Cognitive therapy has emerged as 1 of the most promising psychosocial interventions for the treatment of depression. It appears to be at least the equal of alternative interventions (including pharmacotherapy) with respect to acute treatment. In addition, there are indications that it may reduce risk of symptom return after treatment termination. Nonetheless, design limitations reduce the certainty with which such conclusions can be drawn. Furthermore, tests of its efficacy have largely been limited to nonbipolar outpatient (or subclinical) samples. At this time, cognitive therapy is best considered a promising, but as yet not adequately tested, intervention for the treatment of depression.

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The termination of an active psychotherapy relationship can be a very complex process. It calls for a blending of clinical, practical, and ethical factors that become the foundation for the required level of reasonable professional conduct in this area. Competence in termination requires that the psychotherapist first have a strong foundation in ethics and second understand how to apply the ethical principles and standards in unique and varied clinical settings. In this article, we highlight the necessary foundational competence in ethical knowledge and link this knowledge to practical steps as a general guide for functional competence in psychotherapy termination.

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