Termination Note Cheat Sheet

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Reason for termination

• Choose from the drop-down menu the reason the client is being terminated.  If the client is being terminated for any reason other than achieved treatment goals, include a statement about why.  Ex: The client discontinued contact after the clinician made three outreach attempts to re-engage the client in treatment.
• If the clinician is resigning or is terminated, see the Treatment Plan Expectations for guidance.

Treatment Modality and Interventions

• A comprehensive description of the treatment was provided to the client.  (Use previous progress notes to aid you in writing this section).

Treatment Goals and Outcome

• Include goals and objectives from treatment (use previous notes)
• Outcome - what was the outcome based on the goals and objectives (be specific)
• Include how the treatment was terminated

Referrals made - if the client is terminated for any reason other than achieving treatment goals the client should be given three referrals to continue treatment. (This should be documented in TN in the client’s file).

Example wording: I strongly encourage you to contact the following therapists who specialize your expressed area of need if you would like to continue your treatment:

• Referrals: Samuel Babcock, LPC - 719-247-1350, Emily Rademan, PsyD- Peak Mind Consulting - 719-695-7193, Georgia Allred, LPC - Real Life Counseling - 719-393-5119
  

If the client never attended an intake session, but did fill out the intake packet (therefore signing your disclosure statement) here is what to write:

Reason for termination - The client only attended an intake session.

Chief complaint - This is automatically populated from your intake note.

Most Recent Diagnosis - This is automatically populated from your intake note.

Treatment Modality and Interventions - N/A - “The client only attended an intake session with this clinician; therefore, no treatment modality or interventions were specifically used."

Treatment Goals and Outcome -  N/A - “The client only attended an intake session with this clinician; therefore, no treatment goals were created, and the outcome is a transfer of the client."