Termination Readiness — Clinical Decision Flowchart
No clear criteria, no dashboard to check. This flowchart gives you a structured way to assess whether a client is genuinely ready to end, what to do when they are leaving too soon, and how to make endings clinically meaningful.
What is in this flowchart
The “who raised it” decision tree — client-initiated, therapist-initiated, and external termination. Different clinical considerations and first moves for each.
Readiness assessment checklist — goal achievement, skill development, self-sufficiency, functioning, insight, and the specific signals that distinguish genuine completion from avoidance.
The avoidance branch — clinical signals that termination is being raised to avoid something, with language for the explore-first conversation.
The pattern branch — when leaving is the client’s relational pattern, how to name it directly without forcing them to stay.
External termination protocols — when insurance, relocation, or caseload ends the work. How to name it early, what to address, and how to handle forced endings with clients who have abandonment wounds.
The tapering conversation — how long to taper based on treatment length and complexity, what to cover in the tapering phase, and the return conversation language.
Quick reference table — situations mapped to primary concern and first move.