Termination of Treatment
(May 2005
, Volume 1)
… If the termination of treatment process is not properly carried out, the attempt to end the professional relationship can constitute, or at least be argued as, an abandonment of the patient/client. This could lead to a lawsuit for damages, a complaint to the licensing board, and a complaint to the ethics committee of your professional association(s). While patients generally have a right to terminate at any time and for any reason, not so with therapists!
Therapists typically terminate when the patient can no longer pay for services, when the therapist determines that the patient’s problem is beyond the therapist’s scope of competence or scope of license, when the therapist determines that the patient is not benefiting from the treatment, when the course of treatment comes to an end because of the improvement of the patient, or when the therapist is unable or unwilling, for appropriate reasons, to continue to provide care.
Because the termination process can sometimes be so difficult, the therapist might want to consider adding some provisions to their disclosure statement (given to the patient prior to treatment) that address the issue of termination. Perhaps the patient will think twice about pursuing a complaint against the therapist when reminded that it was disclosed to them, at the outset of treatment, that the therapist is under an ethical duty to terminate when the therapist determines that the patient is not sufficiently benefiting from the treatment and the therapist believes that the patient needs a different level or kind of care (or words to that effect).
|
Termination of Treatment
(June 2005
, Volume 1)
… Here’s a common situation that often creates a dilemma for therapists. Suppose you are treating a minor, eleven years of age, with the consent of both parents. The court had ordered joint legal custody and the court order specifies that: “the consent of both parents shall be necessary in order to make any decisions with respect to the rendering of health care, whether physical or mental, to the minor.” Prior to the commencement of treatment, you obtain the consent to treat from both parents, complying with whatever the requirements are for documenting such approval. Three months later, one of the joint custodians calls the therapist and says that he withdraws his consent. He demands that the therapy end. The other joint custodian wants treatment to continue. Must the therapist comply with the request to end or terminate therapy?
This is not an easy issue to resolve, and a proper resolution will depend upon the interpretations and nuances of state law. Here’s what I have successfully argued in several cases over the years: The therapist had the permission of both parents to treat, as per the court order. Now, one of the parents is in essence asking the therapist to terminate treatment. The therapist, however, has determined that the minor needs continued treatment. The therapist does not want to abandon the patient, and since the therapist does not have both joint custodians agreeing to a termination of treatment (e.g., the mother wants her child to get continued care and believes that the father is acting in bad faith and in his own selfish interests) as the court order appears to require, the therapist properly continued to see the child in therapy. The consent to treat was given at the beginning and cannot be “taken back.” Now the issue is not consent to treat, but rather, termination.
Caution – whether or not the above line of reasoning or argument will work for you in your state and with your license, is a matter that must be carefully examined. The answer will depend upon the applicable state law or regulation and the wording of the court order, which may be ambiguous.
|