Decision Guides for Therapists
Some therapy moments are hard because the therapist does not only need language. The therapist needs a decision.
You may be trying to decide whether to refer out, consult, document more clearly, change the treatment plan, pause the work, make a report, respond to a records request, or name a rupture directly. These decisions often involve more than one variable. There may be client safety, scope of practice, ethics, legal concerns, therapist capacity, relational dynamics, and clinical fit all happening at the same time.
When everything is held in your head at once, it is easy to react too quickly or avoid the decision altogether.
Decision guides give you a structure for slowing the process down. They help you separate what you know, what you need to assess, what requires consultation, and what the next responsible step may be.
These guides do not replace supervision, consultation, legal advice, or your licensing board’s ethical standards. They are designed to help you think more clearly before, during, or after those steps.
Available Decision Guides
When a Client Wants to Stop Therapy
A decision guide for premature termination — how to assess whether to explore or accept the decision, and what clinical signs suggest the ending needs more attention.
Repairing Ruptures in Therapy
A repair framework for different types of ruptures — how to assess what happened, decide how to name it, and determine when a rupture signals something deeper.
Clinical Documentation That Protects You
A documentation decision guide for high-stakes situations — risk, safety planning, records requests, and incidents that may have legal or licensing implications.
When Clients Text Between Sessions
A clinical decision guide for between-session contact — when texting is routine, when it signals something important, and how to bring the pattern into the room.