Terminated by therapist and unsure if I should send a formal complaint?

[Sapphire Phoenix]

Hey, all! Have been in trauma-focused therapy since earlier this year. Diagnosed BPD, MDD, but relate most to CPTSD (although can not receive a diagnosis here in the States). I also believe I may be neurodivergent, and was only diagnosed with BPD following an in-patient stay where it was slapped on my medical notes without me being told).

My therapist and I had great rapport and he saw me through multiple crises this year. He brought up the possibility of needing to refer me out, but assured me he would not drop me suddenly and that I could potentially still see him while finding someone that had a better skillset. I had no issue with this as I realized it would be ethical if he didn't think he had the right skills anymore, and I trusted he would help me make any transitions to more adequate care.

A week later, he made it a point that I needed to physically write a safety plan and commit to it, reminding me this was a boundary necessary for therapy to continue. He said I had a few days to think it over, and I agreed to draft up a safety plan and truly work on it. However, hours before our next scheduled session, he called me over the phone to terminate services. He later documented this was a mistake to do so over the phone. I told him I had a safety plan ready for that day's appointment and was ready to take therapy seriously (I had only been out of the hospital for a few weeks due to an attempt, and was struggling day-to-day with functioning but showing up each session at least). He said he wasn't confident I could keep myself safe, and that he suggested a higher level of care. However, he did not help me try to get into IOP, we never discussed details about options, and his official referral was to a community drop-in clinic that provides no higher level of care.

It's months later and although I've found a new therapist who I've been able to discuss this with in a judgment-free zone, I am still experiencing extreme mental distress and dissociation, more than I ever have in my life. I've sat on this for awhile about the pros and cons of a board complaint about my previous therapist. I'm not looking for revenge or retaliation and I know it will likely get dismissed. I know a therapist doesn't "owe" their client anything, and they can terminate for any reason even if we may not see it as professional or ethical. The therapist holds such a position of power. But it is not like I was ever harassing or threatening my therapist, never stayed longer in session or refused to leave, never violated personal contact boundaries, etc. The official reason for my termination was my "conflict of interest" for no longer having the same therapy goals and engaging in self-destructive behavior.

My complaint I drafted states: "Due to an abrupt termination without continuity of care, I experienced severe mental distress as well as a significant increase in dissociative symptoms resulting in loss of time, memory, and executive function. I was abandoned during a time of crisis when care was still necessary, without receiving notice or being given the opportunity, in a reasonable period of time, to procure services from another mental health professional. My ongoing treatment needs were not appropriately defined or arranged in advance."

Any advice on if you think this is valid to make a complaint about? I might show my new therapist the letter I have, it was cathartic to write and this is not something I take lightly. Any insight is much appreciated!

 

[Sideways]

Speaking from personal experience, active suicidal and parasuicidal behaviour, or serious self-harm, changes things dramatically with Ts, especially of they’re already working close to what they consider their professional limits.

Worst one I had was a T that I’d been seeing 3 days a week terminated our relationship by getting his boss to call me. Ouch! Essentially he wasn’t coping, so I let it go. There was obviously a significant level of distress for him that he’d been carrying because of the persistent and imminent threat of me suiciding, and at a personal level, I could understand that he needed to step back.

I told him I had a safety plan ready for that day's appointment and was ready to take therapy seriously

The second part of this statement is likely the key issue here. In your mind, that should have made things fine. But if he considered that you hadn’t been meaningfully engaging with his treatment, and that you continued to be at risk of danger, then he made right call.

Unfortunately, it doesn’t matter that in your mind, this may have been a genuine statement. He’d already made that call, and my personal experience of Ts terminating is that once they’ve made that call for their own reasons, there’s no amount of “I’m ready now” that will change the situation.

Are there other trauma-focused providers in your area you can reach out to? If not, I find that my GP is always a good launching pad for where to start looking.

 

[whiteraven]

hours before our next scheduled session, he called me over the phone to terminate services. He later documented this was a mistake to do so over the phone. I told him I had a safety plan ready for that day's appointment and was ready to take therapy seriously (I had only been out of the hospital for a few weeks due to an attempt, and was struggling day-to-day with functioning but showing up each session at least). He said he wasn't confident I could keep myself safe, and that he suggested a higher level of care. However, he did not help me try to get into IOP, we never discussed details about options, and his official referral was to a community drop-in clinic that provides no higher level of care.

I had a similar experience, except my psychiatrist gave the reason that I apparently was having trouble paying the bill (he charged $300/hour, and my balance due was $58.58), and he didn't even call me. He sent me a *certified and registered* letter. I was not in good shape when I last saw him, and this made it 1000% worse.

My complaint I drafted states: "Due to an abrupt termination without continuity of care, I experienced severe mental distress as well as a significant increase in dissociative symptoms resulting in loss of time, memory, and executive function. I was abandoned during a time of crisis when care was still necessary, without receiving notice or being given the opportunity, in a reasonable period of time, to procure services from another mental health professional. My ongoing treatment needs were not appropriately defined or arranged in advance."

I reported my psychiatrist to the Board of the psychiatric center where he was medical director, and my complaint was much, much longer. He was gone from that position and center (which is the largest in our area) in two months.

It helped me to send a complaint, even though I got no response. I still think about it sometimes, but all the reactionary stuff after I got the letter went away soon after I sent my complaint. Somebody needed to hear how badly his way of terminating affected me.

Your complaint sounds reasonable to me.

 

[Sapphire Phoenix]

Speaking from personal experience, active suicidal and parasuicidal behaviour, or serious self-harm, changes things dramatically with Ts, especially of they’re already working close to what they consider their professional limits.

Worst one I had was a T that I’d been seeing 3 days a week terminated our relationship by getting his boss to call me. Ouch! Essentially he wasn’t coping, so I let it go. There was obviously a significant level of distress for him that he’d been carrying because of the persistent and imminent threat of me suiciding, and at a personal level, I could understand that he needed to step back.


The second part of this statement is likely the key issue here. In your mind, that should have made things fine. But if he considered that you hadn’t been meaningfully engaging with his treatment, and that you continued to be at risk of danger, then he made right call.

Unfortunately, it doesn’t matter that in your mind, this may have been a genuine statement. He’d already made that call, and my personal experience of Ts terminating is that once they’ve made that call for their own reasons, there’s no amount of “I’m ready now” that will change the situation.

Are there other trauma-focused providers in your area you can reach out to? If not, I find that my GP is always a good launching pad for where to start looking.

True, very good points here, thank you. And I'm so sorry you experienced that with your T.

I logically know if he didn't think I was going to take my own safety seriously, and prior history showed that I was a danger, then he has every right to terminate. Especially if he felt like he did all he could yet I was not getting better or being able to self-regulate, well then that's a problem... and I honestly think he didn't want to see me keep hurting myself (even though I was in a long depressive state and kind of retraumatized from the hospital, etc).

Many thanks! I was able to get in with an intern right after this termination who specializes in trauma, is trained in EMDR and does somatic work. She is communicating now with a psychologist I got in to see for DBT work, so we'll see. Right now it's kind of finding the right modality, and making sure my nervous system isn't overwhelmed. I think two clinicians may be a lot, so we're trying to form a treatment plan for me.

I had a similar experience, except my psychiatrist gave the reason that I apparently was having trouble paying the bill (he charged $300/hour, and my balance due was $58.58), and he didn't even call me. He sent me a *certified and registered* letter. I was not in good shape when I last saw him, and this made it 1000% worse.

I reported my psychiatrist to the Board of the psychiatric center where he was medical director, and my complaint was much, much longer. He was gone from that position and center (which is the largest in our area) in two months.

It helped me to send a complaint, even though I got no response. I still think about it sometimes, but all the reactionary stuff after I got the letter went away soon after I sent my complaint. Somebody needed to hear how badly his way of terminating affected me.

Your complaint sounds reasonable to me.

Hey, thanks so much for replying. That sounds like such a horrible situation and to not even call just for that amount? I can't imagine having to deal with that kind of stuff on top of everything else. I'm glad it helped you to send the complaint and that it was heard, it sounds like.

Appreciate your support.

 

[Sideways]

She is communicating now with a psychologist I got in to see for DBT work, so we'll see. Right now it's kind of finding the right modality, and making sure my nervous system isn't overwhelmed.

Yep, for sure. You’ll potentially find DBT incredibly frustrating, and know in advance that it doesn’t solve any of your trauma issues!

It’s one of those therapies that I’m really grateful I stuck with though. In hindsight, the skills I got from it definitely made the rest of my therapy treatment survivable. The reality is I wouldn’t have survived it without those skills on board.