Discharge Policy

Purpose

This policy sets out how and when Zameen Counselling clinicians end a therapeutic relationship with a client ("discharge" or "discontinuation of services"). It is designed to ensure that every discharge is made in the client's best interests, in good faith, without discrimination, and with appropriate referral and documentation — consistent with CRPO Standard 6.3.

Scope and Applicability

This policy governs all discharges, whether initiated by the clinician, the client, or the practice, and whether services were delivered in person or virtually.

Zameen Counselling operates across Canada. This policy applies in full to services provided by clinicians registered with CRPO and to CRPO-regulated work. Clinicians regulated by a college in another province or territory must, at minimum, meet the standard set out here and follow any additional or more stringent requirements of their own regulatory body.

Guiding Principles

What "Appropriate Discontinuation" Means

Under O. Reg. 317/12, discontinuation is appropriate where the clinician could reasonably regard it as appropriate, weighing:

• the clinician's reasons for discontinuing;
• the condition of the client;
• the availability of alternate services; and
• the opportunity the client was given to arrange alternate services before discharge.

Clinicians consider all four factors before proceeding.

Legitimate Grounds for Discharge

Discharge may be appropriate in circumstances such as:

• the clinician lacks the competence needed to continue working with the client;
• the clinician reasonably believes the client will not benefit from continued therapy, or therapy is no longer indicated (see also CRPO Standard 3.5);
• treatment goals have been met and the client is ready to conclude;
• the client chooses to end services or requests transfer to another provider;
• a fixed number of sessions was agreed in advance and has been completed;
• the clinician is closing the practice, reducing hours, or changing the client population served or modalities offered;
• the client has not met an agreed obligation to pay fees (see Section 8 and CRPO Standard 6.1); or
• the clinician or staff would be at risk of serious harm if services continued (see Section 7).

Grounds That Do Not Justify Discharge

The following are not, on their own, valid reasons to discontinue and must not be used as such:

• disagreement with a client's political, religious, or personal views;
• a client's disability (subject only to genuine undue hardship);
• incompatibility of personality or ordinary friction in the therapeutic relationship;
• a client's occasional use of foul language;
• any ground protected by the Human Rights Code.

Disagreements over the treatment plan, personality mismatch, and general use of foul language do not meet the threshold for safety-based discontinuation.

Discharge on the Basis of Clinician or Staff Safety

A clinician may discontinue care where they or staff feel genuinely threatened by a client's behaviour, have been subjected to ongoing abuse, or have been directly threatened.

The decision must still be made in good faith and documented.

Where safe and possible, the reason is communicated to the client and a referral is offered.

Immediate safety of the clinician and staff takes priority; where notice or a session is not safe, the reason and the safety rationale are documented in the record.

Discharge for Non-Payment

Where a client has not met an agreed obligation to pay fees, services may be discontinued in line with the fee agreement and CRPO Standard 6.1. Clinicians:

• give the client reasonable notice and an opportunity to resolve the balance before discharge;
• do not discontinue therapy solely because a client cannot afford a fee increase (reasonable notice of any increase must be given); and
• document the account status, the conversation, and the client's condition at discharge.

Conflict of Interest

Where an irreconcilable conflict of interest requires discharge, the clinician upholds all confidentiality obligations. The existence of a conflict is noted without disclosing any detail that could identify another client (for example, where two individual clients turn out to be connected outside of therapy). The clinician provides an effective referral where the client wishes to continue treatment.

Discharge Procedure

• Raise discontinuation as a topic in session and discuss it collaboratively with the client, including the rationale and the client's readiness.
• Where the client wants further treatment, discuss options and make reasonable efforts to provide referrals.
• Agree a discharge plan, including any transition to other services.
• Where practical, hold a closing session to consolidate gains and relapse-prevention / maintenance planning.
• Document as set out in Section 12.

• Acknowledge and respect the client's decision.
• Offer a brief closing conversation and, if the client is open to it, note reasons and provide referrals.
• Document the client's decision, their condition at discharge, and any referral offered.

• Confirm the ground is legitimate (Section 5) and made in good faith.
• Provide the client with reasonable advance notice wherever possible.
• Clearly communicate the reason for discontinuing.
• Make reasonable efforts to provide referrals if the client wants to continue treatment.
• Document as set out in Section 12.

Where a client stops attending without notice:

• Make and document reasonable follow-up attempts across the client's consented contact methods over a defined period (e.g., [two] outreach attempts over [30 days]).
• Send a closing communication confirming the file will be treated as inactive/discharged after a stated date, and offering re-engagement or referral.
• Document the attempts, the client's last known condition, and the outcome before formally closing the file.

Referrals

When discharging a client who is interested in further treatment, the clinician makes reasonable efforts to provide referrals to other qualified providers. Referrals should, where possible, reflect the client's needs and circumstances (including language, cultural context, cost, and availability of services). Where the practice can refer internally to another suitable Zameen Counselling clinician, that option is discussed with the client.

Documentation Requirements

For every discharge, the clinical record must clearly document:

• the reason(s) for discontinuing services;
• the client's condition at the time of discontinuation;
• the discharge plan, including any transition or referral to other services; and
• a record of the conversation(s) held with the client about the discontinuation (including notice given and referrals offered).

Where the reason cannot be fully explained to the client (e.g., a confidentiality-protected conflict of interest) or where a safety situation prevented full discussion, the record notes this and the rationale.

Roles and Responsibilities

Clinicians are responsible for applying this policy in their own caseload, exercising clinical judgment, and completing documentation.

The Clinical Director supports clinicians with complex discharges, monitors compliance, and is available to consult on safety-based or conflict-of-interest discharges.

Administrative staff support notice, referral logistics, and file closure under clinician direction.

Related Standards and Resources

• CRPO Standard 6.3 — Discontinuing Services
• CRPO Standard 6.1 — Fees
• CRPO Standard 6.4 — Closing, Selling, or Relocating a Practice
• CRPO Standard 3.5 — Unnecessary Treatment
• O. Reg. 317/12 (Professional Misconduct) under the Psychotherapy Act, 2007

Policy Review

This policy is reviewed at least annually and whenever CRPO amends Standard 6.3 or related requirements. Clinicians are notified of any changes.