When and How to Fire a Client

Tuesday, May 23, 2023, 09:25 AM

Practitioners should never disregard their own safety when working with clients. This means taking steps to ensure that your physical and emotional well-being are protected during interactions with clients.

Terminating a client can be a difficult decision that should be made with careful consideration and consultation with colleagues, supervisors, or professional guidelines.

NHPC members have the right to terminate a client if the client's behaviour is inappropriate or threatening or if the client refuses to comply with the clinic's stated policies.

A practitioner holding up their hand to stop

Setting Boundaries and Expectations

Establishing clear boundaries with clients is important for maintaining a healthy and productive therapeutic relationship.

Boundaries provide structure and guidelines for the treatment process, and they help both the client and practitioner engage safely and respectfully.

Here are some examples of setting boundaries and expectations in the treatment room.

Review Professional Guidelines

Familiarize yourself with the guidelines, clinic policies, and ethical standards set by your workplace and your professional association. This will help you manage your clinic and let clients know what to expect when they come to see you.

Here are some suggestions to consider including in your clinic policy document:

your client service philosophy
late arrival/cancellation/no-show/sickness policies
health history/informed consent
massage for minors policy
scope of practice
payment/receipts/third-party payments/direct billing/gift certificates
respect for client needs and boundaries
professional boundaries and consequences for crossing professional boundaries
how abusive behaviours, including sexual harassment, will not be tolerated and will result in client dismissal (termination)
privacy/confidentiality/release of records

Establish Treatment Goals

Establish clear treatment goals to ensure that you and the client are working towards a common goal. It also helps avoid any misunderstandings that may lead to termination.

Document the Treatment Process

Keep detailed notes and records of the treatment plan and process, including any incidents or concerns related to the client's behaviour and progress.

You should consistently maintain the same set of standards with all clients throughout the course of treatment.

Identifying Inappropriate Behaviours

If a client exhibits inappropriate behaviour, you should address it immediately and take appropriate steps to ensure that the behaviour does not continue.

Inappropriate behaviour can take many forms, and it can be subjective, depending on the context and the relationship between the individuals involved. However, there are some general behaviours that are inappropriate in a client-therapist relationship:

Sexual Behaviour

Any behaviour that involves sexual contact or advances, comments, or suggestions that are of a sexual nature should be addressed immediately. Incidents of sexual assault should be reported to the police.

There should be zero tolerance for sexual harassment, and clients need to know up front that sessions will be terminated if it occurs.

An example of a disclaimer for sexually inappropriate behaviour could be:

Massage sessions are strictly non-sexual. Any suggestive statements, inappropriate jokes, innuendos, or actions will result in immediate termination of the session wherein the client pays the full cost of the session. Law enforcement will be notified if deemed appropriate.

Rehearse with your colleagues, supervisors, or professional association how to terminate treatment sessions when a client is sexually inappropriate.

Practice different scripts and scenarios so you are better prepared if the incidents happen and you avoid second-guessing yourself.

Personal Disclosures

You should be cautious about sharing personal information about yourself with clients, as it can create an unbalanced dynamic in the relationship.

Similarly, you should not ask clients for personal information that is not relevant to the treatment process. If a client is sharing more than necessary, revert the conversation back to what's appropriate.

Discriminatory Behaviour

Your client policy document could include a statement that your clinic is an inclusive environment that welcomes and values diversity, and derogatory remarks or racist slurs will not be tolerated.

If a client behaves inappropriately involving race, gender, sexual orientation, or any other characteristics, including derogatory comments or using offensive language, stop the session and instruct them to leave.

Punctuality

If a client is repeatedly late or fails to show up to an appointment without a valid reason, despite previous discussions or reminders, you may need to consider termination.

Consistently missing or arriving late to appointments can disrupt or hinder progress toward treatment goals, may indicate a lack of commitment to the process, and can also impact other clients, as it may delay other appointments.

Terminating A Client-Therapist Relationship

If you decide that termination is necessary, take appropriate steps to ensure that the process is conducted in a safe and ethical manner. This may include the following steps.

Notify the Client of the Decision to Terminate

You may notify the client of termination in a letter. You could state that you feel they would benefit from seeing a different therapist going forward or let them know that you may not be a good fit for them.

Keep the tone of the letter neutral and professional. For example:

I have appreciated your business in the past, but I no longer think that I can serve your massage therapy needs because of (insert the issue in a neutral way). I believe you would benefit from another massage therapist, so I suggest trying (insert suggestions here). They may be better suited in meeting your needs.

Provide Referrals to Other Resources

You do not need to provide a referral to clients who have been abusive or sexually inappropriate. You could direct the client to contact the local Chamber of Commerce or other business directories for a referral.

Develop a Plan for Ending Treatment

Determine the timeline for termination; discuss any outstanding issues, concerns, or fees; and provide the client with guidance on how they can transition out of your care.

Document the Termination Process

Document the termination process, including the reasons for termination and any actions taken to ensure safety.

It's important to remember that you are not alone in this process. You can turn to your manager, colleagues, or professional association for support and guidance.

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