1. By: Lyndsie Barnett, Jessica Childers, and Jordan Sliger
Proper termination procedures as it relates to counselor’s sickness and/or sudden death
By: Lyndsie Barnett, Jessica Childers, and Jordan Sliger

2. What is sudden termination?
Termination: The ethically and clinically appropriate process by which a professional relationship is ended. (Younggren and Gottlieb); the last phase of therapy
Sudden Termination: the quick, often unexpected ending to a professional relationship
Abandonment: “to give up; discontinue; withdraw from” (dictionary.com)

3. American counseling association (aca) –what does it say about sudden termination?
A.1.b. Records and Documentation
A.1.c. Counseling Plans
A.2.b. Types of Information Needed
A.11.a. Competence Within Termination and Referral
A.11.d. Appropriate Transfer of Services
A.12. Abandonment and Client Neglect

4. American psychological association (APA) – What does it say about sudden termination?

5. National association of social workers (NASW)- what does it say about sudden termination?
1.03 (a) Informed Consent
1.07 (n) Privacy and Confidentiality
1.07 (o) Privacy and Confidentiality
1.16 (f) Termination of Services

6. National association of social workers (NASW)- what does it say about sudden termination?
RECEIVING AND MAKING REFERRALS
Referrals may continue after the announcement of your retirement. Setting a date when new referrals will not be accepted is important and new patients should be informed of the retiring date during the initial referral and given an opportunity to accept or deny services.
If continued services are required, patients should be given several options for treatment and at least three referrals. Patients should also be informed of the credentials, name, address, and phone numbers of the clinicians or organizations to whom you are referring them. Web sites, pamphlets, business cards, and other information about the referral sources would be helpful. To facilitate referrals of their choice, patients should sign the appropriate release of information forms.
CLOSING OR TRANSFER DOCUMENTATION
The closing or transfer treatment record should include a psychosocial assessment, treatment plan, and progress notes and documentation of all visits and contacts. In addition, a closing or transfer summary of each patient is recommended to assist in a smooth transition to future services. The following information is helpful to include: • Summary of the case, including a diagnosis and treatment plan • Progress in meeting treatment plan • Transfer or closing plans • Follow-up recommendation

7. NASW CONTINUED… (Sudden termination)
STORAGE OF RECORDS
Retain all of your clinical records for all patients, including those who have died. Many states have statutes of limitations for professional liability and regulate how long you need to keep records. Because statues of limitations are based on when the injured party realizes or should have known that the clinical social worker harmed him or her, NASW recommends that you retain your records indefinitely in the event a malpractice suit arises against you later.
Proper storage of records is very important and special safeguards should be taken to protect them. You may store them at your home in a dry, secure, fireproof file cabinet or other container or rent storage space at a facility. Many clinical social workers store records electronically. In such instances, special HIPAA security measures, including encryption software and firewalls should be followed when maintaining an electronic file. An emergency back-up file for electronic records should be maintained in the event of a natural disaster or other emergency.
MALPRACTICE INSURANCE
Your professional liability insurance agency should be notified that you are closing your private practice prior to your retirement date. Continuous payment of your malpractice insurance will avoid any gaps in coverage. Most professional liability policies offer an option to extend coverage after you close your practice. The extended reporting period, also known as "tail,” provides coverage for future claims based on events that occurred before your practice was closed. Maintaining continuous extended liability coverage after retiring your practice is important because it protects you from liabilities from former patients who may sue you at any time. Discuss your options with your insurance carrier prior to retiring your practice. If you have professional malpractice insurance through NASW, you may contact the American Professional Agency at
PROFESSIONAL WILL
Clinical social workers in private practice should have a professional will. If you do not have one at the time of retirement, it is best practice to prepare a professional will that provides instructions on how patient records should be maintained and appoints a custodian for the patients’ records in the event of your death. Consulting with an attorney or legal representative can be helpful in preparing a professional will, estate planning, and other legal issues concerning the retirement of your practice.

8. NASw: termination of services
1.16 (B) Social workers take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in situation and taking care to minimize possible adverse effects. Social workers assist in making proper arrangements for continuation of services when necessary.
1.16(E) Social workers who anticipate the termination or interruption of services to clients should notify clients promptly and seek transfer, referral, or continuation of services in relation to the client’s needs and preferences.
1.16(F) Social workers who are leaving an employment setting should inform clients of appropriate options for the continuation of services and of the benefits and risks of the options

9. All possible way to terminate a client (if alive vs. if deceased)
“Good” reasons:
Ensure basic emotional needs are met outside of the therapy room
Your partner/spouse gets a new job or is relocating to a new state
Your client has outgrown you and needs a referral
Draw their attention back to their original therapy goals
You’re practice is growing and you need to move into a larger office space
Make it clear from the beginning that therapy will be finite
You’re practicing better boundaries and limiting the number of times you are willing to be stood up by a client
Bad reasons:

10. Unacceptable ways to terminate a client
Handing over client records to a colleague without the client’s permission.
Allowing access to a client’s records to other counselors after the counselor’s death without the client’s permission.
Allowing a colleague to have the names of your clients to contact them to set up sessions in the event of your absence without your client’s permission.
Special note, client’s permission has to be written consent. Verbal means nothing.

11. Acceptable way to terminate a client
Seek consultation
Create a discharge and aftercare plan
Give verbal notice
Offer referrals
Give written notice
Discuss maintenance of and access to your clinical records after termination
Have an attorney review your written notice, before sending it
Establish a termination date with your client
Review progress made during therapy
Send a termination lette
Identify and discuss the remaining challenges
From: Tamara G. Suttle, M.Ed., LPC, founded Private Practice from the Inside Out in 2003

12. Legalities of Handling sudden termination
Vasquez, Bingham, and Barnett (2008) suggest:
informed consent should include specific information about what the client can do if the psychotherapist suddenly becomes unavailable because of sickness or death
In addition, the informed consent document should be printed and a copy should be provided to the client for record keeping and reference in case the therapist becomes incapacitated.

13. Case study #1 Greg 48 years old LPC Has cancer Passes away
How should Greg have been prepared for this situation?
How should all practitioners be prepared?
What steps should Greg have taken so that his clients were as prepared as possible for his outcome?

14. By protecting our clients, we protect ourselves.
Summary of sudden termination – How to correctly handle it with illness and/or respond to sudden death
Obligation to protect clients from abandonment and from violation of privacy.
We need to include proper termination procedures in the case of an emergency in our informed consent.
By protecting our clients, we protect ourselves.