It happens to everyone. Usually, you don’t know you’ve been fired.  You simply have a patient that stops coming to see you and avoids your attempts to contact them. 
 
Today, I received a phone call from a patient who fired me.  This is a patient that I’ve seen for a while and felt we had a good rapport.  Unfortunately, I had to set some limits with this person last week due to a relapse that had occurred.  
 
I sensed when I set these limits with this person that it wasn’t well received, but you have to set clear boundaries when you work with addictions.   I attempted to be supportive and accepting of the patient as well as firm and clear. 
 
This patient did call me to say they wouldn’t be returning and I was proud of them about that.  I did appreciate knowing what the decision was, even if it wasn’t what I hoped for.   It’s worse when you have no closure.  
 
I let the patient know that when they were ready, I would be here waiting.