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Therapist's Guide For Preparing a Professional Will
The following material is from chapter 8 of the book How To Survive & Thrive as a Therapist: Information, Ideas, & Resources for Psychologists in Practice, by Kenneth S. Pope & Melba J. T. Vasquez, published by the American Psychological Association (2005). The American Psychological Association holds the copyright to this chapter. This electronic reprint is provided solely for individual, personal use. For any other use that involves copyright issues, please contact the Rights & Permissions Office of the American Psychological Association. To purchase a copy of this book, please follow this link to the APA Order Department's page for the book or this link to Amazon's page for the book. © American Psychological Association, 2005
Unless a therapist is invulnerable and immortal, it is a good idea to prepare a professional will.
Unpleasant as it is to think about, all of us are vulnerable to the unexpected and at any time our lives may be suddenly ended by a drunk driver, a stroke, a mugging, a heart attack, a fire, a plane crash, or countless other misfortunes.
A professional will is a plan for what happens if a therapist dies suddenly or is incapacitated (e.g., falls into a coma) without warning. It helps those whom you designate to respond promptly and effectively to the needs of your clients and to the "unfinished business" of your business.
It also gives others the basic information and guidance that can be so hard to come by at a time of shock and mourning.
Preparing a professional will is another of the important steps we recommend you take before you open your practice. We can't schedule our personal misfortunes or postpone accidents so that they happen later in our careers. Our professional responsibilities include preparing for the possibility that something may happen to us, taking away our ability to function adequately, at any time without warning.
No single professional will with a "one size fits all" approach will work well for every psychologist, every kind of practice, or every situation, but this chapter looks at the items and issues that are useful to address in a professional will.
THE PERSON YOU DESIGNATE TO ASSUME PRIMARY RESPONSIBILITY
Who would respond effectively in the event that you suddenly die or are incapacitated? Who can make necessary arrangements in a time of great stress; take care of matters sensitively, efficiently, and effectively; and make sure nothing important is overlooked? Who is the best person to talk to many, if not all, of your clients? A good professional will clearly designates a qualified person to serve as the executor of the will and explicitly authorizes that individual to carry out the tasks that the will specifies.
It's useful to provide adequate information about how the designee can he contacted in the event of your sudden death or incapacitation. What is the person's phone, fax, and pager numbers? What are the person's office and e-mail addresses? Are there others likely to know where the person is if he or she proves hard to reach?
THE PEOPLE SERVING AS BACKUPS
Life tends to he full of surprises and sometimes hesitates to cooperate with our plans. At the time he or she needs to step in and take charge, the person you designated to assume primary responsibility may he overseas at a conference or on vacation, attending to a family emergency, seriously ill, or otherwise unavailable. It's important to have a second and third designee, each ready to step in if necessary.
COORDINATED PLANNING
Coordinated planning can make for a much more useful professional will and make it easier for the executor to carry it out. You can meet with your primary designee and both backups to outline what you want done, what needs to be done, and what information the designee will need. One person may think of something that the others have overlooked, and what the psychologist may think "goes without saying" ("You all know that bookshelf where I keep my appointment book, don't you?") may need clarification for the will's executor.
If the designees have trouble relying on a verbal description of where something essential is, they can be shown. They can be introduced to the people they'll need to work with (e.g., your secretary, the executor of your personal will, your accountant, your attorney, your office landlord) and exchange contact information with them. If the time comes that the designee must take charge, he or she will have detailed instructions and information in your professional will, but the designee will also know the rationale for each step (having been involved in the planning process), will know the key people to work with, and will know where the records and other materials are.
YOUR OFFICE, ITS KEYS, AND ITS SECURITY
In addition to providing your office address, it's helpful to be as specific as possible about where each key to your office can be found. For example, "There are four copies of the key to my office. One is on the key ring I always carry with me. It is the key with the blue plastic on it. My partner, whose contact information is ______, also has a key to the office. My secretary, whose contact information is _________, has a key. The building manager, who can be contacted in an emergency at ________, has a key."
There may be separate keys for each of the consulting rooms, the storage room, the filing cabinets, the desks, the computer, and the door to the building itself. It's easy to overlook a key that someone will need to fulfill the responsibilities outlined in your professional will.
Some offices have a security system that requires a code. Be sure to specify the necessary codes, instructions, and where the system is located.
YOUR SCHEDULE
Where is your schedule kept? In a daily planner you keep with you, in an appointment book at the office, on your computer, or in a personal digital assistant (FDA)? Once the record of your scheduled appointments has been located, is additional information needed to access it? For example, if you keep your schedule on your computer, what passwords are used to log on and access the schedule? Where on the drive is the schedule kept? What are the names of the relevant files? Is there a backup somewhere if the copy on your computer has become corrupted of if the computer itself is unavailable (e.g., destroyed in an office fire or earthquake or stolen)?
AVENUES OF COMMUNICATION FROM CLIENTS AND COLLEAGUES
Do clients and colleagues contact you through an answering machine, e-mail, or other method? Clearly describe each one and how the person implementing your professional will can access the messages. What is the code used to retrieve messages from your answering machine? What are the names of any relevant e-mail accounts, along with the user name, password, server address for receiving and sending mail (POP or SMTP), and so on?
CLIENT RECORDS AND CONTACT INFORMATION
Depending on the method of notification you choose, the person implementing your professional will may need to initiate contact with your clients. He or she may also need to return calls from clients whose message lacks a return number. A professional will needs to include clear instructions about how to locate and access client records and contact information. The ability to locate treatment records promptly may become exceptionally important because the sudden death of a therapist may trigger a crisis for some clients. The professional will should also designate whether the person implementing the will or someone else will maintain the therapist's client records. This information can he announced in the local newspapers or filed with the state psychology licensing board and state psychological association.
CLIENT NOTIFICATION
Therapists may choose one or more methods to notify clients of their death. They can choose to have their executor call each client, place a notice in the local newspaper, change the outgoing message on the answering machine to include the announcement or ask clients to call the clinician implementing the deceased therapist's professional will, or by letter. It is worth spending some time considering the potential impact of each method in terms of the Golden Rule and how each of the current and former clients might respond. Would any of us want to learn of our own therapist's or clinical supervisor's death by reading about it in the newspaper or hearing a recorded announcement on an answering machine? Are there resources that our clients might find helpful in these circumstances (e.g., designated colleagues who will make appointments available to your clients to help them deal with the immediate consequences and, if the clients choose, to locate subsequent therapists)? You'll have a good sense of which approaches will work best for your individual practice based on the relationship you have with your clients.
It's important that the notification be made in a way that respects each client's right to privacy. Letters and phone messages can, if not carefully handled, lead unintentionally to the disclosure to a third party that the client is seeing a therapist. Family members and others may not always respect the privacy of someone's mail and may, perhaps "accidentally," open and read something not addressed to them. Someone could also hear a phone message on an answering machine not meant for him or her. In some cases, such unintentional disclosures can place a client at great risk. The abusive partner, for example, of a client who sought therapy because she is a battered woman may become enraged at finding out, through an intercepted letter or phone message, that the client has sought help and may react violently, perhaps lethally.
COLLEAGUE NOTIFICATION
Which colleagues should be notified immediately? Are you a member of a group practice or do you share a suite of offices with someone? Are there clinicians who provide consultation or supervision to you on a regular basis, or are there clinicians who receive those services from you? Do you co-lead a therapy group or family sessions with anyone? Are there conferences or workshops that you present on a regular basis? It can be helpful to look over the listings in your scheduling book for a few months to ensure you don't overlook any colleagues who should be listed (along with contact information) in your professional will for immediate notification.
PROFESSIONAL LIABILITY COVERAGE
It's useful to include the name of the company providing professional liability coverage, their contact information, the policy number, and instructions for the company to be notified immediately after the therapist's death or incapacity.
ATTORNEY FOR PROFESSIONAL ISSUES
Many psychologists have consulted attorneys for professional issues. The attorney might have reviewed the psychologist's office forms (informed consent, release of information, etc.) to ensure they conform to state legislation and case law requirements. The attorney might have discussed the psychologist's policies and procedures, format for keeping records, or particularly troublesome cases that raised puzzling legal questions. The psychologist might have sought legal consultation about bow to respond to a subpoena or legal representation in a malpractice suit. It's useful to provide contact information for an attorney whom the psychologist has consulted for practice issues.
BILLING RECORDS, PROCEDURES, AND INSTRUCTIONS
The person whom the professional will designates to take charge will need to know where the billing records are, how to access them (e.g., if they are maintained by computer software), who prepares and processes the bills (e.g., a billing service, accountant, or office clerical worker), and how pending charges are to be handled.
Some therapists may be both financially able (e.g., they have no large outstanding debts and there are adequate funds for their financial dependents) and desirous to forgive part or all of any remaining unpaid bills that were to be paid out of their clients' own pockets (i.e., excluding due or overdue payments from insurance companies). Some may want to provide a session -- at the deceased therapist's expense -- for each client, during which the clinician serving as executor of the professional will would work with the client to discuss the situation, assess current needs, and explore options for future therapy. The professional will should include explicit instructions about any such wishes.
EXPENSES
How have the psychologist preparing the professional will and the person designated to serve as professional executor decided that the executor will be compensated? Perhaps the easiest arrangement is at the executor's customary hourly rate, but other approaches can be used (e.g., a flat fee, a token payment, the executor declining any compensation for rendering this service to a friend, or a contribution to a charity chosen by the executor). A professional will needs to include clear instructions about how all business-related expenses are to be paid.
YOUR PERSONAL WILL
To avoid unintended problems and conflicts, it's helpful to review both your professional will and your personal will side by side to ensure they are consistent. If a personal will, for example, directs all its assets to be disbursed in a certain way but makes no mention of the funds to be used to pay the executor of your professional will, problems can arise. It is useful if each will makes explicit reference to the other.
LEGAL REVIEW
A review of the professional will by an attorney skilled and experienced in mental health law can prevent numerous problems. The executor of the professional will can consult with the attorney should any legal quandaries arise in the days, weeks, and months after the psychologist's death. The attorney can also advise on whether, in light of state legislation and case law, the professional will is best authenticated simply by the signatures of disinterested witnesses, the seal of a notary, or other means.
COPIES OF THE PROFESSIONAL WILL
Copies of your professional will can be given to those designated as potential executors and to your attorney. Some psychologists may consider making special arrangements to ensure the executors' access to such information as their passwords for retrieving e-mail and answering machine messages is granted only after their death. This avoids having this confidential information distributed to others in multiple copies of the will.
REVIEW AND UPDATE
People, practices, times, and situations change. A professional will that is perfectly suited to us when we draw it up may have out-of-date contact information and aspects that don't fit us well at all just a year or two later. It's helpful to review a professional will on a regular basis-say, once a year-and make an immediate update whenever there is a significant change in our circumstances.