Termination notes document the end of a therapeutic relationship, summarize treatment progress, and provide recommendations for future care. These examples demonstrate how to write thorough termination documentation across different scenarios, from planned endings to client dropout and therapist-initiated terminations.
Part of our therapy notes examples guide.
Therapists concluding treatment and documenting outcomes
Clinicians managing planned and unplanned terminations
Providers documenting treatment outcomes for clinical records
New therapists learning termination documentation standards
Treatment Summary
Client completed 16 sessions of Cognitive Behavioral Therapy (CBT) over 5 months for Social Anxiety Disorder (F40.10). Treatment focused on cognitive restructuring of negative self-evaluation, graded exposure to social situations, and social skills building. Client completed all exposure hierarchy items through level 8 of 10.
Outcomes
Liebowitz Social Anxiety Scale (LSAS) decreased from 78 (severe) at intake to 35 (moderate) at termination. Client reported attending two social events per week compared to zero at intake, initiating conversations with coworkers daily, and delivering a work presentation without avoidance. Treatment goals were substantially met.
Termination Process
Termination was discussed over the final 3 sessions. Client and therapist collaboratively reviewed progress, identified remaining growth areas, and developed a relapse prevention plan. Client expressed readiness to continue skill application independently.
Relapse Prevention
Client identified high-risk situations (large group settings, authority figures) and reviewed coping strategies for each. Relapse prevention plan includes: continued use of cognitive restructuring for anticipatory anxiety, weekly self-directed exposure to one feared social situation, and self-monitoring using the LSAS monthly. Client instructed to seek therapy if LSAS exceeds 50 or if avoidance patterns return.
Recommendations
No immediate referrals needed. Client encouraged to continue independent exposure practice and cognitive restructuring. Follow-up contact in 3 months offered to assess maintenance of gains. Client may return to therapy at any time without re-referral.
Treatment Summary
Client attended 6 of 12 scheduled sessions over 2.5 months for Posttraumatic Stress Disorder (F43.10) related to domestic violence. Treatment modality was trauma-focused CBT with safety planning. Sessions focused on psychoeducation, safety planning, grounding techniques, and beginning trauma narrative work. Client dropped out of treatment during the trauma processing phase.
Attendance and Outreach
Client attended sessions 1-4 consistently (weekly). Session 5 was a no-show without notice. Client attended session 6, reporting increased distress after beginning trauma narrative. Sessions 7-9 were no-shows. Three outreach attempts were made: phone call (no answer, voicemail left), secure message via client portal, and a mailed letter encouraging return to treatment. No response was received to any outreach attempt.
Outcomes
PCL-5 decreased from 52 (above clinical threshold) at intake to 44 at last attended session. While some symptom reduction was noted, the client remained well above the clinical threshold of 33. Safety plan was established and reviewed. Client reported ongoing contact with domestic violence advocate. Clinical concerns at time of dropout include incomplete trauma processing, ongoing PTSD symptoms, and uncertain safety status given DV history.
Clinical Concerns
Client dropped out during the most clinically sensitive phase of treatment (trauma processing). Increased distress following session 6 suggests possible trauma activation without adequate processing or resolution. Without follow-up, it is unknown whether the client is experiencing symptom exacerbation, has returned to an unsafe environment, or has sought treatment elsewhere. These concerns are documented for any future treating provider.
Recommendations
Chart will remain open for 90 days should client wish to return. If client re-engages, recommend resuming treatment with stabilization and safety assessment before continuing trauma processing. Referral information for local DV resources, crisis services (988 Lifeline, National DV Hotline 1-800-799-7233), and trauma-specialized therapists was provided during treatment. Records available for transfer upon client request and signed release.
Treatment Summary
Client attended 22 sessions over 9 months for Bipolar II Disorder (F31.81) with comorbid Borderline Personality Disorder traits. Treatment modality was integrative therapy combining DBT skills training and mood monitoring. Sessions addressed emotion regulation, distress tolerance, interpersonal effectiveness, and medication adherence. Client demonstrated inconsistent engagement with treatment recommendations.
Frame Violations and Clinical Concerns
Over the course of treatment, multiple therapeutic frame violations were documented: arrived to sessions intoxicated on three occasions (sessions 12, 17, 20), repeated boundary violations including after-hours contact attempts and requests for dual relationship, verbal hostility directed at therapist during sessions 18 and 21 including threatening language. Each incident was addressed directly in session with clear limit-setting. Behavioral expectations were reviewed and documented in writing after session 17.
Consultation and Decision
Therapist consulted with clinical supervisor Dr. Chen on two occasions (following sessions 17 and 21) regarding appropriateness of continued treatment. Consultation determined that the therapeutic relationship has been compromised to a degree that effective treatment is no longer feasible in the current dyad. Therapist-initiated termination was recommended with appropriate transition planning.
Outcomes
Treatment gains were limited and inconsistent. Client demonstrated improved distress tolerance skills when sober but was unable to apply skills consistently due to substance use. Mood instability remained significant throughout treatment. No standardized outcome measures were administered at termination due to client's intoxication at final attended session. Last available PHQ-9 (session 19): 14 (moderate). Client's presentation suggests need for personality disorder-specialized treatment with concurrent substance use intervention.
Termination Process
A 4-week transition period was implemented. Client was informed of termination decision in session 22 with clear, non-punitive explanation. Termination letter was provided in writing. Three referrals were made to personality disorder specialists with substance use expertise. Client was offered two bridge sessions during the transition period. Crisis resources were reviewed and provided in writing.
Recommendations
Referral to Dr. Hernandez (DBT program with substance use track), Crossroads Behavioral Health (dual diagnosis IOP), and Dr. Kim (personality disorder specialist). Recommended comprehensive substance use evaluation prior to resuming individual therapy. Coordination with prescribing psychiatrist Dr. Okafor regarding medication management during transition. Crisis plan reviewed: 988 Lifeline, local crisis stabilization unit, and emergency department for imminent safety concerns.
Termination notes are an essential part of the clinical record that documents how and why therapy ended. They serve both clinical and legal purposes, providing a clear record of the treatment course and its conclusion.
Planned therapy completion when treatment goals have been met
Client dropout or loss of contact after repeated outreach attempts
Therapist-initiated endings due to clinical or ethical concerns
Provider transitions when the therapist is leaving a practice or relocating
Treating therapists documenting the end of a therapeutic relationship
Clinical supervisors reviewing termination documentation for quality assurance
Program administrators managing caseloads and chart closures
Licensing boards and auditors reviewing clinical records
Provides a legal record of how and why therapy ended, protecting both therapist and client
Documents clinical reasoning for the termination decision
Creates a clear handoff for any future treating provider
Demonstrates ethical practice by documenting referrals, outreach, and crisis resources provided
Client completed 14 sessions CBT for social anxiety. LSAS: 72 at intake, 34 at termination. Treatment goals met. Termination planned over 3 sessions. Relapse prevention plan provided. Open-door policy for future treatment.
Client attended 8 of 16 planned sessions for PTSD (DV-related). PCL-5 decreased from 52 to 44 (still above threshold). Client stopped attending after Session 8 when trauma processing was initiated. Three outreach attempts made (2 calls, 1 letter) with no response. Clinical concern: premature termination during active trauma processing. Chart closed per 30-day no-contact policy. Letter sent with invitation to return, trauma-specialized therapist referrals, and crisis resources (988, local DV hotline). Chart open for 12 months. If client returns, consider EMDR as alternative to CPT given possible avoidance of cognitive processing approach.
See how termination notes compare with other common therapy documentation formats.
| Format | Best For | Key Sections | Pros |
|---|---|---|---|
| Termination Notes | Ending therapy, client dropout, therapist-initiated endings | Treatment summary, outcomes, termination process, recommendations, referrals | Legal protection; documents clinical reasoning; ensures ethical closure |
| SOAP Notes | Ongoing session documentation, medical settings | Subjective, Objective, Assessment, Plan | Structured and familiar; widely accepted by insurers; easy to review |
| DAP Notes | Session documentation with clinical interpretation | Data, Assessment, Plan | Simpler structure; focuses on clinical reasoning; efficient for experienced clinicians |
| Progress Notes | Tracking treatment progress over time | Session focus, interventions, response, plan | Flexible format; tracks change across sessions; adaptable to any modality |
Follow these best practices to write termination notes that are clinically thorough, legally defensible, and useful for any future treating provider.
Provide a thorough treatment summary — include diagnosis, modality, number of sessions attended vs. scheduled, and specific goals addressed throughout the course of treatment
Use objective documentation — describe the circumstances of termination factually, avoiding subjective interpretations or value judgments about the client's choices
Describe the termination process — document how the ending was handled, including number of sessions devoted to termination, outreach attempts for dropouts, or transition planning for therapist-initiated endings
Include actionable recommendations — specify referrals, relapse prevention strategies, crisis resources, and clear conditions for returning to treatment
Incomplete documentation of termination circumstances
Failing to document why therapy ended, what outreach was attempted (for dropouts), or how the termination process was handled. Every termination note should clearly state the reason for ending, who initiated it, and the steps taken during the transition.
Judgmental or blaming language
Using language that implies fault or negative judgment about the client's decision to leave therapy. Write objectively (e.g., 'Client elected to discontinue treatment' rather than 'Client abandoned treatment'). This is especially important for dropout and therapist-initiated terminations.
Missing follow-up plan
Ending therapy documentation without specifying what happens next. Every termination note should include referrals (if applicable), conditions for returning to treatment, relapse prevention strategies, and crisis resources — even when the client has stopped responding.
No outcome comparison
Failing to compare intake and termination assessment scores. Without pre/post data, there is no objective record of whether treatment was effective. Always document baseline and final scores on standardized measures, or note why scores could not be obtained at termination.
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A termination note should include the reason for termination, a summary of the treatment course (modality, number of sessions, goals addressed), pre- and post-treatment assessment scores, the termination process (how ending was handled), clinical outcomes, recommendations for future care, referrals provided, and any relapse prevention planning.
When a client drops out of therapy, document the last session attended, the number of missed sessions and outreach attempts made, any clinical concerns at the time of dropout, the client's last known clinical status with assessment scores, and any safety concerns. Use objective, non-judgmental language and note that the chart remains open for a specified period should the client wish to return.
Therapist-initiated termination may be appropriate when the therapeutic relationship has been compromised by repeated boundary violations, when the client's needs exceed the therapist's scope of competence, when there are safety concerns that cannot be managed in the current setting, or when the client is not benefiting from treatment despite modifications. Consultation with a supervisor or colleague is recommended before initiating termination.
Yes, termination notes should always include referral information when clinically appropriate. Document the specific providers or programs referred to, the reason for the referral, whether the client consented to transfer of records, and any coordination of care that was completed. Even when clients terminate against clinical advice, offering referrals is considered best practice.
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