It is difficult to think about becoming incapacitated or dying (DeSpelder & Strickland, 2014); it’s not something most people think about, and that includes art therapists working with clients in private or group practice. What would happen to your clients if you were suddenly gone?
For many art therapists working in well-established agencies or hospitals, there is a procedure in place for the transfer of care, ensuring the continuity of care for your clients. But what if you are a sole practitioner? Several questions immediately surface such as, “What would happen to the clients who had appointments that day? Who would notify the clients of your situation? Where will your clients go for therapy in the coming weeks?” and “What will happen to their records?” Over time, more questions will likely arise such as, “What will happen with the accounts payable, and accounts receivable?” The answers to all of these questions focus on the importance of creating a professional will, securing a records custodian, and planning for a streamlined succession of care for your clients, while maintaining confidentiality to the best of your ability. This will ensure that the welfare and well-being of your clients will be adequately addressed and protected. Moreover, by doing so, you will be complying with the ATCB ethics code sections that pertain to this situation and I will focus on four:
- Creating a professional will.ATCB Code 1.1.9 specifically addresses having a professional will in place and states: Art therapists shall make all attempts to ensure there are procedures in place or follow recommendations for a “professional will” that suggests the handling of client documentation and art, if applicable, in the event of their unexpected death or inability to continue practice. Art therapists shall recognize the harm it may cause if clients are unable to access services in such a situation and identify individuals who can assist clients with obtaining services and with appropriate transfer of records. These written procedures shall be provided to the client.
- Securing a records custodian and establishing a cohesive plan of succession. ATCB Code 1.1.7 states: Art therapists must not abandon or neglect clients receiving services. If art therapists are unable to continue to provide professional help, they must assist the client in making reasonable alternative arrangements for continuation of services.
- Maintain confidentiality to the best of your ability.ATCB Code 2.1.1 states: All therapists shall inform clients of the purpose and limitations of confidentiality. If something were to happen to you and you have a records custodian in place, then the client would need to know that the records custodian will have access to client information should you suddenly become incapacitated or die. It is recommended that this information be given at intake (Wheeler & Bertram, 2015).
- Since state laws vary, it is important that each therapist conform to laws of their specific state (Remley & Herlihy, 2016). ATCB Code 1.1.13 states: Practitioners of art therapy must conform to relevant federal, provincial, state, and local statutes and ordinances that pertain to the provision of independent mental health practice. Laws vary based upon the location of the practice. It is the sole responsibility of the independent practitioner to conform to these laws. Art therapists shall be knowledgeable about statutes and/or laws that pertain to art therapy and mental health practice in any jurisdiction (state, province, country) in which they practice.
Let’s look at this more carefully. What exactly is a professional will? A professional will “is a document that gives details for the treatment of clients when the clinician is absent due to retirement, death or serious illness” (Bradley, Hendricks & Kabell, 2012, p. 309). The professional will should clearly outline what should happen going forward by asking a trusted colleague who will oversee that clients have continuity of care and manage all of the professional details related to caring for your clients and its related logistics. That trusted colleague is often referred to as a records custodian or professional executor. Attorney Dean Dietrich (2018) emphasized and acknowledged that making plans for one’s own incapacity or death can be difficult, but it is important to do because “Solo practitioners must prepare to protect clients’ interests in case something happens to [that] solo practitioner.” (Deitrich, 2018, p. 60). He recommended that the solo practitioner and the records custodian make an agreement, develop a procedure, all of which would be in writing and signed by both parties so that the expectations and procedures are clear to both parties (Dietrich, 2018). Additional information worth including is stating where keys to the building/office are located, how to log into accounts and files (including access to passwords, safes and filing cabinets) and detailing where to find other sensitive information necessary to ensure continuity of care for clients. Additionally, Wheeler and Bertram (2015) noted that the records custodian should not be a close friend, or relative and said that if the therapist “meets an untimely or sudden death, the surviving spouse, significant other or close family member or friend is often left with the task of winding up a practice without much guidance and during a time of personal grieving” (pp. 255-256).). Wheeler and Bertram (2015) also recommended addressing this issue at the time the practice is forme
Things that you can do:
- Develop your own professional will. Bradley, Hendricks and Kabell (2012) provided a sample professional will in Appendix A of the resource below. They noted that “it is our ethical responsibility to prepare a professional will for to do so otherwise could result in harm and/or abandonment of the client” (p. 312).
- Seek the agreement of a trusted colleague to serve as your records custodian who will oversee the implementation of your professional will so that there is a cohesive transfer and continuity of care in the event that you are incapacitated or dead.
- Meet with that records custodian to develop procedures and explain any logistics that will provide optimum protection of client confidentiality, ensuring continuity of care.
- Contact an attorney who will document the professional will and the corresponding agreement so that it will be legally filed so that if something should happen, this legal protocol is in place.
- Inbed into your intake and consent to treat documents language whereby the client consents for you to designate a mental health professional of your choosing to take possession of the client’s records in the event of your death or incapacity and serve as the custodian of those records.
Katy Barrington is a Registered and Board Certified art therapist (ATR-BC) and a Certified Thanatologist (CT). She earned her PhD as well as a Certificate of Aging Studies from Florida State University in 2008. Dr. Barrington is interested in death education and has worked with older adults as well as families involved in hospice. She is currently an Associate Professor at Adler University in Chicago, Illinois and has authored two book chapters each focusing on her work. Dr. Barrington has presented at conferences in the United States, Singapore, Ecuador, Italy, and South Korea. She continues to advocate for seniors and those who are marginalized.