Termination Summary & Follow-Up Plan

A summary of our work together as we close this chapter of therapy. We honour the gains, name what is still unfolding, and set up a sturdy plan for what comes next — including how to reach back to us when that feels right.

Header

Client name:

Total sessions:

Treatment period (e.g. "Mar 2024 – May 2026"):

Termination date:

Reason for Ending

If other or there is helpful context, please describe:

Presenting Issues at Start

What brought you in initially:

Treatment Course Summary

A summary of the work — themes explored, modalities used, turning points:

Gains & Strengths Built

Coping skills, insights, behavioral changes, and relational growth:

Ongoing Concerns / Areas for Continued Growth

What is still unfolding — areas where continued attention may be helpful:

Relapse Prevention Plan

Early warning signs to notice — physical, emotional, behavioral:

Coping toolkit — what has worked best for you:

Support people you can lean on:

Daily and weekly self-care commitments:

Crisis Plan

A reminder of supports for difficult moments — local crisis lines, a trusted person to contact, and the nearest emergency department. Please write down what you would want a future-you to remember.

Referrals

Psychiatrist / medication provider:

Group therapy or workshop:

Peer support program:

Community resources (local services, helplines, advocacy groups):

Aftercare Resources

Apps, books, podcasts, online communities that may support continued growth:

Client Reflection

Optional — what stands out from our work together, what you want to remember, what you might say to a future-you:

Therapist Reflection

Therapist's observations on growth, key moments, and what stands out:

Open Door

Ending therapy is not goodbye forever. The door stays open in the ways below — please tick those that match our agreement.

I consent to a 6-month follow-up check-in

Signatures

Client signature:

Therapist signature:

Date signed:

I have reviewed this summary and agree it reflects our work together

Thank you for trusting this work. The skills and insights you have built belong to you now — carry them forward gently, and reach back when it serves you.