Q: Therapy is a profession without any clear retirement age. How do we know when it’s finally time to stop seeing clients?

A: We like to think that with age comes wisdom, but often what accompanies it are unwelcome changes in outlook and acuity that may go undetected in a therapist’s work. Experienced clinicians take pride in their ability, honed over decades, to stay alert and attuned to the nuances of their clients’ histories. But as we grow older, details in these histories may slip from memory, and our stamina may be diminished throughout day.

Nevertheless, it can be hard to decide when it’s time to slow down, or even close a practice. How many therapists recognize their own cognitive decline? If they do see signs, do they simply go on autopilot? Many competent therapists who’ve been in practice for a long time probably know how to cover up and compensate for minor losses of attention and memory. Some may rest on their laurels or assume that having “seen and heard it all,” they can practice at full tilt without being fully present. How many of these clinicians have honest friends, colleagues, or relatives who will tell them when it’s time to reconsider how they work?

The solo practice of psychotherapy is a largely unregulated career path. No one watches your sessions, measures the outcomes, evaluates your efficacy, or dictates when you should…