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Draft:Clinical will

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  • Comment: Please see my previous comment. Needs better / more secondary sources discussing the topic to show that it meets the notability criteria for an article. Mgp28 (talk) 17:15, 22 August 2024 (UTC)
  • Comment: I suspect this topic is notable but I suggest trying to find better secondary sources. Reference 1 is good. References 4 to 6 are regulators discussing their own regulations (and reference 6 discusses "suitable arrangements for the responsible care of clients" but doesn't mention clinical wills) so do not seem to be secondary sources. Reference 3 leads to a file-not-found error.
    I note you have declared a conflict of interest. Is this for a relationship with ClinicalWill.app? The links to the app are to pages trying to sell a product so do not count as independent sources for the assessment of topic notability, and their presence in this article feel a bit forced. I suggest trying to write the article without links promoting that product. Mgp28 (talk) 16:38, 14 August 2024 (UTC)

A clinical will.[1], sometimes known as a therapeutic will, is a set of instructions made by a therapist, counsellor or other helping professional, usually working in private practice, which lays out what should happen to their practice if they are unable to work due to sudden or unforeseen circumstances.

In particular, a clinical will is intended to allow for clients undergoing therapy or counselling to be notified if their therapist or counsellor is unexpectedly unable to continue working with them. As part of a therapist or counsellor's duty of care towards their clients, the need for a clinical will is reflected in the ethical codes of most bodies that govern and regulate the practice of psychotherapy and counselling in many jurisdictions.

Purpose and contents

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The primary purpose of a clinical will is to provide clear instructions on how to handle important aspects of a therapist or counsellor's practice in circumstances in which they are unable to do so themselves, typically in cases of sudden, serious illness or death[2]

Primarily, these instructions allow for important clinical tasks to take place in line with ethical and professional standards, although clinical wills might typically also include instructions for tasks related to administrative or business aspects of a therapist or counsellor's practice. A clinical will typically includes:

  • Provision for clients to be appropriately notified in the case of an unplanned change in the therapists or counsellor's circumstances, as part of a therapist or counsellor's ethical responsibility to prioritise their clients' wellbeing and safety. For clients currently in therapy, this might involve arrangements for another therapist or counsellor to work towards an appropriate ending or offer ongoing support. In some cases, a therapist or counsellor might also want past clients to be notified.
  • Details of other clinically relevant people, such as supervisors or supervisees, who need to be notified in the case of a change in the therapists or counsellor's circumstances.
  • Instructions for the management or deletion of client records and other confidential information, to ensure compliance with data protection regulations, and relevant legal and ethical standards.
  • Instructions on how to handle administrative or business-related matters, such as outstanding business payments, bank accounts, insurance policies, rented rooms, membership of professional bodies or groups, or details of other businesses directly related to a therapists or counsellor's practice.

Ethical considerations

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The creation, maintenance and execution of a clinical will requires careful consideration of various ethical, clinical and regulatory factors, including:

  • Client wellbeing and safety - a therapist or counsellor's duty of care extends to circumstances in which they are not able to manage an appropriate ending to their with a client themselves. Furthermore, a clinical will should ensure not just that clients are notified of an unplanned change in their circumstances, but that any contact is carried out by a person who is clinically and professionally qualified to do so. Therefore, the person nominated to carry out a therapist or counsellor's instructions, known as a clinical trustee or executor[3], is usually another therapist or counsellor with the relevant clinical experience, training and qualifications to act in this capacity.
  • Clinical confidentiality - client information contained in a clinical will falls within the limits of clinical confidentiality. For this reason, a clinical trustee or executor will be considered to be working within the bounds of confidentiality in the event that they access the client records contained in a clinical will.
  • Data storage - all records relating to clients in therapy must be stored in line with the relevant data protection regulations, and with client confidentiality in mind. In some jurisdictions (for example those covered under GDPR), clients also have the right to know how confidential data relating to them is stored and who has access to it.
  • Ethical codes - many licensing, governing or accrediting organisations, such as the APA (United States), BACP, UKCP, BABCP and BPC (UK), CCPA and CPCA (Canada), IACP (Ireland) advise or require licensed or practicing therapists and counsellors to have a clinical will, usually as part of formal codes of ethical and professional standards[4].[5][6]
  • Impact on family and friends - as well as considering the impact of an unplanned ending on clients in therapy, a clinical can also be planned to reduce the impact on the family or friends of a therapist or counsellor who falls ill or dies, by reducing the administrative burden they might carry in such circumstances.

Practical considerations

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As well as containing all the information a clinical trustee might need, a clinical will needs to ensure that a clinical trustee is able to access the information when needed. Therefore, hardcopy or digital records need to be easily accessible by a clinical trustee, and a suitable mechanism for notifying the clinical trustee must be in place - for example, by instructing a relative or friend to contact the clinical trustee in the event that they need to act as intended.

At the same time, the information stored in a clinical will must be stored in line with data protection regulations and ethical considerations around confidentiality, meaning that access to client records must be restricted to the clinical trustee.

A clinical will needs to be up to date so that it is not missing client details or information a clinical trustee will need. Equally, a clinical will should not contain client details or information that is out of date.

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References

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  1. ^ "Where there's a will, there's a way". www.bacp.co.uk. Retrieved 2024-07-25.
  2. ^ "ClinicalWill.app". clinicalwill.app. Retrieved 2024-07-25.
  3. ^ "Professional Trustees". British Psychoanalytic Council. Retrieved 2024-07-25.
  4. ^ "Your Professional Will: Why and How to Create" (PDF). www.apaservices.org. Retrieved 2024-07-25.
  5. ^ "BABCP | British Association for Behavioural & Cognitive Psychotherapies > About > Governance and Policy > Policies and Documents > Clinical Wills". babcp.com. Retrieved 2024-07-25.
  6. ^ "The Irish Association Code of Ethics". iacp.ie. Retrieved 2024-07-25.