abandonment or acceptable practice?

I thought I would put this out on the list to see if anyone had guidance or suggestions. I have consulted with a social work clinician who was working with a young adult female client with borderline diagnosis. Client was seeing a psychiatrist for meds and bimonthly psychotherapy, and seeing the msw for weekly sessions.

After seeing her for about a year, Client began to express anger at msw and wrote several notes with veiled threats including references to the kind of car the msw drove and other similar stalking-like references.

MSW, consulted with psychiatrist and both agreed that continued treatment would be difficult as the MSW was now feeling afraid of client and assessed the threats as beyond the symptomatic borderline ranting.

Rather than confront the reasons in the office (private practice, solo office where she didn't feel safe)MSW only told the client that the treatment was no longer working and they would have to terminate. Client was given assurances as to the availablity of the psychiatrist to increase sessions and that her former therapist of 8 yrs had also agreed she would be available as an interim source of support.

Client is now bringing a complaint with licensing board re. abandonment. It seems that the consultant who reviewed this case felt that the threat was a normal part of working with borderline clients and that the MSW should have stuck with it and addressed it directly with the client. MSW feels that she has done that with other similarly diagnosed clients but this felt different in every way...she was scared and beleived herself in danger.

Any thoughts? Any literature or cases that lend substance to either side of the argument? Do you think she inappropriately ended treatment given the presence of the other service providers who had agreed to see the client?

• No (?) duty to see patient by William Reid, 2/17/99