't actually involved in this process (do we know for sure she's still with the practice?), or B) Susan's supervisor told her to terminate with you, possibly for an awkward reason*, and didn't give good guidance on doing so.

I'm guessing, based on your wording, that your individual therapists are with this same practice. If that's the case, you and your wife should definitely talk to your respective therapists about this situation, because they're the people most likely to be willing and able to shed some light on what happened. They can also help each of you evaluate whether there are genuinely some individual issues that need attention before couples counseling will be helpful.

Once you've gotten any information your individual therapists can share, it would be fine to send a note to Susan and her supervisor, but keep it extremely short, like: "On X date, [Practice manager] notified us that our session that day and all future sessions with Susan were canceled due to Susan feeling we were a poor fit for couples therapy and should focus on individual therapy. We asked for clarification from Susan but had no further contact with her. The way we were notified about terminating with Susan was abrupt and upsetting, and we feel abandoned and confused. We encourage you to consider alternative ways of communicating this type of information with clients, such as having the therapist or therapist's clinical supervisor communicate with clients directly." Bring the letter(s) you want to write to individual therapy--talk through your feelings and experiences in detail. But as for what you actually send, keep it short, like one paragraph, max. It's much more likely they'll read and take to heart a concise critique of having the practice manager abruptly terminate with a client than a long account of your experiences, as painful as they were. And if they're open to that shorter message, they may well ask for more information.

*Here's an awkward termination scenario: say my spouse is unhappy in their job and complains about their manager, Maggie, often... and then after a few sessions I realize my new client Margaret is actually the same person. It's going to be really hard to be the therapist Margaret needs under those circumstances, and I should refer out due to a conflict of interest. But unless it's likely we'll cross paths, I'm probably going to say, "I need to refer you out due to a conflict of interest," rather than, "I need to refer you out because i only just realized you're my spouse's boss."
posted by theotherdurassister at 5:58 PM on March 23, 2022 [10 favorites]

I ran this by a therapist I know who has done a lot of supervision. She was boggled by the treatment you received.

One thing that she pointed out was that either actively or passively the supervisor was part of your mistreatment. So if you’re going to send a letter you may want to cc: their boss as well.
posted by Tell Me No Lies at 9:17 PM on March 23, 2022 [4 favorites]

Good couples therapy is hard to find. We went through probably ten different ones before we gave up. Sorry this happened but I agree best plan is to forget it and find someone else
posted by tillsbury at 2:22 AM on March 24, 2022 [1 favorite]

To me, it sounds like either something has happened with the therapist or that the therapy went over her abilities. It’s possible they found out she doesn’t qualify to do couples therapy, that there was some practicum requirement they messed up on as a company, that she failed an exam, they didn’t get liability insurance, or, as noted above, there’s some sort of awkward story. If it’s a practicum, they perhaps can’t just scoot someone else in because of fee structures or other conflicts (could be the supervisor with a conflict). But it’s also possible something happened with the practicum student’s abilities. For example, they may not be able to manage something going on in session. That could be for all the reasons relationship counselling isn’t recommended in certain situations, as Darling Bri and others note, or it could be that there are some complex individual needs the therapist cannot manage and the supervisor cannot support.

While it’s unprofessional, I have seen two situations where supervisors cut off contact when a situation involved a student. I’m not sure if that’s normal or if I just got unlucky twice. I think it’s often because of limited funds, no replacement person for work for free and ethics rules about supervision. Sometimes they are just breaking even on the supervision costs for students. Anyway, I am sorry it happened and I encourage you to take it back to your individual therapists and have them help. Maybe they can unpack something said in your latest session that could have even a red flag.
posted by shockpoppet at 7:50 AM on March 24, 2022