Leaving a Mental Health Position
The new year is upon us and some of you may be considering another position. The new job seems more challenging, the pay is better, and overall it seems just right. Only one problem- how do you leave your students in the middle of the year? Despite what is compelling you to move on, aren’t you abandoning your students? Is it even ethical for you to leave?
At the outset, it must be stated that mental health therapists have no moral obligation to remain in a job and serve students if their current remuneration is inadequate. They can leave their job and terminate their relationships with their students if they so desire. However, termination ethics is a gray area, especially when that termination may cause an interruption of services between therapists.
What must be kept in mind is that the counseling relationship is different from other jobs in critical ways. Building trust in the therapeutic relationship requires time and the student’s vulnerability. So it follows that ending that relationship demands certain sensitivities and protocols to protect the student.
Difference between Termination and Abandonment
Termination is the process of ending services with a student. Distinguishing abandonment from termination is essential to understanding what is ethically responsible in this frequent inevitability of mental health care.
It is mistaken to think that terminating a student against the student’s wishes, such as when changing employment, automatically constitutes abandonment. Termination is not synonymous with abandonment. It is only when the termination is inappropriate that it is considered abandonment.
Abandonment is when the therapist leaves students without services and assistance. The 2014 ACA (American Counseling Association) Code of Ethics states, “Counselors (must) assist in making appropriate arrangements for the continuation of treatment, when necessary, during interruptions such as vacations, illness, and following termination.”
Therefore, to avoid abandoning or neglecting students, counselors and organizations need to provide for the continuation of treatment that is appropriate to a student’s needs when the original provider will no longer continue.
When a therapist is terminated and prevented from making arrangements for ending treatment with students, including a proper referral, then it is mistaken to accuse this counselor of abandonment. On the other hand, if a therapist accepts another job, leaves without adequate notice, and doesn’t provide for the continuation of services for students, this would fit the definition of abandonment.
The Ethical Way to Terminate
What is the ethical way to terminate so that it isn’t considered abandonment?
The Ethics Code requires that the mental health therapist terminates in a clinically sound manner, minimizing the likelihood of harm. A primary issue regarding improper termination is the failure to complete all of the required student documentation, including case notes, mandated reports, informed consents, and releases of information.
When a therapist leaves a position without completing their required student documentation, it will very likely compromise the student’s continuity of care. How could the next therapist know what has worked and what has not worked with this student?
For example, the student may have shared sensitive information with a therapist that was key in directing the therapy. Since it may take a while for the student to trust the new therapist enough to repeat that information, lacking documentation, the therapeutic relationship, and the student’s progress could be stymied. The key is to recognize that the student’s needs are paramount.
Irrespective of the reason for termination, mental health professionals must ensure that the school has ample notice of the impending end of a therapeutic relationship and is provided with options for continuing treatment. These options might include a referral to another agency or transitioning to a professional in the same agency or practice.
Appropriate termination ensures that students who may have significant issues are not harmed by an interruption of service. Values of professionalism would suggest that all student’s notes and any other required paperwork that will help to facilitate student care be completed with proper care. This may include alerting collaborating professionals of the change to ensure a smooth transition.
For example, if serving the student requires collaborating with a psychiatrist, the psychiatrist must be informed that you will no longer be working with the student. This helps the psychiatrist to adjust the student’s treatment if necessary, perhaps changing the frequency of appointments until the student has adjusted to the new therapist.
This would apply to school personnel as well. Perhaps, when the student’s behavior got out of hand, the school reached out to you for assistance. It would be important for the school to be informed of your departure so that necessary adjustments could be made.
Terminating a job and a professional relationship is never simple. And it is even more challenging for mental health therapists who have unique obligations, based on laws and codes of ethics, to ensure that the needs of their students are met when the therapist will no longer be working with them, irrespective of the reason.
Following the aforementioned guidelines will help to ensure that mental health therapists meet their professional obligations while remaining sensitive to the needs of their students.