31 Comments to
Client Dumping by Therapists

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  1. Parents often leave their children and hire BABYSITTERS. T’s go out of the country (where their cell phones don’t work) and have someone cover for them in emergencies. I was deeply attached to my T, but I didn’t complain when he took a vacation out of the country. He always gave me a couple of weeks notice and he always had a covering doc and he is, after all, entitled to a life and time off from my, and other patients’, incessant demands.

  2. If the therapist doesn’t recharge their own “batteries,” they will not be able to continue to care for their clients for very long.
    And it’s a life lesson for those of us in therapy. Nothing is permanent. Learn to deal with it. It’s also a GREAT opportunity to practice some of the life skills that the therapist has been, (hopefully), working on with the client.

    I’ve been seeing a therapist for a few months, and really was getting places with her. She told me a few weeks ago that she had to take leave for a month for a medical issue. It took me back for a few moments, but, the fact is, she needs to care for herself right now. Without that, she can’t help me. And she left a list of names and numbers in case of an emergency. That’s being responsible.

    For whatever reason, personal, medical, social, even religious reasons, therapists may have to take time for themselves. It is their right as human beings. And sometimes, it’s even their responsibility to us, as their clients. They too, need to heal themselves.

    Peace!

  3. This blog is not about responsible therapists it’s about ones who leave distressed clients in the lurch.

  4. And then, there are the tougher calls.

    Therapists who have long-term (say, more than thirty or forty or even fifty or a hundred and fifty meetings together) clients who are relocated or relocate for work or military purposes, maybe for as short a period of time as a year or two, and are unwilling to use the available technology like Skype or the telephone to maintain therapeutic contact. Instead, they opt to terminate, though the clients are willing to try Skype or the phone. Granted that it’s not the same as being in the office, but is 80% effectiveness with an established therapeutic alliance inferior to 100% effectiveness with a brand-new therapist, after the disruption of termination?

    I’ve heard of this from both sides of the equation, both the therapist who just doesn’t want to work electronically because s/he isn’t comfortable working that way, to therapists who work electronically all the time.

    Tougher call.

  5. As a response to TPG, Skype can be an option for therapists HOWEVER this is only appropriate if the client is moving within the same state. Therapists are only permitted to practice within the boundaries of their licenses, and licenses only allow therapists to provide treatment within the state where they are licensed. I work at a psych clinic where we provide services via Skype (for a research study), and we are only permitted to charge for Skype services to patients within Florida.

    I think you’re right on Sonia — many therapists would never leave their clients in the lurch like this, but there are some who do not consider the consequences of sudden vacations without appropriate notice. I am glad my T is very conscious and respectful of my needs and always gives me plenty of notice when she will be away.

  6. Therapists are entitled to take vacations without client contact. Imagine a T working with a full caseload without a break from that caseload, ever. Everyone needs to recharge sometimes. Dependency is one thing but it’s not the T’s obligation to be there personally all the time. As long as something is in place for the client, an alternate or something, the T has done their job.

  7. According to anecdotal evidence, most clients are fine with therapist holidays, but there is a very small percentage, usually those who suffer abandonment issues, who find the lack of contact utterly unbearable. These are the clients who cannot cope with long lengths of non-therapist-contact. I am talking about one or two from a client base of about forty who could end up suicidal or in a psychiatric hospital if they do not have that consistent, reliable support.

    These are people who have usually been with the therapist for many years and are dependent on them. The average client does not need or want this.

    A quick phone call, email, text message will hardly disrupt a vacation for anyone in any profession and this could be a literal lifesaver for the very few who need it.

    I would be interested to hear what an actual therapist has to say about this.

    Anyone out there?

  8. Therapists need vacations too. I don’t know how they do it, bouncing from one patient to another constantly listening to all those issues and trying to solve everybody’s problems with no time to even think about their own problems. They need a vacation, but they have no choice to stay in contact with certain clients, there is no way around it, they trust you and look up to you, there is no way around it. This article reminds me of a Seinfeld episode, where Elaine goes to Italy with the therapist of Crazy Joe Divola and he’s worried about Joe and goes out of his way to make sure Joe has his prescription renewed because he is worried about him. He called back home while on vacation for his patient. The same applies in this situation.

  9. I think therapists need more of a break from clients who may have more intensive needs, for example, those who have abandonment issues. Even a mother needs time away from her children. (My mother had no break until her children started school, pushed me into school at age 4, when I was not socially ready.) Part of the reason I turned out with attachment issues is because my mother never had a break. Her having children with no support was way too much for her to cope with.

    (Picturing therapists on vacation, with a sense of imaginary ‘children’ latched on to them as they try to move about…)

    I was once abruptly and cruelly terminated by a therapist for whom I had intense attachment feelings for. Yeah, it hurt (gut-wrenching) and I still think he handled it poorly. However, I learned alot from that experience, and I wouldn’t have found my present, very genuine, therapist if not for that awful situation.

    Maybe the discussions and insights that follow the temporary absence will prove useful and productive? I mean its not realistic to be shielded and protected by the ideal for the rest of our lives, no matter what or who that ideal may be.

    Try to think of it in terms of the airline safety briefing before a flight…where in the event the cabin loses pressure, you must place the oxygen mask on yourself before giving your children oxygen. The flight attendants can’t assist other passengers unless they first give themselves air to breathe.

  10. Wow this just sounds like a plain obsession with ones therapist. I hadn’t seen my therapist in nearly three weeks due to christmas and new years day falling on our scheduled day…I certainly didn’t expect her interrupt her time with her children (they had winter break) to talk to me…even if it were only for a few minutes. When I am on vacation from my job I want to leave it all behind and not even have my job cross my mind when I am on vacation. If I were a therapist I wouldn’t want to have to deal with needy, clingy clients when I am supposed to be resting and relaxing. What if a client reveals something traumatic or threatens to take his or her life/take the life of someone else? (keyword threaten…some may manipulate the therapist this way as a way to make them feel guilty for taking the vacation). How are they supposed to relax know crap is hitting the fan back home?

    I don’t know I guess what I am trying to say is if someone has such a severe dependancy on their therapist that they are going to have a tantrum whenever the therapist wants to take a few days vacation (and they are more entitled to do such, and they don’t have to justify themselves to anyone) then I think it’s time to find a different therapist. It sounds as if they are doing more harm than good. What is going to happen when termination becomes an option? staying in therapy forever isn’t an option and if you are with your therapist for more than ten years at a time it’s obvious they aren’t helping much at all.

    Sorry if this fell a few yards short of making sense…it’s late and I am tired.

  11. I am a master’s level therapist and a client myself.

    I do believe therapists have a responsibility to their clients when they leave. Where I work, we have back up therapists for the purpose when the therapist is on some sort of leave.

    As a *client* I understand the thought of “a few mintues out a day, that should be managable”.

    As a therapist, I realize that I am not “on my game” when I am out of my office and in vacation mode. I don’t have proper resources in front of me in case I did need immediate assistance for my client. I also do not have privacy, in terms of my child running in and out of the room screaming “Mom, mom come on!” Especially if I am trying to have some privacy calling from the bathroom with my little one yelling for me.

    A client in distress deserves undivided, professionally focused attention, and that is NOT me while on vacation.

    If I agree to text/email contact, and then I am out of range, or have no connection, or flat don’t get the chance to check my email, that creates higher fears of abandonment and anxiety.

    I am much more rested when I get a true vacation away from my job and crisis. And they in turn will get much better care upon my return.

    Before I leave I make sure a plan is developed about who they may contact and what to do in an emergency situations.

  12. I would love to how many therapists have honestly manipulated the truth at the expense of the client?
    How many have denied access to a client with no history of violence or crime purely because you might have misreported the truth?

    How many of you have made mistakes but blamed the client for fear of a licensing board complaint?

    How many have no problem behaving unethically knowing your behavior has been catastrophic for the very client you tried to help?

    And how is countertransference not handled appropriately?

    Thank you

  13. I meant to say how many have denied access to a client’s file because you are hiding something that could hurt you if the board investigates?

    How do you justify breaking your code of ethics?

    After my therapist misreported and got a restraining order her friend (who introduced us ) told me” So what? It’s only a restraining order? ” But for someone who is fragile and was betrayed by the very person that went above and beyond to help it is traumatizing.
    But her comment made me think that she rationalized it by saying “my career and licensce versus a client restraining order, she’s not losing anything but i could” But I lost a lot too. I lost my ability to believe in the profession, to believe that i am lovable to believe her sincerity……

    Those are my thoughts

  14. Sonia, most of your posts are well thought out and balanced. This one, however, reeks of unresolved transference. It is clear that you have some issues with your therapist, past or present, perhaps, that need to be worked through. It kind of amazes me that you don’t see it. Show your doctor — she will see it in a second!!

  15. Abby,
    No kidding! I got dumped abruptly by her and did not get a chance to work through my tranference nor understood her countertransferance.
    Are you a therapist? Do you have any idea what it feels like to have been manipulated by a therapist for her own self interest?

  16. I’m studying psychology and expect to become a therapist once I graduate. This isn’t something I had previously thought about, so thanks!

  17. Unless we expect to be available to answer the phone and email all through our vacations, I don’t see how we can expect therapists to do the same throughout their vacations. It’s an unreasonable expectation, it’s not fair to the therapist, and it will lead the therapist to become burnt out (and possibly make them very tired of the client they have to call frequently while on vacation). Not to mention the problem with the idea of a 3 minute phone call – it’s only going to be a 3 minute call if the client is doing well. If they’re not doing well, it’s liable to turn into a long phone session during what is supposed to be a break from seeing clients.

    It’s just not a good idea. If a therapist can find a substitute therapist a client can call if they need to talk while the original therapist is away, that might be a good solution to the problem.

  18. New to this forum. As a former client, i see a huge difference between a therapist taking personal time and “dumping [the] client unceremoniously”.

    I think it is reasonable to expect clients to understand that therapists are human and can’t be available all the time. I’ve had no problem respecting that, but i may not be a particularly needy client (and therefore not the subject of this post). For clients who do require more reassurance, it does seem appropriate for the therapist to lay out a backup plan in advance, and just in general — you never know when some unexpected personal emergency might come up.

    I’ve also had a therapist say to me, when i was suicidal and in denial, “This is driving me crazy; i can’t work with you anymore.” To me, that’s in a separate category altogether. It felt like a rejection, and since i never saw the therapist again (landed myself in hospital and was then moved out of state), i’m not sure i’m entirely over it, though i try my best to understand and forgive. (I’m not exactly glad to hear that others have experienced this, but i am glad i’m not the only one… if that makes sense!)

  19. After reading the post and comments, I am even more grateful to my therapist for his sensitive handling of his vacations, sick days, etc. Because of my dissociative disorder, I am very emotionally attached to him. He lets me know well in advance when he is going to go away. We talk about the ways I am going to take care of myself and he expresses confidence in me that even though I will miss him, I will be ok. If the absence is for a longer period of time, he will make a tape for me to listen to when I am very stressed. I, in turn, respect his privacy and wouldn’t dream of expecting him to have any real communication during his vacations,etc.
    I can’t imagine what it would be like to have a therapist (that I was attached to) suddenly leave town or dismiss me as a client without warning. ouch!

  20. This reminds me of what happened when my therapist went on vacation at a bad time for me. I was having a lot of serious issues, so she set my up with another therapist during that week. (I was seeing her 2 or 3 times a week). She also said I could call her cell phone for any reason while she was on vacation (not too far away). Anyway, sure enough during the week I seriously deteriorated. After much trepidation and guilt I called her cell phone twice and left messages. She never got back to me. (Apparently I didn’t make it clear I wanted her to call me back) Also the therapist she set me up with turned out to be a bad match and the session with this other therapist just made things worse for me.

    The session after she came back, I told her what had happened and she felt really really bad. She looked pretty anxious and genuinely upset. This was a therapeutic rupture that took awhile to repair.

    Even though my therapist does allow me to call, in fact has encouraged it, I find it very hard to call her because I feel so guilty and the waiting for her to call me back is really hard. A couple of times she had called me “just to check in,” and that has definitely made a real difference. Its so hard for some clients to call the therapist because we don’t want to annoy them or interfere with their home lives.

    On the other hand, sometimes a therapist needs to say “absolutely no contact” because the client is pretty stable and they want the client to learn to deal with their own problems and not to rely on the therapist as much. Also, the therapist could have to deal with a family crisis or health problem or need to completely “recharge” and can’t deal with their clients right now.

    Also, are therapists allowed to have phone sessions with out of state clients? Is that really not allowed? And if it isn’t, is it actually enforced? I have called my therapist and had phone sessions out of state and she has never mentioned this before. I know I have to pay out of pocket, but I didn’t think it was against the law.

  21. I recently heard from a friend the most dishonest, unethical therapist ever is teaching at University. That is a shame. The woman is a loose canon and it has enlightened me to the power this profession has to truly cause harm to clients.

  22. Just like people who are not therapists and get burnt out on the job, so do therapists desrve the same right to be away from the work place, so that they can rest and take care of themselves.
    I don’t think it is fair to expect a therapist to call a patient, if the therapist is on vactaion. It’s better for you “the patient” when the therapist, takes a break and goes away. you the client, will have a therapist who took care of her or himself,so that they can better assist you.in the meant time you, “the client” should be taking care of yourself.Good luck and best wishes to all humans.

  23. Imagine being notified that your therapist is on leave for about two and a half months via email, with no reason given and no back-up therapist offered.

  24. I suffer from therapist dumping in a different way not during his vacation but even if he’s not, plus I’m a kind of pt who really cant bear abundant especially in crises times when experience sucidallity and lose control and ended up for me to recurrent overdose.

    As from beginning of treatment my therapist knows my specific problem and him self offered to give me his mobile number and can call him in crises time and this agreement was discussed and but all boundaries and condition when and why to contact him .many times I’m calling him not respond or answered and told me to call him later ,

    What I mean he is promising some thing and doing different ,plus last time I was really in crises and he saw me in clinic and seem worry about me he request me to call daily afternoon to ease my tension and all bad emotion through talk even he advice me to write an email for him ( by the way my therapist living in another country but I can reach him within 2 hrs in clinic ), so, I called many times and send massages he didn’t respond and what happened that he didn’t have proper manage in my case as he ignore my cry for help and post pond my appointment and cancelled another one just because he is busy with other pt but what about me which really effected me and ended me in emergency room after massive overdose

    At the end I’m not plamming my therapist for what happened to me but he is some how responsible as he didn’t be on his promise and he knows my condition and my need well, so, really no excuse for him for his behaviour

    (BPD sufferer )

  25. please sonia i need your comment on my condition with my therapist and adviced regarding changing him as now i’m 3 yrs with him ,and really uncomfortable with him at the same time its hard for me to start with new one and remember all the pain and difficult emotion and tell all details again

  26. I find it harmful that therapists reinforce a parent-child relationship to begin with. Many clients walk in the office as self-reliant adults and in time revert to dependent, anxious creatures who treat therapy like a fix they need. I don’t consider this healing.

  27. I was in crisis this week. I have contacted my therapist in the past but usually over everyday things.
    This week I was in crisis, I contacted them. No reply. After 18 hours I sent another text to check they had received it and they answered they had not yet read it as were busy with stress. I felt for them, was their family ill. A bit later I received another text to say there stress was good so not to worry.

    I was devastated, I had been in a bad place, had asked for help for the first time and was met with silence/no response and then that.

    I feel like sacking him for it, takes my money but when I needed him emotionally he was busy, why give me his number if he is not even going to acknowledge my desparate text.

  28. My therapist emailed me on a Satuarday to say that she was leaving for two weeks, but she would be checking her email.

    When I complained via email, about the short notice she did not answer me for two full weeks, and when she did answer me she lied about having a family emergency.

    I know this is a lie, because about a month ago she mentioned she had a trip (to the sameplace) coming up sometime in the future. Also it could not have been an emergency as half of her party was planning on driving all the way across the country to get to their destination, rather than flying! I also know that she got back 4 days ago, because her email said that is when she would be back then.

    This is the second time she has done this!

  29. Also there was no back up counselor set up.. just a sudden email saying she was leaving, followed by two weeks of silence and then another sudden email claiming it was an emergency trip and asking me to see her in two hours. And she forgot to schedule an appointment for me the week before she left.

    Another time she was counting down on Facebook the days until her vacation for about 6 weeks in advance so, I knew she was leaving but she did not know that I knew. I kept wondering when she was going to tell me or if the trip was just a weekend trip and there was no need for her to tell me. Then day of her trip (a week long trip it turns out) she emailed and asked me to see her that day! Remember she had been counting down the days til this trip on Face book for the last six weeks, but she thought it was OK to tell me the day of the trip and reschedule me for that morning. She did not know I could see her Facebook.

    She put up a sign in her office saying that some group that she was supposed to run was cancelled due to illness.. another lie.. it was cancelled due to her flying to Jamaica!

    This is so frustrating because she is a good therapist when she does not have a migrain and when she actually keeps her appointments..

  30. My psychologist of 8 years recently had to have heart surgery. When she first said she would be out about 8 weeks, my first response was what will happen to me… then I thought again, what would happen to her if she didn’t take the time for the surgery and recovery. That brought me back to the correct issue, her health. She said her partner could see me if I needed but because I had never talked with her, I didn’t want to see her and start a new therapeutic relationship for only a few weeks. Instead, my case manager saw me on the days that I would have seen my psychologist until she was able to return. After eight weeks, she is back, healthy and ready to be a therapist again. Even though I had some depression while she gone, and a crisis (my sister was diagnosed with cancer) she was entitled to meet her own needs.

  31. My therapist died so I don’t expect any phone or text messages soon. Think about that, therapists die too so let them have a vacation. it is good for them and will help you deal when they kick it.

  32. My therapist is from France and vacations there yearly. At first I was kind of freaked but now after 5 years I don’t have such problems with abandonment so for me the vacationing therapist has been a good thing. She even calls me from France for a minute or two each year which really makes me feel like a special client.

  33. As a psychologist, I would like to chime in on this topic. A client who assumes that a therapist is not allowed to have personal time away from work (including electronic contact)needs to remember that we are human and have to clock out and take vacations too. I believe that non-DBT therapists who allow clients an all access pass are not only enabling unhealthy, dependent, and insecure attachment patterns- but not allowing the client to learn self soothing skills and learning to cope without them. It is also extremely unhealthy for the therapist’s wellbeing not to have boundaries and limitations in place in regard to client contact. Emergency contacts should be in place when the therapist is not available. I tell my clients that in the case of actual life threatening crises, the person needs to call 911 and the place to go is to the ER. All other matters can wait until the next appointment as distressing as they may feel in the moment, but this is called coping and what I strive to eventually have my clients internalize.

    • I have to disagree with you as does Marsha Linehan who states: One cannot do therapy with a dead client.

 

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