Course excerpt from Ethics & Risk Management: Expert Tips 8
In June, 2015, The New York Times published a story highlighting Charlize Theron’s decision to dump Sean Penn by suddenly refusing to respond to his texts. This widely shared article drew attention to the disappearing act known as “ghosting,” which also surfaces as a frequent topic in psychotherapy.
Rejection is painful, no matter how you slice it. The digital age has made it easy to reject someone without engaging in a direct conversation. This passive-aggressive strategy leaves jilted individuals longing for information and wondering what went wrong.
In addition to its role in terminating relationships, ghosting is also an unfortunate strategy for ending therapy. While not the norm, ghosting a therapist is an under-discussed phenomenon. Most, if not all, clinicians have experienced a client who calls to cancel a session, states intent to reschedule and then disappears. Equally unfortunate is the client who does not show up for a session, does not respond to attempts to follow up and is never heard from again.
It is much easier to ghost a therapist than it is to ghost a suitor.
Therapists are usually trained and ethically obligated to follow up once or twice, but anything more can constitute a violation of the client’s privacy. Most professions in the psychotherapy field have some ethical guideline stating the professional’s obligation to know who is currently in therapy and who has ended. Clinicians should consider difficult questions, such as whether a client is still in therapy if he or she does not show up for a session, does not return a clinician’s follow-up call and then weeks later causes life-threatening harm for himself or herself or another person.
To this end, it is ethically prudent for therapists to request that clients sign a “termination agreement” when the clinical relationship begins. Without such an agreement, therapists can unknowingly continue certain ethical responsibilities to clients long after the therapist has been ghosted. The agreement I use with clients explains: “Clients who have not had a session in over 30 days (or within a mutually agreed upon time) will be considered inactive…. It is always preferable to have a final session before ending therapy in order to review and evaluate the sessions and assess overall progress. Please be fully assured that anyone wishing to return to active therapy can do so by contacting me to make arrangements to resume the therapeutic relationship.”
In concert with this ethical principle, I emphasize the importance of goodbyes and let clients know that I will respect decisions to end therapy. I make a deliberate effort to understand the urge to end without saying goodbye, and I encourage clients to schedule a final session to evaluate our work before they terminate. It was not until I read about it in The New York Times that I learned the term ghosting – and I’m glad to discover that such a suitable term for this troubling phenomenon has entered the public lexicon.
Interestingly, when clients open up about how much it hurts to be ghosted, they can often recall several stories in which they have ghosted others. Many times, they don’t realize that they have ghosted others until I ask. Even more relevant, such experiences often relate to primary formative relationships. These earlier experiences are usually more meaningful and worthy of exploration than trying to over-analyze the motivations of a random “match” on Tinder who seemed great until he or she became a ghost.
Our society shies away from endings. They are awkward and uncomfortable and it is easier than ever to avoid them all together. The same client who speaks of how much it hurts to be ghosted will describe skipping a friend’s going-away party, or convincing an employer to not plan a departure celebration so that they can move to a new job without saying a proper goodbye to co-workers that have been a significant part of their lives for years.
Each ending is an excellent opportunity for emotional growth. The passive-aggressive act of ghosting represents a missed emotional opportunity. Concluding a relationship with the respect it deserves demonstrates the ability to own and articulate an independent decision. Therapists who are willing to emphasize endings with clients are using the clinical relationship to help clients practice more adaptive relational patterns while simultaneously attending to important ethical obligations.
Ethics & Risk Management: Expert Tips 8 is a 3-hour online continuing education (CE) course that addresses a wide variety of ethics and risk management topics, written by experts in the field. Course #30-99 | 2017 | 49 pages | 20 posttest questions
Professional Development Resources is approved to sponsor continuing education by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC ACEP #5590); the Association of Social Work Boards (ASWB Provider #1046, ACE Program); the American Occupational Therapy Association (AOTA Provider #3159); the Commission on Dietetic Registration (CDR Provider #PR001); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy (#BAP346), Psychology & School Psychology (#50-1635), Dietetics & Nutrition (#50-1635), and Occupational Therapy Practice (#34); the Ohio Counselor, Social Worker & MFT Board (#RCST100501); the South Carolina Board of Professional Counselors & MFTs (#193); and the Texas Board of Examiners of Marriage & Family Therapists (#114) and State Board of Social Worker Examiners (#5678).