No one likes to think about dying or becoming unexpectedly incapacitated. Still, as human beings, we all know our time is limited, even if we do not know exactly how long we have. Beyond the frightening prospect of “what comes after,” the logical next thought should be, what will we leave behind?
Just like for parents of young children, the idea that there are people who depend on you, who rely on your care, your expertise and the practical aspects of the relationship, should be of great concern to therapists.
And, as many new parents do, setting up alternative plans for how these relationships should be handled when you are gone should be a priority.
“Catastrophes are not planned, “said Melba J.T. Vasquez, Ph.D., ABPP, co-author of “Ethics in Psychotherapy and Counseling” (John Wiley, 2016) “and we must prepare for the possibility that something can happen to us that robs us of our ability to function, without warning.”
Creating a plan to leave behind, often known as a professional will, can ease the transition for patients, staff, and colleagues.
“It is very important to create a professional will from ethical, legal, and clinical points of view,” said Ofer Zur, PhD, founder of the Zur Institute, a provider of online continuing education courses for mental health professionals that offers an online course in creating a professional will.
“If something happens to a therapist, such as death or disability,” he added, “and there are no instructions…this can be clinically disruptive and likely be ethical and/or legal violations. That can cost money, can involve legal claims and big headaches to the partner, colleague, or survivor.”
In many cases where a therapist has died while still running a full-time operation, the staff can be left trying to handle questions from clients and not knowing exactly where to turn.
“I have known of a couple of instances of colleagues who shared an office with a colleague who died suddenly and who thus had to unexpectedly and quickly figure out how to contact the professional’s clients, what to say, what to do about referrals, records, bills, etc.” said Vasquez.
Start with choosing a trustworthy and knowledgeable executor, a colleague may best suit this position. Vasquez recommends a backup executor as well.
The next step would be to start making a list of everything someone would need to know from basic information about the office including keys, security information, lease and rental details, to staffing and payroll.
Think about how you schedule patients and how they can be notified if you are not able to reach them.
Keep a list of passwords, and be sure to update them as you change them.
An executor should know about billing and patient files in order to remain within ethical and legal guidelines. Include information about where past patient files are kept and how long they should be kept and when and if they should be shared.
In her book, Vazquez also recommends notifying all clients that you have set up a professional will with an executor who will handle your business if need be.
“The fact that you have a professional will and a designated colleague as a professional executor in case of death or incapacitation should be included in the client’s informed consent for release of information,” she wrote.
“This is usually provided to the client at the initiation of services, but can be added or reviewed throughout treatment.”
The biggest issue in creating a professional will is just in getting it done. The best time to do it, of course, is today, since the whole point is not putting it off until it is too late.
“The best way to get to the task,” said Vasquez, “is to take it from the end of the list of things to do, place it on top, gather resources to create a professional will, and focus on it as a priority.”
By Catherine Robertson Souter