Professional wills and continuity of care planning can help ease the burden for therapists and clients alike
By Faye Beard
Termination of services should denote a success in therapy. In a perfect professional world, the therapist would part ways with the client by communicating with compassion. This process, however, does not always go as planned.
Too often clients have felt abandoned, wondering why their therapists have engaged in disappearing acts.
Practitioners are duty-bound to mitigate harm to the people they serve. It says so in the National Association of Social Workers’ Code of Ethics: “Social workers should make reasonable efforts to ensure continuity of services in the event that services are interrupted by factors such as unavailability, disruptions in electronic communication, relocation, illness, mental or physical ability, or death.”
Therapists are supposed to prepare clients for termination as soon as services begin, said Kara Bagnerise, LMSW, a therapist based in Dallas-Ft. Worth. “If you’re doing really well, we’ll be terminating your services, and we should be reminding you of that.” However, she noted, therapists should not be randomly terminating or ghosting their clients.
In one of many comments swirling on social media, a social worker lamented about how she was forced to ghost her clients. She was released from her job and not allowed to have further contact with them.
Bagnerise, herself had been ghosted by her therapist of two years. It left her with unanswered questions: “Are you doing therapy anymore? Are you alive? Where are you?”
In a Therapist Ghosting Survey conducted by researchers at Columbia University, 77 respondents who reported being ghosted by their therapists expressed feelings of shock, frustration, anxiety, resentment, and sadness.
The impact of therapist ghosting can be even more detrimental, deterring clients from seeking support, Bagnerise warned. “If I build this relationship with you, I tell you my whole life and my trauma. Then you disappear, and I have to start over with a new therapist. It can be re-traumatizing.”
Bagnerise understands that therapists have lives and things happen, she said, “but we are supposed to remove our personal lives from the fact that we are providing treatment.”
In extreme cases, clients are ghosted because their therapists are dead. A recent New York Times article, “The Ghost in the Therapy Room,” revealed some patients felt betrayed because their therapist hadn’t disclosed they were ailing.
While mental health professionals navigate how much of their personal lives they choose to share, they can still plan for unexpected occurrences.
In “Why Social Workers Need a Therapist Professional Will,” a Social Work Talks podcast episode, Ann Steiner, Ph.D. discussed the mandate for therapists to secure a backup plan for those expected and unexpected absences.
Unlike a personal will, a professional will addresses more than end-of-life affairs; it shares the therapists’ wishes and instructions whether they plan to miss one session or never practice again. To draw up a professional will, Dr. Steiner recommends selecting a team, which she called an emergency response team, whom the therapists can trust to take over their practice temporarily or permanently. “Who do we have that we could send one text to and say, ‘Please contact my patients and cancel them for the next week, because I don’t feel well enough to be able to do that?’”
An internationally recognized authority on the taboo topic, Dr. Steiner wrote The Psychotherapist’s Professional Will e-book, which is scheduled for a Fall 2025 release. For 25 years, she has been lecturing to mental health practitioners to consider this a matter of urgency. Dr. Steiner likened the necessity of professional wills to that of personal wills, which people rarely get around to writing.
“Termination is often the most important and richest phase of therapy, and it’s often overlooked,” Dr. Steiner said. She suggested that therapists ask their clients if they want to be contacted in case the therapist retires, relocates or dies. “When they graduate, I write all my patients farewell letters,” Dr. Steiner said. “It’s a termination ritual that honors their hard work and progress, and the letters are often treasured.”
Terminate can sound very harsh, said Bagnerise, who also uses the term graduate. “You are graduating to the next level of your life,” said Bagnerise.
“You are moving forward to some bigger and better things, but if you need me in the future, reach out and we can work things through.”
Faye Beard is a freelance writer in New York City.
