When It's Not Working: Letting a Clinician Go Without Betraying Your Values
By Emelie Douglas, LPC, MBA · Founder, Sprout Your Practice
Letting a clinician go can fit your values if three things are true: they knew the expectations and had a real chance to meet them, their clients are protected through the transition, and they leave with their dignity intact. Most of what makes a separation ethical happens months before the conversation. What usually goes wrong isn't the decision. It's the delay.
I write a lot about retention, and I'm proud of the roughly 90% annual retention we've held at Sprout Therapy PDX. High retention doesn't mean never ending an employment relationship. It means doing it rarely, and doing it well.
How do you know it's time?
It's time when a problem is a pattern, you've named it clearly, you've offered real support, and it hasn't changed. Or when client safety or ethics is at stake. Before deciding, sort the issue into one of three buckets, because each calls for a different response.
• Skill gap. Documentation, clinical judgment, or a specific modality. Usually a supervision problem first.
• Fit or capacity. Caseload, schedule, life circumstances, or a mismatch with your population. Sometimes solvable by changing the role.
• Conduct. Boundary violations, billing irregularities, or ethics concerns. A different track entirely. It may involve board reporting obligations, so get consultation early.
What should you try first?
A clear, written, time-bound performance improvement plan built as support, not as a paper trail. If you've never told someone plainly what needs to change, you're not ready to let them go.
A good plan names the specific expectation, describes the current gap with real examples, lists the support you'll provide, sets check-in dates, and says plainly what happens if things don't change. Before you write it, check your own systems. Many "performance problems" turn out to be caseload, admin load, or onboarding problems. Fix those and the person often recovers.
How do you protect clients?
Clients aren't the practice's property or the clinician's. Their continuity of care comes first. The ACA Code of Ethics (A.12) says counselors don't abandon or neglect clients and must help arrange continued treatment after termination.
Build a transition plan before the separation date:
• Decide who tells clients, when, and with what script.
• Give clients real options: stay with the practice under another clinician, follow the clinician if they're continuing in practice and that's permitted, or get a referral out. Clients choose.
• Prioritize warm handoffs for high-risk clients. If you can, set the last day after those handoffs are done, even if that means paying through a transition period.
• Keep records with the practice as custodian, and transfer them only with client consent.
What does the conversation itself look like?
Short, decided, and kind. It's a notification, not a negotiation. Say the decision in the first sentence and the reason in one or two more, then move to what happens next.
Cover final pay, benefits, client communication, records access, and who to contact with questions. Have a second person in the room in an operations or HR role. Don't relitigate the improvement plan. If you've done the earlier work, the person won't be surprised.
Mind the calendar. In Oregon, a terminated employee's final paycheck is due by the end of the next business day, according to BOLI. A Friday separation means the check is due by end of day Monday. Late final pay can trigger penalty wages.
How do you tell the rest of the team?
Promptly, briefly, and without details about the person's performance. Silence creates a vacuum, and gossip fills it.
Tell the team the clinician is leaving, when, and what it means for coverage, consultation groups, and referrals. Protect the departing person's privacy. Your team is watching how you treat someone on the way out. That tells them more about your culture than anything in your handbook.
A simple test I use: if the clinician described exactly how this went to a colleague, would you be comfortable with the story? If yes, you probably did it right.
Things to verify with a professional:
Employment law, contract terms, and licensing-board obligations vary, even across states. This post isn't legal advice. Review any separation, and especially any conduct-related one, with an employment attorney. And contractors (1099) follow a different process than W-2 employees.
FAQ
Can a departing clinician take clients with them?
The client's welfare and choice come first. Your contracts may limit active solicitation, so review them with an attorney. Still, a client who asks where their therapist went deserves a straight answer and real options.
How long should a performance improvement plan run?
My recommendation is usually 30 to 90 days. That's a common practice, not a legal requirement. It should be long enough to see real change with support, and short enough that clients and the team aren't left in limbo.
About the author
Emelie Douglas is a Licensed Professional Counselor, MBA, and the founder of Sprout Your Practice. She built Sprout Therapy PDX from a solo private practice into a group of 40+ clinicians with ~90% annual retention, and served as president of the Oregon Counseling Association. She helps therapists and group practice owners grow businesses that are profitable, ethical, and sustainable — without burnout. Book a free consultation.