It is the member’s professional obligation to ensure that s/he acts in the best interests of clients at all times, including when discontinuing services. Once a member begins working with a client, the relationship should continue as long as the client is benefiting from therapy and/or wishes to continue receiving services. Members should not unilaterally discontinue services to clients without good reason. There are several legitimate reasons for discontinuing services to clients, including:
- the member lacks the necessary competence to continue working with a client;
- the member believes the client will not benefit from continued therapy;
- the member would be at risk of serious harm if s/he were to continue working with the client, e.g. the client threatens or assaults the member;
- the member is closing his/her practice;
- when by prior agreement a fixed number of sessions is to be provided; and
- when the client has not met his/her obligation to pay fees as agreed (see Standard 6.1, Fees).
In all cases, the member makes reasonable efforts to inform the client of the reason for discontinuing services, and refers the client to another service provider, as appropriate. The member also documents the reason for discontinuing services.
Discrimination and the duty to accommodate
Members shall not decline to provide services, or discontinue services for personal reasons if, for example, the therapist does not like a client, or does not agree with the client’s political views. These are not acceptable grounds to discontinue therapy. Ontario’s Human Rights Code also prohibits the denial of services on the grounds of race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, gender identity, gender expression, age, marital status, family status or disability.
Members must not refuse to work with a client or discontinue therapy because of a client’s disability. The Human Rights Code requires that persons with disabilities be accommodated, unless this would cause undue hardship for the therapist. Members are required to make reasonable efforts to accommodate the needs of persons with disabilities. A decision to end therapy should always be made in good faith. For example, a therapist must not tell a client that s/he is ending the therapeutic relationship because the therapist lacks the competence to work with the client, when the real reason lies elsewhere. To avoid confusion and concerns about discrimination, the therapist should always clearly communicate the reasons for ending the therapeutic relationship, and document the discussion in the client’s file.
The Standard: Discontinuing Services
A member discontinues professional services only when doing so would be reasonably regarded as
appropriate, having regard to:
- the member’s reasons for discontinuing services;
- the condition of the client;
- the availability of alternate services; and
- the opportunity given to the client to make alternate arrangements before services are discontinued.
Demonstrating the Standard
A member demonstrates compliance with the standard by, for example:
- discontinuing services only when the decision to do so is made in good faith;
- clearly communicating to the client the reason for discontinuing services and referring the client to other
services if needed;
- recording the reasons for discontinuing services;
- not discontinuing services on a discriminatory basis.
Note: College publications containing practice standards, guidelines or directives should be considered by all members in the care of their clients and in the practice of the profession. College publications are developed in consultation with the profession and describe current professional expectations. It is important to note that these College publications may be used by the College or other bodies in determining whether appropriate standards of practice and professional responsibilities have been maintained.