Can A Therapist Refuse To Treat A Patient?

Can A Therapist Refuse To Treat A Patient

Therapists are often required to treat patients they believe are dangerous or violent. In some states, therapists are even required to report suspected abuse to authorities. Is it ethical for a therapist to refuse to treat a patient?

The American Psychological Association (APA) has long held that psychologists should not discriminate against clients.

This includes not discriminating because of their race, religion, gender, sexual orientation, disability, age, or other characteristics.

It is permissible for a psychologist to decline services to a client if they reasonably believe that they cannot provide competent and safe service by professional standards.

Reasons Why A Therapist May Refuse To Treat A Patient

Therapists may refuse to treat a particular client when they believe that there are legitimate reasons why the patient should not receive the services.

This could be, for example, where the client does not meet the requirements for treatment or where the nature of the problem involves a level of expertise that the therapist lacks.

In addition, therapists may refuse to treat a client when it appears that they will put themselves at risk through inappropriate conduct.

For example, if a client continues to engage in dangerous behaviors such as self-harming or engaging in risky activities such as unprotected sex and drug-taking.

In fact, where the client engages in conduct that puts themselves at significant risk, the therapist may feel that they cannot provide a competent and safe service.

Refusing Treatment

While refusing to see clients is certainly ethically permissible, it can also result in considerable distress for both the therapist and the client.

Therefore, it should only happen after careful consideration and discussion between therapist and client.

This decision must consider the facts of each individual situation and, if necessary, involve other professionals.

Once agreed, the decision should remain confidential from outside parties and should never be used against the client in the future.

What Should Be Done When A Client Refuses Treatment?

There is no definite correct response to patients who refuse treatment. However, there are two main options available, although neither is ideal.

The first option is to continue treating the patient without allowing them access to the rest of the therapy program.

This usually means continuing to give sessions but making sure that certain parts of the session are omitted so that nothing important occurs during those times.

Can A Therapist Refuse To Treat A Patient?

The second option is to stop seeing the patient altogether. While this is clearly unacceptable for some cases, it can sometimes be helpful.

Especially when the therapist believes that the refusal to accept treatment is due to factors unrelated to the therapy itself.

For example, if the client refuses any form of treatment because he or she has been told that they are “mentally ill.” They feel ashamed of their behavior and want to keep the diagnosis secret.

They explain that everyone knows about their illness and fears rejection or social isolation.

In another example, a client may refuse treatment because she is afraid that the therapist might find out she has had an affair with someone else.

She is ready to work on her issues but does not want anyone to know about the experience.

These examples demonstrate how difficult it can be to decide whether or not to continue treatment when a client refuses.

It is also essential to remember that while you do have the right to refuse treatment, you need to explain your reasoning and ensure that your decision was made conscientiously.

As a therapist, you should try to make things as easy as possible for the client. For example, you should avoid using phrases like “I cannot help you.”

In addition, it’s best not to say, “You would have to withdraw from treatment otherwise,” which suggests that the refusal represents failure rather than choice.

Of course, if the request is unreasonable, then the therapist should refuse. However, you should still try to understand why the client has reached the decision they did.

Therapy Is Not Always Required

It is important to note that therapy is not always required, even though people often think it is. For example, most psychologists agree that psychoanalysis (the talking cure) can be very practical.

However, not all psychotherapies require formal psychological theory or practice (see below).

Similarly, many doctors believe that cognitive-behavioral therapy (CBT) is the most effective way to help people cope with stress, anxiety, depression, addictions, etc. This is because CBT involves changing thoughts and behavior.

However, CBT needs to be taught by qualified therapists. In some countries, such as England, it is available through NHS-funded courses.

If a person is experiencing mental health problems, they will likely benefit from counseling or psychotherapy. However, not every situation requires professional help.

In fact, many people prefer to deal with their own difficulties at home or within their social circle. If you feel confident that you can provide adequate support to yourself, you may choose to do so.

Can A Therapist Refuse To Treat A Patient?

Self-help can be highly effective if you are clear about what you expect of yourself and the results you hope to achieve. In addition, it’s essential to follow an appropriate set of guidelines when helping yourself.

Nevertheless, please consult your doctor before taking action, especially if you experience symptoms of depression, substance abuse, or suicidal tendencies.

A good rule of thumb is to ask yourself if you are willing to put your ego aside for the time being and focus solely on helping the other person.

If you answer yes, you probably already have enough knowledge and skills to help your patient without seeking formal help.

However, if you feel unsure about this, consider consulting a professional experienced in dealing with individuals suffering from severe emotional problems.

The Importance of Ethics And Honesty

Let us clarify one more point: ethics and honesty go hand in hand. Ethical decisions must be based on sound moral principles and sound personal integrity.

When making ethical decisions, honesty is vital because it prevents unnecessary conflict.

Although there are no hard and fast rules regarding truthfulness, honesty is desirable since it ensures both parties understand each other’s position.

Ethics And Honesty In Therapy 

As discussed above, ethics refers to principles used to guide our actions. These include issues like justice, fairness, and morality. The concept of honesty stems from these same values.

Because ethics and honesty are closely related, they are sometimes confused. However, honesty does play a role in ethics.

For instance, when deciding whether or not to disclose information, the best policy is usually to tell the truth, unless withholding the report serves a higher purpose.

For example, suppose you are treating a patient with extreme difficulty quitting smoking. You have tried everything and are losing hope.

Then, you discover that his ex-wife has been trying to get him to leave, and she is also addicted to cigarettes.

You might decide to keep this secret from your patient in this situation. However, if you were honest and told him the truth, he would appreciate knowing how much you care about him.

By keeping the secret, you may feel better in the short term; however, you are doing more harm than good in reality. This is because your patient won’t receive any assistance until he gets better.

That means you lose out on the chance to save his life.

Final Thoughts

Refusing treatment is never easy. It requires great patience and determination. However, some patients will need additional assistance to recover fully. In such situations, therapists should always try their best to provide help.

They also have the responsibility of protecting themselves against unethical behavior by patients.

About our Author Michelle Landeros, LMFT license# 115130
Author: Michelle Landeros, LMFT

Michelle Landeros is a Licensed Marriage Family Therapist (LMFT). She is passionate about helping individuals, couples and families thrive.

Last updated: April 12, 2024