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Clinical Wills 

What is a clinical will?

A clinical will is a formal written document that sets out what will happen to your clinical practice in the event of you suddenly being unable to practice, for example due to sudden illness or death. Its function is to provide instructions as to how an appointed clinical executor should act should you no longer be able to continue your clinical practice. This would include how to inform and support your clients and manage any additional administrative and financial arrangements that would be involved with your practice.

Why is a clinical will important?

Unplanned or unexplained endings can be distressing for clients, and by having a clinical will in place, you can ensure that they are appropriately informed and supported should something happen to you. It also ensures that this this role is carried out by someone you trust and who is appropriate to take on this responsibility, removing the burden of this task falling to loved ones.

The BABCP Standards of Conduct, Performance and Ethics now includes the requirement that all members practicing CBT must have a clinical will in place.

8.2 You must have a process in place to ensure that appropriate action will be taken if you were to unexpectedly become unavailable, for example, due to serious illness, death, suspension or dismissal. This is usually referred to as having a ‘clinical will’. Arrangements include identifying who will be responsible for informing and arranging support for your clients if you are suddenly unavailable, and ensure that any other relevant person or organisation such as a referring agency is also informed. Employers may have a policy to make sure that this happens, independent practitioners must arrange their own. Therapists must declare that they have arrangements in place that cover their practice.

How do I set up a clinical will?

Before you prepare your clinical will, you will need to appoint an Executor of your clinical will. This needs to be a person who you can trust to carry out your instructions competently, within the limits of clinical confidentiality and with the sensitivity that this role requires. They must also be available and willing to act as Executor and this should be thoroughly discussed and agreed with them. Often the Clinical Will Executor is a trusted colleague or supervisor who has the relevant clinical experience to be able to perform this role.

You will also need to appoint a Clinical Will Initiator. This may be a close relative or friend, who can inform the Clinical Will Executor should you become incapacitated that they need to carry out the instructions in your clinical will.

Once you have these in place, you can start to draw up your clinical will. 

The clinical will should cover three broad areas. The clinical part of the will should include how to inform clients, supervisees, and anyone else who is relevant, that you are no longer able to practice; it also might make provision to arrange the transferring of the therapy to alternative therapists. The financial part should include how to contact and stop payments associated with your clinical practice, e.g. registrations, accreditations, indemnity insurance, etc. The administrative part should specify the storage and disposal of client records and clinical notes; how to contact and delete social media accounts and mailing lists; how to cancel any other professional commitments.

It is up to you exactly what information you put in your clinical will, but at the minimum we recommend the following to ensure that this can be carried out effectively:

  • Your details e.g. full name and address, name and address of practice (if different), contact details such as email and phone number.
  • The name of your Clinical Will Initiator
  • The name and address of your Clinical Will Executor
  • Details of where your list of clients can be located and full instructions on how the Executor can access these e.g. where keys to filing cabinets are located or passwords to devices
  • Specific instructions on how you wish your Executor to carry out the instructions e.g. please notify my clients of my death or incapacity. Please use your clinical judgement and allow the possibility of a face to face or video meeting if they request it. Please ask if they would like you to help them to find a new therapist, and make some referrals or direct them to CBT Register as appropriate
  • Details of other people who may need to be contacted e.g., supervisor/supervisees and any specific instructions you have for the Executor around this
  • Arrangements around the disposal of client records and notes- and how long they should be stored before disposa

You may also want to include:

  • Any specific instructions around cancelling subscriptions, memberships, indemnity insurance
  • Taking down any social media or website listings
  • Instructions on how to fulfil any financial obligations such as room rental payments etc.

Important considerations

In order for your clinical will be to carried out, you will need to keep your clinical will up to date with the relevant information. This includes keeping your client information up to date. You should consider carefully how your Clinical Will Executor can access the information they need, and that any sensitive information is stored securely and in line with GDPR and data protection regulations.

Clients should be informed about the clinical will during the initial contracting process at the beginning of therapy so they are aware that the Clinical Will Executor may need to access their confidential information. They should also give informed consent for this to happen. One way to inform clients is to include a section on this in any initial information you give out.

Online Q&A session - June 2023

We hosted an online Q&A session for members to put questions to us about the new policy on Clinical Wills. You can see the recording of this session here -

 

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