By: Chelsea Glover-Jordan, LCSW-C, LICSW
Ending relationships is not always easy, especially if the “breakup” was seemingly an abrupt decision based on “whatever” by only one of the parties. There does not seem to be enough talk about ending the therapeutic relationship between client and clinician. More commonly, ending family ties and intimate dynamics are widely talked about and are agreeably part of the “normal” human experience. Shining light on the therapeutic relationship and how intimate it could be depending on the level of vulnerability and transparency exhibited by the client should also be noted and in some cases, studied. Although the therapeutic relationship is inherently one-sided, one party seeking clinical insight and guidance from another party who is trained and paid to maintain poise and clinical professionalism, human nature would dictate some level of emotional impact the relationship may have on the latter party.
As a clinician who has interactions with the same 35-40 clients each month, some of those clients seen on a weekly basis, inevitably emotional connections can flourish. Now, I am not referring to unconventional, unethical, and unprofessional dynamics, I am speaking on getting to know the darkest depths of a client, witnessing their failures, triumphs, and their realizations and then suddenly, not being so privy to those things anymore. We as clinicians are professional listeners. In that listening, although not usually blatant to the naked client eye, we have internal responses and ways in which we connect with our clients. We are able to set the tone for the therapeutic experience, highlighting a client’s strengths and helping them build the lives they want off of those strengths. We are able to assist clients in conceptualizing their being and identity outside of the confounds of their families of origin, their culture, and restrictive social constructs. Our clients, who are the flowers, symbolically lack water and fertilizer. We as providers are the green thumbed gardeners designed and cultivated to clinically emotionally and mentally pour into them what certain people and entities have taken away.
But what happens when the clinician is either “ghosted” or services have to abruptly come to an end because of an unknown issue that may arise on behalf of the client? Sometimes as clinicians, we can anticipate the relationship dissolving based on consistent rescheduling, late cancellations and even client “no shows”. In those instances, clinicians may have time to progressively detach from the therapeutic relationship. In other instances, such as abrupt changes in the client’s insurance, tragic life experiences, and even a client’s death, it can be difficult for a provider to not wonder what “happened” or what is “going on” with specific clients they have essentially seen on a regular basis. Now, this is not to discount the purpose of the therapeutic alliance which is to be goal-oriented in the healing and addressing of presenting issues a client has initiated services for. As trained professionals, we are taught how to minimize countertransference as much as possible, a way to create a buffer between the clinician’s personal being and their professional being when engaging with clients. In fact, it is our ethical and moral duty to not exhibit anything that remotely compromises the professional dynamic. That still does not take away from our human experiences when being such an instrumental tool in others’ lives.
If services must be discontinued or if there is any type of interruption in the continuity of services, here are a few ways to professionally respect your provider while still honoring your own autonomy and self-agency:
1. Be honest with your provider about logistics. If you know your insurance has changed or you no longer are covered by insurance and you are not able to afford out of pocket expenses for therapy, your provider may be willing to work with you. There is this thing called a sliding scale and usually at the discretion of the clinician, they may be able to offer you continued services at a discounted rate or even a pro bono rate (some clinicians have specific pro bono and sliding scale slots they allocate to clients who may be in the very exact situation you have found yourself in).
2. Be honest with your clinician about the quality of service. Not everyone is a good fit for everyone. As a client seeking services for healing and growth, you owe it to yourself to get the experience you and/or your insurance company are paying for. Don’t remain in a therapeutic relationship that you feel is not serving you. Simply tell your provider and in all likelihood, they will be in a position to refer you to a provider who is a better fit. They may even share in similar sentiments and your voice could be the confirming one.
In efforts to validate and honor you as a client and your right to continue and discontinue services whenever you want, please do not compromise on any healthy stated boundaries within the therapeutic relationship. In addition, please be considerate to the professional and ethical integrity that your clinician hopefully offers you.
Comments