SOME PRACTICAL AND EMOTIONAL CONSIDERATIONS
Ten years ago, I was preparing to close my practice as counsellor, supervisor and trainer, relocate to another part of the country and start up again in a place where I knew no-one. By far the hardest part of the 2 year wind-down was deciding how to bring different things to a close[i], and then working out how and when to give notice (by degrees) to clients, supervisees, trainees, managers, agencies, and the network of referrers. I was helped by discussions with my supervisor, and guided by the ethical principles of the profession.
The question of when to stop (or cut down) has been discussed in several places[ii],[iii],[iv]. Very little has been written about how to close a practice or retire as a therapist or supervisor. To fill the gap, in 2010 I wrote a guidance document[v] for therapists who might be closing down (permanently or temporarily).
More recently, running workshops (“Thinking about leaving the profession? Identity, loss and letting go”), I have discovered that thinking about stopping work as a therapist commonly engenders fear, anxiety, uncertainty, ambivalence and loss. “Who will I be when I am no longer a therapist?”[vi] There is also anticipation and delight. “How wonderful to be able to cook fish, wear gardening clothes all day, leave a mess in the hall!”Whether the decision to go or wind down is elective or forced (for example by illness or the end of a contract), there are many practical considerations. In this article I explore the practical considerations as well as the uncertainties, challenges, losses, and emotions to be navigated in thinking about leaving the profession. It is relevant to practitioners who are self employed or employed, working from home or from other premises.
I start with the practicalities. Can you afford to reduce your income? There are online budgeting tools to help your calculations. One from Citizens Advice England[vii] allows you to print a hard copy (in other words, you do not have to enter your details online). An accountant will advise on the most advantageous time (from a tax point of view) to close a self employed business[viii]. If you decide to stop altogether, contact your professional indemnity insurer to arrange run-off cover: this will typically insure against claims during the 3 years after you have done the last piece of eligible work. Note that if you have worked for agencies (eg EAPs), when you finish your name will stay on their books until their contractual liability has expired.
You can cancel public liability cover (if you work from home, this may be covered by your household insurance), and professional Memberships, Registration, Accreditation. If you are in rented premises, you will need to give appropriate notice. To dispose of notes, reports and tapes, be guided by the policies of any organisation you have worked for, by your professional body, and by the Data Protection Act. Update your clinical will[ix]. Close down your website, and cancel your entry in online directories. Cancel journal subscriptions. Find a good home for books that you no longer want. ** The final practicality is to manage your diary so that you move towards new life balance. This may also involve the diaries of partner, family, friends.
I said above that in closing down before relocating, I was mindful of the ethical dimension. I wanted, as far as possible, to make a good enough ending for all concerned. I had to work out for myself what this meant in practice. There was a lot of uncertainty and not knowing. But when I was relocating, I knew that the interruption was only a temporary. Participants on my workshops, who are thinking about finishing permanently, forever, reflect on some deep issues: intimations of mortality, envy of the younger generation of therapists, a sense of shrinking, losing structure and status, relinquishing the deep emotional connection that is part of the work. There is fear of emptiness and loss of meaning. There is anxiety about the impact on relationships and income, as well as joyful anticipation of freedom, new horizons and a less sedentary life.
Doing the endings can be hard, so many goodbyes, and not all of them straightforward or rewarding. There may be little recognition of our professional worth from agencies or professional bodies, and probably no golden handshake. So we close the door of our room, knowing that we have done enough, and inch towards a new life, an unknown future: a beginning as well as an ending.
I end with a passage by Lesley Murdin [x].
THE GOOD ENDING
“All therapists need to envisage ending their own work as therapists and supervisors. We all need to make a therapeutic will which will allow for the safe care of our patients and supervisees in the event of an accident or sudden death. Even more difficult for many is to plan retirement and put it in to practice. Like our patients, we also need to be able to let it all go and say that we have done enough before that recognition is enforced by illness or debility or incompetence. Working in the field of psychotherapy is one of the most fascinating and rewarding experiences that anyone can have. Yet we all come to the end of a useful working life sooner or later and can learn to exist without patients to help us. It is therefore essential some day to be able to choose to say that I have done my share, had my turn and now I shall leave it to others.”