From the following list, each of you should choose a scenario. Write two-three pages dialogue, one with each of you roleplaying the PMHNP provider and one the patient. Attempt to come to a resolution of termination during this time; it is expected that one or both parties may not be happy at the end.
The objective is to practice a difficult termination conversation/interaction.
1. Patient owes $600 and cannot pay for past or future visits. Provider must terminate.
2. Patient demands to stop the psychotherapy sessions. However, patient is still using illegal drugs and has not found an effective way to use coping skills. Provider does not believe termination is in the patient’s best interests.
3. Patient brings in a loaded weapon and sets it on the couch during the session. In a prior session, provider had asked patient not to bring in a weapon in future sessions. Patient refused. Provider terminates.
4. Despite having had eight prior sessions with provider, patient has not followed treatment plan and states they are unwilling to change. Case management is pushing provider to discharge patient from individual therapy.
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