Treatment Termination Due to Lack of Progress Template

If you’re looking for a “Treatment Termination Due to Lack of Progress” template, then you’ve come to the right place.

Just like other service providers, mental health therapists deal with treatment discontinuation with their clients. There are several reasons to discontinue treatment, which include client-led and therapist-initiated terminations. 

In this article, we focus on reasons for ending a client relationship, what to include in your letter, and sample therapy termination letters—including a “Treatment Termination Due to Lack of Progress” template that you can customize for your practice and save in your electronic health record (EHR). 

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Reasons for treatment termination

Mental health therapists support a wide range of clients with varying needs. While the assessment, diagnosis, treatment planning, and intervention process often follows the same guidelines, sometimes clinicians may need to send a therapy termination letter. 

There are several reasons why treatment may be terminated. These include: 

Lack of progress 

The therapeutic process involves working toward achieving certain goals, such as symptom reduction, processing grief, or obtaining skills to improve quality of life. Sometimes, however, a client may not make progress and the clinician may determine it is in the best interest of the client to terminate treatment and refer them to another provider.

Client and therapist suitability

Sometimes, clients may find it more supportive to find a clinician with a similar identity. For example, a person with Christian beliefs may find a clinician with the same religious beliefs more supportive or a queer person may feel better supported by an LGBTQIA+ therapist.

Safety reasons

On occasion, a clinician may feel their client is a danger to themself, to the therapist, or to someone else and the only way to provide safety is to terminate treatment with the client. 

Changes to personal circumstances 

Clinicians may change practices, switch to a new specialty, or move out of town. Clients may also relocate to different areas or change insurance plans.

Poor attendance 

If a client repeatedly shows up late or fails to attend appointments, the clinician may decide to terminate therapy with the client.

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Examples of therapist-initiated termination due to lack of progress

In an ideal situation, therapy is terminated once the client and therapist mutually agree that they have achieved their goals. However, there are occasions when clients do not make progress, and despite the best efforts of the therapist, it is in the best interests of the clinician and the client to end the relationship. 

This could happen for various reasons, including:

The client requires treatment by a specialist 

Perhaps the client sought therapy to gain control over their relationship with substances, however, as time went on, the therapist determined that the client needed a higher level of care, such as inpatient substance use disorder treatment.

Therapist expertise 

A client may have initiated therapy due to relational difficulties, but as sessions progressed, they exhibited traits consistent with borderline personality disorder, which may fall outside the clinician’s specialty, competence, or clinical training.

Underlying issues 

Clients who struggle to achieve their goals may be dealing with underlying issues. For example, the therapeutic goals may be too significant, there may be underlying trauma, or perhaps the therapist is unfamiliar with treating the particular neurodivergence their client comes to exhibit. The therapist should redefine goals with the client, however, if progress is still not being made, they may have to refer the client to a clinician with different and/or more specific expertise.

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Key information included in the "Treatment Termination Due to Lack of Progress" template

When preparing to end a therapeutic relationship—whether it’s in person or by sending a therapy termination letter—there are a few key points to address. 

In the downloadable “Treatment Termination Due to Lack of Progress” template, these essential points are included along with sample text.  

Your reason for ending the relationship 

Be specific and state that you are terminating treatment due to lack of progress.

Referral information

If you have a clinician in mind, you can offer to make the referral or provide the therapist’s contact details in your letter.

Release of information (ROI) form 

In order to exchange information with your client’s new provider, accompany the letter with a client release of information form and ask them to complete and return it if they want their records forwarded.

If necessary, you can also include a list of mental health directories for your client, such as:

• SAMHSA Treatment Locator for Behavioral Health Treatment Services: a behavioral health treatment services locator for mental health and substance use/addiction concerns
• Therapy for Black Girls: an online community and directory of Black therapists, based in the U.S. 
• Latinx Therapy: a list of Latinx therapists and speakers around the country 
• Asian Mental Health Project: a directory for Asian communities seeking mental healthcare
• LGBTQ Psychotherapists of Color: a network of therapists for BIPOC LGBTQIA+ individuals in the Bay Area, CA—with some therapists providing virtual services across the state
• South Asian Mental Health Initiative & Network: a directory of South Asian mental health providers, including LGBTQIA+ affirming clinicians in the US

You can also include information on crisis support lines if applicable:

• SAMHSA National Helpline: a 24/7 referral and information services for mental health, addiction, crisis/disaster response, and treatment referral. Call 1-800-662-4357, or text your zip code to 435748
• Call Blackline: crisis counseling, support, and resources for Black LGBTQIA+ individuals that can be reached by calling 800-604-5841
• National Suicide Prevention Lifeline: free, confidential, 24/7 suicide and crisis support for people experiencing mental health-related distress or for those concerned about a loved one who may need crisis support from a trained crisis counselor. Call or text 988, or chat at 988lifeline.org 
• The Trevor Project: 24/7 support by trained counselors for LGBTQIA+ youth. Call 1-866-488-7386, or text “START” to 678-678

We’ve included a free “Treatment Termination Due to Lack of Progress” template to customize to the specific needs of your client situation. We’ve included several sample paragraphs to choose from, such as lack of progress, ROI information, and safety concerns. 

READ NEXT: What the Termination of Therapy Process Looks Like

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