As an owner of a small practice, I have had many therapists come and go over the years. We are in a small community and often have individuals work with us to get licensed so they can later move on to greener pastures closer to a metropolitan area. As such, transferring with a caseload has not been an issue, but it has given experience in having individuals leave a practice. Each time almost all the clients were able to transfer to the new therapist smoothly. In fact, many performed better with the new therapist. This could be because the new perspective helped further growth. Although I have seen patients that had difficulties transitioning, it has been no more than 1 to 3 clients for a single provider at most. A good case could be made for transferring with a few clients to a new practice, but not an entire caseload.

I also disagree with this advice…I was shocked to see #1. It’s not about the business, it’s always about what clients want. As clinicians we build relationships with these people, they are not part of a sales/numbers system on whoever brought in the clients gets to keep them mindset. I really hope this part of the article gets taken down…

Truly, thank you for sharing your thoughts here. They are very useful in understanding and empathizing with the business owner’s perspective. This is certainly a layered ethical situation, both from a clinical and business perspective. Similar to the psychologists/clinicians who also commented here, I will always put my clients first, ethically. Including before business. Therefore I would not tell the clients that they were required to transfer to another provider. From my perspective, that would be unethical.

However, I really did appreciate the other possibilities suggested: (1) reimburse the agency, and (2) slowly wean down. May I ask, when the counsellor you spoke of above was weaning down, was it okay with you/her to take her off your website during that time? So when she was googled, her private practice would come up, instead of your practice? I am trying to take a business owner’s perspective on this.

Any response would be much appreciated.

Thanks again for sharing your thoughts.

I absolutely disagree with this advice, as well. Ethical psychotherapy practice is ALWAYS about respect for client autonomy / their right to make their own decisions. This advice puts the income of a business owner over the rights and well-being of the clients served by the therapists of that business, and the well-being of their clients should always be a Therapist’s highest priority!!!!

Sorry that we disgusted you, Susan!

Very much agree.
Thriveworks, I appreciate your writings but I was disturbed by this piece as well as it seems to focus exclusively on the well-being of a business. I see nothing in here about clients and their well-being. This is obviously a business-based article. Counseling should not include “so much business” perspective that everything else gets lost.

I have clients who want to come with me and I would not be an ethical therapist if I said “no, you can’t come with me, stay where you are.” A lot of my clients have children with behavioral problems or suicidal ideations and we have built a relationship. If I say “no, you can’t come with me” wouldn’t I be violating the American Counseling Associations ethics on client-therapist relationship?

I feel that as long as the clinician doesn’t solicit client’s that it should not be an issue, and as an agency that provides quality care, the agency should understand the importance of the therapeutic relationship between client and counselor.