Termination and Abandonment: History, Risk, and Risk Management

Despite the frequency with which it occurs in daily practice, appropriate and inappropriate termination of psychotherapy has received very little empirical attention. The existing literature offers suggestions for managing termination that are based primarily on theory and anecdotal data, but the actual level of risk arising from such complaints is not clear. This article selectively reviews the history of this issue, including some of the available literature and several versions of the American Psychological Association's ethics code. Next, it summarizes the empirical data currently available. Then it lists a variety of types of termination and concludes with a list of questions to assist practitioners in determining what type of termination is appropriate in a given circumstance and how to reduce risk for both the patient and the practitioner in the process.