Transferring psychotherapy clients: State of the art.

Abstract

Transferring psychotherapy clients from one therapist to another is a common event that may pose clinical and administrative problems. Clinicians and therapists in training transfer clients when their professional role or activities change or when they leave their clinical settings. We review the literature on transferring psychotherapy clients and report on aspects of the transfer process and procedures used by a national sample of psychology training clinics. We also report and discuss the results of an exploratory analysis of training clinic records in which we investigated the relation between transfer outcome (successful vs. unsuccessful) and a set of treatment and demographic factors. Last, we suggest several ways of handling difficulties that arise as a result of clinical and administrative reassignment.Transferring clients from one psychotherapist to another is a common clinical occurrence. Routinely, transfers occur at training centers and clinics where treatment is carried out by students. Transfers also take place when professionals leave clinical settings or change job descriptions. Although this is a common clinical event, most clinicians proceed in accordance with their intuition (Chang, 1977).

What happens when the therapist leaves? The impact of therapy transfer on the therapeutic alliance and symptoms

“…However, these patients may also perceive a transfer even more negatively, as they are unwilling to adapt to another therapist yet again. Wapner et al (1986) examined demographic and clinical factors that may help to predict successful transfer outcomes in a psychology training clinic using archival clinical data. Only the history of previous therapy experience showed a trend effect (p < 0.065).…”

“…Therapy or case transfers from one therapist to another are common in clinical practice (Wapner, Klein, Friedlander, & Andrasik, 1986). They occur as a result of turnover, sick leave, or parental leave.…”

The Cost of Client Transfer

“…With the advent of psychoeducational treatments of specified time lengths, it is becoming more common for agencies to offer many services, and for clients with multiple problems to be transferred from one psychoeducational treatment to another as the case requires. In the literature in which transfer has been reviewed (Gavazzi & Anderson, 1987;Wapner, Klein, Friedlander, & Andrasik, 1986), it has been addressed with interesting suggestions but with no empirical evidence.In training settings, referral is not only common, it is structurally part of the treatment facility. Transfer is so common that O'Reilly (1987) has called the process involved "the transfer syndrome, " and Muller (1986) has claimed that these cases are different from all other cases.…”

Guidelines for an Effective Transfer of Cases: The Needs of the Transfer Triad

“…Most of the literature recommends preparing the client for the transfer in advance (Scher, 1970;Sederer, 1975;Wapner, Klein, Friedlander, & Andrasik, 1986), with more notice necessary when transfer resembles past losses for the client (Bostic et al, 1996). Notifying clients approximately eight or nine weeks before the anticipated departure has been recommended by some, although there is no consensus on this issue.…”

“…In contrast, Klein (1992) has argued for encouraging institutional rather than therapist-directed transference to prevent or ameliorate difficulties for clients likely disturbed by transfer. Most agree clients should be involved in the transfer process (Wapner et al, 1986). It may be helpful to explore the advantages and disadvantages of various options with the client (Bostic et al, 1996).…”