What is a Clinical Will?
What is a Clinical Will?
A Clinical Will is a set of instructions made by a therapist,
counsellor or coach for what will happen to their practice in the event that
they are no longer able to work due to sudden illness or death. As a minimum,
it lays out how clients can be contacted and supported if a practitioner is
unable to do so themselves. Additionally, a Clinical Will might also include
details of other people or organisations related to a practitioner’s business
that might need to be notified.
the requirement is not only to make sure clients are notified if their
therapist or counsellor is taken ill or dies, but that any contact is made by
an appropriate person and takes place within the limits of clinical
confidentiality. This person, usually known as a Clinical Trustee, might also
help clients think about finding a new therapist, or simply support them in
coming to terms with an unplanned end to their therapy. Therefore, the person
we appoint to contact our clients on our behalf is usually a trusted colleague.
Why do I need a Clinical Will?
Imagine a client coming to a session to find that their
therapist isn’t there. No one answers the door. They have a phone number or
email address they can use to contact their therapist, but there is no reply. A
few days later, they still haven’t heard from their therapist. The client is in
the dark and unsure about whether to come for their next session, or even
whether the therapy will continue.
What the client doesn’t know is that their therapist was
taken ill suddenly and won’t be able to contact their clients until they
recover. This really happens, or worse; therapists, like all people, sometimes
die unexpectedly. In cases like these, clients are left unsupported and likely
worried or distressed about what might have happened to their therapist. Often,
the only person who knows where to find a comprehensive list of client contact
details is the practitioner themselves.
Ethical practice is the foundation of our work as therapists,
counsellors and coaches, and is based on our commitment to always act in the
best interests of our clients. As part of our duty of care towards our clients,
we have to consider what will happen in the event that we are suddenly unable
to carry on working with them. For many clients, an unexpected or unexplained
ending in the therapeutic process might be disturbing or damaging. For these
reasons, Clinical Wills are explicitly mandated in the ethical frameworks of
all major professional membership organisations such as the
as well as many training organisations.
A separate function of a Clinical Will is to reduce the administrative and
emotional burden on family or friends if we fall ill or die, especially as they
may be anxious or grieving, or preoccupied with other duties relating to our
illness or death. In the same way that we take our ethical responsibilities
seriously as practitioners, we should also consider how to minimise the impact
of our illness or death on those closest to us - a Clinical Will helps do this.
What do the BACP, UKCP and BPC specifically say
about Clinical Wills?
In the event of death or illness of sufficient
severity to prevent the practitioner communicating directly with clients, we
will have appointed someone to communicate with clients and support them in
making alternative arrangements where this is desired. The person undertaking
this work will be bound by the confidentiality agreed between the practitioner
and client, and will usually be a trusted colleague, a specially appointed
trustee or a supervisor.
BACP Code of Ethics and Professional Practice
As a practitioner you must... have arrangements
in place for informing clients and, where appropriate, providing them with support
in the event of your illness or death.
UKCP Code of Ethics and Professional Practice
Registrants must nominate two colleagues to
hold a list of their patients and supervisees in confidence, in the event of
death or an inability to work.
BPC Code of Ethics
More recently, the BPC has drawn up additional, detailed guidance on Clinical Wills and how to give
Clinical Trustees, available
How do I set up a Clinical Will?
If you work as a practitioner in an organisational setting,
there may be a formal procedure in place in case you fall ill or die. However,
if you work in private practice you will need to take responsibility for your
own Clinical Will. This may also apply if you work for a smaller organisation.
If you are unsure, it is your responsibility to check, as it is unlikely anyone
else will do so on your behalf.
The following practical points will help you set up a
Clinical Will that is fit-for-purpose. As a starting point, decide what
information to include. As a minimum, a Clinical Will should contain:
- The names and contact details of your current clients
- The names and contact details of your Clinical Trustee(s) (see below for more information on selecting
act as Clinical
- The names and contact details of your Next of Kin
You may also want to include:
- Other clinical information about your clients which your
Clinical Trustee might need, such as details of session
days or times, and any other relevant information that will help them contact
your clients supportively and sensitively. For example, you might want to
indicate that illness or death is a trigger for a client, or give details of
what you want your Clinical Trustee to tell your clients about what has
happened. You might also want to include details for how a client prefers to be
contacted, for example by email rather than by phone.
- Contact details for past clients, especially
if you keep materials they have a right to access after you have finished
working together (for example materials produced in art therapy). Some
practitioners may also request that past clients are invited to their funerals.
- The names and contact details of your supervisees
- Instructions for the disposal or deletion of physical or
digital client records. This might include details
of where to find paper records, or how to log on to devices or accounts that
hold digital records containing confidential client information.
Beyond this information, you might also want to include
non-clinical details related to your practice, such as:
- Details of any other people or organisations you work with, for example, peer supervision or
professional development groups, EAPs
or insurance companies you work for, professional membership bodies, and you rown therapist.
- Details of accounts held with other relevant businesses, such as the landlord or management of your
consulting room, your
professional insurance provider, website hosting companies, and any therapist
directories or social media platforms associated with your practice.
As well as the information your Clinical Will contains, you
also need to consider who will make sure your instructions are carried out, and
how. Planning this will be your responsibility, therefore you should make sure
- Ask someone who knows you personally, to act as your Next of
Kin or Clinical Will ‘Initiator’. They will be responsible
for contacting your Clinical Trustee if you fall ill or die suddenly and will
likely be a family member, friend or neighbour you know well. You might want to
ask more than one person to act as your Next of Kin or Initiator as this will
make it more likely that your Clinical Trustee is contacted as soon as possible
if need be.
- Ask someone appropriate to act as your Clinical Trustee. They will be responsible for carrying out the
instructions in your
Clinical Will. As outlined above, a Clinical Trustee needs to be someone with
the relevant clinical experience to act on your behalf within the limits of
client confidentiality. Therefore, Clinical Trustees are usually other
practitioners, such as a colleague or supervisor, most likely working in the
same modality or therapeutic approach as you. Sometimes, Clinical Trustees
agree to act for each other in a mutual ‘Co-Trustee’ arrangement. Again, you
might want to ask more than one person to act as your Clinical Trustee as this
will make it more likely that your instructions are carried out as intended -
some organisations, like the BPC, formally require you to nominate two Clinical
- Discuss what is expected of your Clinical Trustee and Next of
Kin with them and leave them clear instructions for them about what to do
if they need to carry out their responsibilities as agreed with you. You might
want to consider including details of whether your Clinical Trustee is expected
to deal with outstanding fees, or fees paid in advance, on your behalf. You
might also want to offer your Clinical Trustee payment for the time they will
spend carrying out your instructions.
- Consider carefully where you will leave any information your
Clinical Trustee needs to access. You will need to make sure
any clinical or other sensitive information, such as passwords for accounts or
devices, is stored securely, but is easily accessible by your Clinical Trustee
if they need to carry out your instructions. This might involve leaving a
physical copy of the relevant information in a safe place they, or giving your
Clinical Trustee access to a secure digital copy of the relevant records.
Ideally, all the information they need will be in one place that is easy to
- Do not give your Next of Kin or Clinical Trustee access to
more information than they need. Under
data protection regulations such as the UK GDPR and DPA 2018, we are required
to make sure we only share information for a good reason (called ‘legitimate
interest’). Giving a Clinical Trustee access to records that include process
notes or other information not related to the function of a Clinical Will would
breach these regulations; importantly, your Next of Kin should usually not have
access to any client details at all.
- Inform your clients about your Clinical Will arrangements. Not only is this required under data
regulations, but also
forms part of our ethical obligation to communicate with our clients about what
would happen in the event of us unexpectedly falling ill or dying, and
discussing this with them if they have any questions.
- Inform the executor of your personal will about your Clinical
Will if necessary, and make sure it allows for any
instructions you give your Clinical Trustee, for example permitting access to any
relevant documents or personal devices containing client or business details.
You might also want to include details of how your Clinical Trustee will be
paid if you have offered to do so, or how should manage any payments of
outstanding or overpaid session fees.
Once you have set up your Clinical Will, chosen your Clinical
Trustees and Next of Kin or Clinical Will Initiator, it is important that you
make sure the arrangements you have put in place remain fit-for-purpose as long
as you are working. In particular, this means you should:
- Keep your Clinical Will up-to-date.
Most importantly, this means adding or removing client contact details as soon
as possible. Forgetting to do this might mean that your Clinical Trustee does
not contact a client you have taken on recently or mistakenly contacts a client
you have already finished working with.
- Review your agreements with your Next Of Kin or Initiator and
Clinical Trustees regularly, inform them of any important
changes to your instructions and ask them to tell you if they decide they can’t
carry out their responsibilities any longer.
- Consider how many other therapists you wish to act as a
Clinical Trustee to. Although it is very unlikely, in cases
where you need to carry out your responsibilities as Clinical Trustee to more
than one practitioner at a time, you may be struggle to do so. Don’t
underestimate the amount of work it might take to fully carry out a colleague’s
instructions in the way they have requested.
Lastly, it is important to remember that creating your
Clinical Will will involve considering circumstances in which you might fall
ill or die, or in which you might have to act as a Clinical Trustee for a
colleague yourself. You might find doing this isn’t easy, either in relation to
yourself, or in considering the likely impact on family, friends, clients and
colleagues. As well as the practical planning involved, you might want help in
working through the wider implications of what it means to face the possibility
of your own death or illness, or that of a colleague. If you feel you need more
support, you could speak to your supervisor or therapist about this.