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What if…?  A Duty of Care

What if…? A Duty of Care

It’s a Monday morning, just after 8am and I’m responding to work emails before seeing my first client of the day. The phone rings and the voice on the other end, someone I don’t know, tells me they are a psychotherapist from a nearby town. Anticipating information about a new referral, I reach for pen and paper. Then, the voice tells me that she is sorry, but she has some very sad news for me. I pause, pen suspended, as my brain makes the connection between the town she is calling from and the phrase “very sad news”. I realise that she is about to tell me that my therapist has died.

This experience brought into sharp focus for me the importance for all psychotherapists to have a Professional Will. I was lucky that my therapist worked within a practice and so a colleague took on the task of contacting her clients. I did not turn up on a doorstep to discover that my therapist was “unavailable”. However, it was clear from the confusion of the days and weeks that followed that my therapist had not had any formal arrangement in place in the event of her inability to work due to sudden incapacity or death. No support was offered, communication was haphazard and a request I had made, which was important to me, got lost due to an administrative error. Even with the benefit, from a professional point of view, of having some understanding of the distress and additional work which had been created for my therapist’s colleagues, I was left feeling upset and angry. What was already a very painful experience was made significantly worse because of the lack of a plan to cover this eventuality.

If any of us died suddenly or became suddenly unable to work, who would have access to our premises in order to contact clients to cancel appointments and give them information about sources of support? It would not be appropriate for a family member to do this because of the confidentiality of the clinical information and the distress and demands they would be experiencing at such a time. Who would inform our colleagues, professional organisations and insurer? Who would have access to our filing cabinets and computer and be responsible for ensuring the safe disposal of clinical notes and other confidential information? It’s an event which is extremely unlikely to occur but it will happen to a few of us and I believe that we have a duty of care to our clients and colleagues to have a Professional Will in place:

A Professional Will is a plan for what happens if we die suddenly or become incapacitated without warning. It helps those whom we designated to respond to our clients’ needs and to the unfinished business of our practice. It spells out decisive details that can be hard or impossible to come by at a time of shock and mourning.[i]

The British Association of Counselling and Psychotherapy and the United Kingdom Council for Psychotherapies both recommend that all counsellors and psychotherapists should have a Professional Will in place. There are useful guidance notes and templates available:

https://www.bacp.co.uk/bacp-journals/private-practice/spring-2016/where-theres-a-will-theres-a-way/

https://www.psychotherapy.org.uk/wp-content/uploads/2017/04/CSRP-Practice-Policy-6_-The-Appointment-and-Duties-of-a-Professional-Executor.pdf

https://www.apaservices.org/practice/good-practice/professional-will-instructions.pdf

https://blog.therapynotes.com/how-and-why-to-prepare-a-professional-will-for-your-therapy-practice

I found it very helpful to go through the process of setting up a Professional Will with a colleague who is also a psychotherapist in independent practice. We each named the other as our professional executor, supported each other through the process of writing our Professional Wills and talking through the arrangement with our families. I hope that if ever my clients pick up the phone and hear a voice they don’t recognise on the other end giving them unexpected news, at least I will have done the small things that can be done to care for them in my absence.

If you are one of those lucky psychotherapists who is invincible and immortal, don’t bother to create a professional will. But it’s a good idea for the rest of us.i

 

BABCP Accredited Psychotherapist

(Name and address supplied)


[i] Dr Ken Pope, Licenced Psychologist and Former Chair of the Ethics Committees of the American Psychological Association.

 

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