Key Issues and Recommendations for Ethical and Effective Endings in Psychotherapy

The ending of the psychotherapy relationship is an important clinical, legal, and ethical matter. While some guidance and requirements are found in the American Psychological Association Ethical Principles of Psychologists and Code of Conduct, psychologists may at times experience challenges regarding when and how to most appropriately end the treatment relationship and even question what their obligations are to former patients after treatment ends. The lead article provides guidance to assist psychologists in proactively addressing treatment endings so that they are planned for and carried out with each patient's best interests in mind. Recommendations are made for how to conceptualize this final phase of treatment as a period of consolidation of gains made in treatment and for preparing the patient to successfully move forward after treatment. Specific recommendations are made for avoiding abandonment of patients and how to engage in appropriate risk management strategies that best serve the interests of patients and psychologists alike. The expert commentaries that follow this lead article offer guidance on how to utilize principle-based ethics to assist psychologists in applying their professional judgment when making decisions about ending treatment, how to avoid nonrational processes in one's thinking and decision making (known as tripping points) to support more effective decision making, and how to apply relevant legal rulings and the role of licensing laws to better understand one's obligations to patients relevant to the ending of the treatment relationship. Public Significance Statement This article addresses clinical, ethical, and legal aspects of the ending of the psychotherapy relationship to include ways for psychologists to fulfill their obligations to patients through prevention efforts and when ending the professional relationship. Guidance is provided for avoiding abandonment of patients and the role of the professional will. Expert commentaries are provided to address questions raised and to offer recommendations for preparing for and engaging in the ending of treatment in the most effective manner possible.