Q: What could we put in place to take care of our clients and close our practices in the unfortunate event that we are no longer able to work, due to illness, injury or death?

A: Death is an uncomfortable subject for many of us. Some of us avoid thinking about it and some joke or make light of it. Very few of us plan how we would like our lives concluded. 

And yet, it is a certainty, and one which we can prepare for if we want to be supportive to those close to us. One way we can do this is to nominate professional executors and make our wishes known through a written clinical will. This idea was brought to my attention recently when a friend of mine told me how she lost her therapist.

When a Therapist Dies

My friend contacted her long time therapist after a short break. Her therapist's partner responded that unfortunately, she had passed after a short illness. My friend was devastated, and without anywhere to process or a referral to support her. I started reading other accounts of similar situations and came across several poignant articles published by clients following their therapists' untimely  or unexpected deaths. I thought about my own practice and how my clients would feel in this situation.

Informing Clients: Lightening the Load for Loved Ones

When I die, I imagine that my loved ones will have a lot on their minds and plenty to do. Depending on how it happens, they may have very little or no notice at all. The immediacy of informing other family members and friends will be intertwined with daily household needs. Once the dust has settled, there will be closing of bank accounts, cancelling telephones, removing social media and a plethora of other administrative tasks to complete. One thing I would like to spare them is advising my professional world - colleagues, students and clients - of my passing. I hope that I will retire before I die, but if I am still practising, I want to plan carefully how my professional life will be concluded.

Ethical Guidelines

The British Association for Counselling & Psychotherapy Ethical Guidelines for the Counselling Professions stipulate that we should have a clinical will in place. It shows respect and care for our clients to have a plan for them should we no longer be available. We should inform them of this in our Therapy Agreement, so that they know that a colleague may have access to their file should we no longer be able to treat them. 

Peace of Mind and Client Support

Creating a therapeutic will not only ensures compliance with ethical guidelines but also offers us peace of mind. Reviewing our business practices and contemplating how we would like our clients to be informed and supported allows us to align our intentions with our actions. Defining our preferences regarding the manner of communication ensures that clients receive the care and space they need during this challenging time. Furthermore, we can plan for our chosen executors to receive compensation for their efforts while providing clients with appropriate referrals and support information.

How Do You Want Your Clients to be Told?

My ideal agreement would involve my clients being informed in person, online via video or by telephone. Having had the experience of surprise news by text and email myself before, I would prefer to suggest other ways to inform clients, and I would like them to have space to process the loss. Clients all have different communication preferences due to ability, culture, neurodiversity, and language so it might be appropriate to have open conversations about how they would like to be contacted in case of unexpected events, and making a note on their file. Some key points to consider are clients' values, beliefs and communication needs when choosing executors, writing instructions and creating resources - so we can be sensitive and considerate in our end-of-practice plans as well as in session.

My ideal plan is for clients to hear from a colleague who knows me but is not so close to me that they are also grieving. I plan for my executors to be paid for their work, at their usual hourly rate, and for my clients to be provided with referrals and support information. This could be a referral list or even a resource list on our websites.

Clinical Executors

Traditionally, therapists choose a supervisor or close colleague they trust to be their professional executor. Most ethical guidelines recommend choosing someone who adheres to the same ethical requirements as you, meaning it should be a fellow licensed or qualified professional and not a family member. 

One thing to bear in mind is that an agreement between two therapists can never be reciprocal. Eventually, one would close the other's practice and seek another colleague to continue the agreement, creating a perpetual cycle. To overcome this challenge, consider the idea of having a primary executor and two or three secondary executors. Delegating tasks among them allows for a shared workload, splitting administrative responsibilities, and offering mutual support. This reciprocal arrangement among executors lightens the load and ensures the smooth closure of a practice.

Get Started on your Clinical Will

To begin the process of creating your clinical will, get started with these steps:

1. Centralise Practice Information: Start by centralising all your practice-related information in a secure and easily accessible location. Consider using a document management system like my "Biz Hub Doc" to store private practice administrative information. This centralisation ensures that important information is readily available to your chosen executors or colleagues who may need to step in.
2. Get Support with your Clinical Wills: Purchase a training or attend a webinar focused on clinical wills and end-of-practice planning. Talk about it with colleagues in your consultation and supervision groups and review regularly. Here's my training and template >>
3. Use a Template for Clinical Wills: Utilise a template specifically designed for clinical wills to guide you through the process. Customise the template to reflect your preferences and ensure that it aligns with your ethical obligations and legal requirements. Here's my template >>
4. Seek Local Legal Advice: It is advisable to consult with a local legal professional who specialises in healthcare or therapy-related matters. They can provide guidance on the legal implications of your clinical will and ensure that it complies with the specific regulations and requirements in your jurisdiction.
5. Conduct Your Own Research: Take the time to research clinical wills, legal considerations, and best practices within your region. Compile a diverse list of resources that includes options for clients from a range of communities. This can involve culturally specific grief support groups, community organisations, or therapeutic professionals who can offer appropriate guidance and assistance. Consider making this information available on your website to ensure easy access for clients.
6. Share with Colleagues: Discuss the topic of clinical wills with your colleagues and peers in the therapy community. Share your experiences, insights, and concerns, and encourage them to create their own clinical wills. Building a network of trusted professionals who understand the importance of clinical wills can provide mutual support and assistance during unexpected events.