Why It Matters to End Therapy Well

In recent weeks, the closures of several Ramsay Health clinics have left many clients suddenly without their treating psychologist. For some, this has meant abrupt endings to therapy, sometimes with little notice, no transition plan, and no clear path forward.

While I of course understand that organisational and financial realities can force these difficult changes, these events have highlighted an uncomfortable truth: the way therapy ends is just as important as how it begins and yet, we don’t seem to spend as much time thinking about the endings as we do the beginnings.

The Emotional Weight of Endings

For many clients, the therapeutic relationship is an important and secure attachment model and the therapy room can sometimes feel like the only place they have felt truly seen and understood. When that relationship ends, particularly without preparation, it can trigger deep feelings of grief, anger, and abandonment, potentially re-opening old attachment wounds.

From an attachment theory perspective, an unplanned ending can reawaken earlier experiences of loss, rejection, or instability. Psychodynamically, it risks replaying unresolved relational wounds rather than offering the opportunity to work through them.

When psychologists have the choice and capacity to plan an ending, the process should be deliberate and collaborative:

• Prepare early: ideally weeks or even months in advance for long-term work.
• Acknowledge and normalise emotions (for the client and the therapist): sadness, frustration, relief, gratitude, all have a place in the room.
• Review and celebrate progress: reflect on goals achieved and skills gained.
• Offer choice where possible: invite clients into the planning process.

The Therapist’s Side of the Story

It’s worth remembering that therapists feel endings too. We can experience loss, pride, guilt, or even relief. Long-term therapeutic relationships carry meaning for us too and closing them well takes emotional energy. That’s why supervision and collegial support are essential, not just for clinical oversight, but for processing our own reactions so they don’t overshadow the client’s needs.

Ethics, Professionalism, and the APS Code of Ethics

The APS Code of Ethics is clear: we have a responsibility to minimise harm, provide reasonable notice, and facilitate continuity of care.

A clinically sound ending is one that:

• Is planned and prepared for
• Processes the meaning of the ending with the client
• Provides options for ongoing care
• Documents the plan and the client’s consent

By contrast, a purely transactional ending risks reinforcing unhelpful relational patterns and undermining trust in the profession more generally.

Practical Considerations for Ending Well

• Notice periods should reflect the nature of the relationship: four to six weeks for most clients, longer for complex or deep attachment work.
• Communicating personal changes (parental leave, relocation, burnout) should be brief, factual, and focused on client care—not on the psychologist’s personal details.
• Referrals should be framed as a continuation, not a replacement. Involving the client in selecting their next practitioner where possible is ideal as well as (with consent) providing handover notes to their new therapist ensures continuity of care.
• Record keeping is non-negotiable: document the ending discussion, the client’s response, the agreed plan, and any referrals. Store records according to legal requirements (seven years after last entry, or until age 25 for minors).

Learning from Endings

If the Ramsay Health closures have taught us anything, it’s that we need to future-proof our caseloads. That means:

• Avoiding the start of long-term work if you know you have a major change coming up
• Building regular goal reviews into therapy from the start
• Talking openly about the reality that all therapy relationships will eventually end
• Ideally making time and space to work through any attachment issues that arise due to the therapeutic relationship ending

For therapists thinking about stepping back, my advice is this: Seek supervision, be honest with yourself about your capacity, and remember that a well-managed ending can be a powerful therapeutic gift. When done with care, endings model respect, boundaries, and healthy separation, something many clients may never have experienced before.

Final Thought:The closure of a therapy space, whether due to organisational change, relocation, or personal choice, will always have an impact. But when we handle endings with planning, compassion, and professionalism, we can transform what could be an experience of abandonment into one of empowerment and closure.