Professional Wills for Therapists: A Practical Continuity-of-Care Checklist

The care you put into your practice includes details someone else may never see: how to reach a client safely, where a record is kept, or which colleagues you trust with referrals. A professional will for therapists is a written plan for how designated people will respond to clients' needs and manage your practice’s responsibilities if you become incapacitated or die. 

Thinking about a time when you can't be there for clients can feel uncomfortable. It also raises practical questions about who could help and what they would need to know. In a solo practice, a conversation with a trusted colleague or qualified adviser can be a manageable place to start.

Key Takeaways

• A professional will for therapists should include a person designated to take over your practice’s responsibilities and contact clients should you become incapacitated or die as well as a backup designee.
• Access arrangements to PHI and other sensitive information need legal and vendor input so the right person can obtain records through an authorized process.
• Client communication and care transitions should be planned around individual needs, preferences, and confidentiality.
• Retaining records, billing questions, and practice expenses are tasks that each need someone responsible for them. 
• A rehearsal with fictional information can reveal where the plan needs clarity, further detail, and next steps.

How a Professional Will Supports Continuity

The purpose of a professional will is to make sure that your clients and your practice will be taken care of and tended to appropriately if you ever become incapacitated or die.It gives designated colleagues clear instructions for responding to a professional emergency. Your personal estate plan addresses your personal affairs, while your professional will focuses on your practice responsibilities. Consider consulting an attorney familiar with healthcare practices and your state’s requirements to help develop or review the plan and coordinate it with your estate documents.

Client notification, referrals, confidential records, and business details all belong in continuity planning. Those responsibilities can be shared among several people or entrusted to one trusted colleague, so long as anyone involved possesses the right qualifications and authority. An attorney can help put the necessary legal arrangements in place and clarify who is authorized to carry out each responsibility.

The details will depend partly on your type of licensure and where you practice. For example, for social workers, the NASW Code of Ethics includes a clause that addresses continuity during service interruptions, including illness and death. The ACA Code of Ethics also includes a section on Counselor Incapacitation, Death, Retirement, or Termination of Practice encouraging counselors to prepare a plan in case of the counselor’s incapacitation, death, retirement, or termination of practice. 

You can begin drafting a professional will using a template and guidance from your professional association. Consulting an attorney familiar with mental health practice is recommended to help you address applicable legal requirements and determine whether additional documents or authorizations are needed to carry out your instructions.

Finding People Who Can Carry Out the Plan

Someone may care deeply about you and your clients and still not be a great fit for the role. Additionally, you may identify someone you think would do an excellent job but they do not feel up to the task. An honest conversation about the actual duties and the person’s capacity gives  room to make an informed choice. Additionally, you might consider asking more than one person to support your clients and practice if the situation ever arises. Clinical referrals, a lease question, and an accounting issue may fall to different people, so creating an arrangement with multiple people who can share the work depending on their strengths is something to consider.

Contacting clients after a therapist's illness or death can involve difficult, emotionally-laden conversations as well as administrative work. Working with landlords and practice management systems to work through details requires someone with strong organizational skills. Taking the time to discuss with someone what the role you are asking them to take on entails can help the potential designee understand what they are agreeing to.

These questions can help make that conversation concrete:

• Which duties the person accepts and which need another professional.
• How they would learn that the plan needs to be activated.
• Who would confirm their authority and answer legal questions.
• How compensation and expenses would be handled.
• Who would act if the first designee were unavailable.

Once the roles are clear, document each person’s responsibilities and when and how the plan should be activated. An attorney can help clarify any legal arrangements needed to support those roles. Make sure everyone involved has the relevant instructions, knows where to find the current version of the professional will, and has contact information for the others. A family member, for example, might notify the designated colleague without being responsible for accessing or reviewing clinical records.

Making Practice Information Available to the Right People

A person stepping in needs to know where to begin before a crisis happens. The appointment schedule, current client contact details, clinical and billing records, and professional contacts are useful starting points. Oftentimes, much of this information will be in your main electronic health record (EHR), although many therapists may use more than one online platform to run their business.

Alongside sharing on how to access each platform, the plan can explain what the information is for, who is authorized to use it, and how approved access would work. Sensitive details can stay in protected locations, with the plan pointing the right person toward them to use only if the situation ever arises, rather than appearing in every distributed copy.

How authorized access would work

For practices subject to HIPAA, the Security Rule requires safeguards for electronic protected health information, including procedures for authorizing access, access controls, and verification of users’ identities. Establishing these arrangements in advance gives your designee a clear process for accessing the information needed to carry out their responsibilities. An emergency does not automatically authorize family members, colleagues, or other helpers to access client records.

Your EHR and other vendors can explain their process for approved access after incapacity or death. Useful questions include what documentation they require, who reviews the request, what the designee could access, and how their activity would be recorded. Shared login credentials don't provide a substitute for that authorized process.

The designated person or people who would be managing your practice also needs someone to ask when access doesn't work as expected. Giving them a vendor support contact and a fallback contact is a wise next step. These questions connect with your broader HIPAA security risk assessment, which considers security risks across the practice beyond the circumstances covered by the professional will.

Who will look after retained records

Clients may still need their records after the practice has closed. Confirm the requirements for retaining records, responding to access requests, transferring records, and securely disposing of them. An attorney can help clarify which requirements apply to your license, practice location, and record types. Don’t assume that a colleague’s retention schedule applies to your practice, particularly if they hold a different license or practice in another state.

Having a named person for records requests gives clients somewhere to turn, with clear information about where and how long records remain and how to make contact. Before closing a software account, confirm how records will stay available for the required period and how any transfer will be secured. Canceling a service and disposing of records are separate decisions.

Helping Clients Through an Unexpected Interruption

For the person contacting clients, knowing what to say and how to say it is only part of the task. They also need to understand the contingency arrangement, the permissions for access to PHI or other authority that apply, and where those arrangements are documented. Additionally, someone who can provide useful referrals in an empathetic manner can help ensure the client’s care and well-being is prioritized. Discussing the plan during informed consent can give clients a chance to understand what would happen if you became unavailable.

Contact that respects the client's circumstances

Detailing a client's communication preferences in your paperwork can help the designee think about how to make contact with the client. For example, a client’s shared email account with their spouse might make an otherwise straightforward message inappropriate. Instructions for verifying the recipient and deciding what can be shared matter because a message could reveal a therapy relationship to someone else.

A qualified clinician can help determine which clients may need more immediate attention or risk assessment and help thoughtfully tend to the effects of the interruption. That level of attuned clinical judgment means this role should be given to a licensed therapist colleague you trust and that has capacity. 

A clear next step for continuing care

Clients need a way to understand how their care will be affected, whom they can contact if a crisis arises or they have questions, and how to request records or discuss continuing care. Where further care is needed, referrals should reflect the client's needs and preferences, relevant access barriers, and actual provider availability.

For a client who needs further care and who is feeling overwhelmed by the current circumstances of losing their therapist, receiving a list of names for new providers will likely only add to their burden. Recommend to your designee that they check the availability of options, including what insurances are accepted, and to step in and continue to guide the warm handoff process if an initial referral doesn't work out.Any record transfer still needs the applicable consent or other legal authority, with confidentiality requirements intact.

If you're planning time away with an expected return, a vacation policy can address that different conversation. Keeping those arrangements separate allows the professional will to focus on unexpected incapacity or death.

The Practice Details Someone Else Will Need

Alongside clinical responsibilities are the questions that keep a practice running: outstanding claims, client statements, balances, recurring expenses, office arrangements, and the website or telephone service. Document key account information and name a contact for each area so your clinical designee knows where to turn for help.

Your accountant, attorney if you have one, and professional liability insurer can help you plan for these responsibilities. Ask your insurer about notification requirements and how your coverage would apply if you become incapacitated, die, or close the practice. Reviewing your professional liability coverage can help you prepare for that conversation.

Coordinate the clinical designee’s responsibilities with those of anyone legally authorized to manage your estate or business. Make clear who will handle financial and administrative decisions and what authority they will need. Recording your wishes in a professional will does not necessarily give your clinical designee authority to access business accounts, end contracts, or distribute funds.

Knowing the Plan Can Be Followed

A plan may look clear on paper and still leave the person using it with questions when the time comes. Walking through it together before an emergency can give those questions an opportunity to surface while you are available to answer them. 

Walking through a fictional situation

A fictional client and a made-up interruption give you a way to run through the process with your chosen designee without unnecessarily accessing real client information. The designee can talk through how they would learn about the interruption, find the current plan, confirm their authority, and obtain information through the approved process. A vendor-provided sandbox or demo account may be useful for the access portion.

Seeing where a task leads

The walkthrough might follow how the fictional client learns an appointment cannot happen, determining where the client will be referred, and instigating a medical records release to the new provider when requested by the client. This process can help uncover gaps, such as missing permissions or outdated phone numbers and gives you an opportunity to resolve and troubleshoot them together.

Keeping the plan current

Dating different versions of the therapist’s professional will and keeping a corresponding dated note about what changed can help make the process easier to understand for all people involved. Changes in designees, software, therapy office locations and leases, practice structure, and other relevant requirements are reasons to revisit the plan, alongside an annual routine review. Making updates and engaging in a review is also a chance to check that your backup is still willing and able to help.

Frequently Asked Questions

How do you create a professional will for a therapy practice?

Start by listing the clinical and business responsibilities someone would need to handle if you became incapacitated or died. Choose willing, qualified designees and document their roles, instructions, and how the plan should be activated. Arrange the access and authority they will need to notify clients, support continuity of care, manage records, and address business matters. A professional will template and guidance from your professional organization can help organize the plan, and an attorney can help clarify any additional legal arrangements needed. Review the plan with everyone involved, walk through how it would work, and update it as your practice changes.

Does every therapist legally need a professional will?

It depend on the licensure type and jurisdiction, and an ethical continuity obligation doesn't necessarily prescribe a legal requirement. Your licensing board and qualified counsel can help you understand which current rules apply to your practice.

Can a spouse or family member carry out the plan?

A family member may be able to help with appropriate nonclinical responsibilities, depending on the arrangement. Confidential record access and clinical decisions should include a licensed clinician that you trust. Those boundaries belong in the discussion before a role is agreed.

Is a professional will the same as a personal will?

No. A personal will generally directs how your assets will be distributed after death and names someone to administer your estate. A professional will outlines how designated people should manage client care, records, and practice responsibilities if you become incapacitated or die. The two should be coordinated, and an attorney can help identify any additional legal arrangements needed to carry out your professional wishes.

How often should a therapist update the plan?

Changes in people, systems, practice arrangements, or systems are reasons to revisit the plan, alongside an annual routine review. Checking the process with the people who would use it gives the review more value and can make a big difference if the time were to ever come where it needed to be used.