[Folding]

Does anyone know what the ethical expectations are for continuity of care in a situation where a therapist suddenly becomes unable to see clients?

I've read a little on professional wills, which ensure that there is someone to contact clients in these events and provide notification that the therapist is unavailable as well as referrals for other therapists, temporarily or permanently. What I've read also mentions that failure to do this could be considered abandonment.

Does anyone have any insight on this?

[Yaowen]

Those are good questions. I imagine it varies state to state by the state law in one's state. A lawyer could help but it could be pricey. Public libraries often have official books on state law. One might be able to call a reference desk at a public library and ask them to find the answers you seek. That would be the least expensive route I would think. Sorry I don't know the answer myself. Hope you find what you are looking for.

[ArtleyWilkins]

I’m sure much depends also on length of absence. A few weeks is not out of the ordinary for an illness. I would doubt backup is a requirement for that short a time period.

[Folding]

Originally Posted by Yaowen

Those are good questions. I imagine it varies state to state by the state law in one's state. A lawyer could help but it could be pricey. Public libraries often have official books on state law. One might be able to call a reference desk at a public library and ask them to find the answers you seek. That would be the least expensive route I would think. Sorry I don't know the answer myself. Hope you find what you are looking for.

Thanks for the ideas. I'm not really looking for laws so much as I'm just trying to guage appropriate expectations.

[ScarletPimpernel]

I don't think not having a professional will constitutes abandonment. Nor being out for an illness. And even if you feel your T abandoned you, it's up to the courts and/or board to determine that, and it's hard to prove.

ETA - The 3 referrals can be anybody. Ex-T picked the first 3 Ts in my area off of psychology today... She put no effort into it.

[LonesomeTonight]

I mean, mine offers me a backup T (which I've used before) if he's going to be gone for a week because he said he otherwise thinks of it a "abandoning his practice." But I get the sense that's unusual, as many people mention their T's going away for planned vacation (let alone illness) for multiple weeks without any sort of backup offered. I'm not sure what he would do in the case of sudden illness (or worse), though I know he has something setup where his wife (not a therapist) would contact his clients to inform them, as I asked about it once (I refrained from asking what if something happened to both of them).


I know if a T terminates, at least in the US, they're supposed to offer a few referrals. I'd think if they knew they were going to be out for an extended period of time they'd at least ask clients if they wanted to see someone else and offer a few names, ideally contacting those T's to try to get their clients to the top of any waiting list. Though there is a therapy shortage in some areas, made worse by the pandemic, so that could complicate things.

[Folding]

Originally Posted by ScarletPimpernel

I don't think not having a professional will constitutes abandonment. Nor being out for an illness. And even if you feel your T abandoned you, it's up to the courts and/or board to determine that, and it's hard to prove.

ETA - The 3 referrals can be anybody. Ex-T picked the first 3 Ts in my area off of psychology today... She put no effort into it.

This is what I read: "What duty does the psychotherapist owe to his or her clients to plan for the client’s care in the event the therapist is killed, severely injured or otherwise rendered incapable of treating or notifying clients? The therapist owes both an ethical and a legal duty to plan for the handling of his or her clients in the case of his or her sudden and unexpected death. Failure to have a plan in place for the continuation of therapy with another psychotherapist may be considered an abandonment of the client."

What To Do When a Therapist Dies

I'm not sure why lawyers or courts have entered this conversation.

[Folding]

Originally Posted by LonesomeTonight

I mean, mine offers me a backup T (which I've used before) if he's going to be gone for a week because he said he otherwise thinks of it a "abandoning his practice." But I get the sense that's unusual, as many people mention their T's going away for planned vacation (let alone illness) for multiple weeks without any sort of backup offered. I'm not sure what he would do in the case of sudden illness (or worse), though I know he has something setup where his wife (not a therapist) would contact his clients to inform them, as I asked about it once (I refrained from asking what if something happened to both of them).


I know if a T terminates, at least in the US, they're supposed to offer a few referrals. I'd think if they knew they were going to be out for an extended period of time they'd at least ask clients if they wanted to see someone else and offer a few names, ideally contacting those T's to try to get their clients to the top of any waiting list. Though there is a therapy shortage in some areas, made worse by the pandemic, so that could complicate things.

From everything I'm reading, I think your T has it right. I think ethically they are supposed to have a plan in place for continuity of care should something happen. I've never worried much about having a back up in place because breaks were always planned and never more than 2 weeks, but now that I've been left in limbo for 5 weeks and counting, I'm going to ask that there always be a back up therapist planned.

Because of my experience, I encourage you to have a further conversation about what would happen if something happened to him and his wife. I initiated the conversation at the beginning of the pandemic, and accepted the answer of "I'd text you." Now, living through the "what if something happens" scenario, I wish I would have asked for a more thorough plan.

[ScarletPimpernel]

If you're questioning what's ethical and what's abandonment, that's up to the board and/or courts to decide.

My ex-T terminated with me, I feel, was unethical and abandonment. Many many others have agreed. But when I reported her to the board, they didn't agree and they didn't tell me why. There are many stories on these forums of unethical Ts or Ts who have abandoned their clients. That is why I bring up courts/board of psychology.

I didn't include L's "backup" plan. Her professional partner is who would be contacting me if anything happens to her. L and I have already agreed I'd go back to T for therapy if something happened. And if/when she goes on vacation and someone is available, I have my choice of T, a colleague, or an ex-group T. I'm lucky to have T as backup.

Both T and L know what I went through with ex-T and I trust it is never their intention to abandon me. Both have proved to be honest and dependable. I am lucky to have both of them.

ETA: It's up to the courts or board to decide if you wish to take action against your T.

[SprinkL3]

I'll send you links from the American Psychological Association later. I replied to your other post though. You could report your T to the licensing board. Her license number should be available online, as it should be public.

I would also report the institution to the licensing board as well, since they lacked finding you an adequate replacement. Waiting 3 months for a T to return is not good for any client, no matter how busy they are, etc. They should have just found you a replacement from the start, and your T should not have placed the burden of her problems on you by telling you specifically what she's struggling with and asking you to wait 3 months for her return. What if she never returns, and you spent all that time waiting? That's not fair to you or your mental health needs.

I'd find a new institution to treat your mental health problems. If it was through a healthcare insurance plan, contact the healthcare insurance as well to see if you can transfer to a different organization. That's horrible what you're struggling with. It's hard for most people to find a therapist, or to afford one, but even harder once you are connected and bonded with a T and then that T just isn't available anymore. I feel bad for the T going through all that she's going through, but the way this has worked out was unethical, it seems.

[East17]

I'm in the UK so I know things will be different here.

My ex-T had to leave her practice due to serious illness. She had no backup plan in place and we didn't have the chance for a proper closure session. It was devastating and hit me really hard emotionally.

My current T has two named people who in the event of her suddenly being unable to continue working, would contact all her clients to let them know and suggest alternatives if appropriate.

So there is a wide variation in practice here.

Is there anyone at your therapists practice whom you could get in touch with, or do they work alone?

If you haven't heard anything from them in 5 weeks, and have a way to contact out of session, I would say it wouldn't be unreasonable for you to enquire what is going on for them, so you can make alternative arrangements if necessary.

I hope get some answers soon. Being left in limbo is a horrible place to be.

Sent from my SM-A526B using Tapatalk

[Folding]

Originally Posted by ArtleyWilkins

I’m sure much depends also on length of absence. A few weeks is not out of the ordinary for an illness. I would doubt backup is a requirement for that short a time period.

I wasn't asking in terms of a specific situation, but rather in general.

As for the need for a backup, wouldn't that depend more on the client's needs, rather than the length of absence? Also, is there a difference between a planned leave of absence that includes informing the client vs an unplanned absence where the client in uninformed?

[Folding]

Originally Posted by ScarletPimpernel

If you're questioning what's ethical and what's abandonment, that's up to the board and/or courts to decide.

My ex-T terminated with me, I feel, was unethical and abandonment. Many many others have agreed. But when I reported her to the board, they didn't agree and they didn't tell me why. There are many stories on these forums of unethical Ts or Ts who have abandoned their clients. That is why I bring up courts/board of psychology.

I didn't include L's "backup" plan. Her professional partner is who would be contacting me if anything happens to her. L and I have already agreed I'd go back to T for therapy if something happened. And if/when she goes on vacation and someone is available, I have my choice of T, a colleague, or an ex-group T. I'm lucky to have T as backup.

Both T and L know what I went through with ex-T and I trust it is never their intention to abandon me. Both have proved to be honest and dependable. I am lucky to have both of them.

ETA: It's up to the courts or board to decide if you wish to take action against your T.

I think we're coming from different places and maybe I'm using the wrong terminology. I have no desire to report my therapist for anything. Yes, I'm in a situation that is horrible for me, but I have no doubt that it happened more from a lack of planning than from a deliberate act. I'm trying to wrap my head around what is supposed to be required of therapists in terms of planning for situations where they are suddenly incapacitated or die unexpectedly, in order to advocate for myself and others. No one likes to think about situations where horrible things happen, but when those situations can negatively impact your clients, it seems to me that some forethought is necessary. Especially during a pandemic where people are literally going from healthy to dead in days! And especially when you work with clients who have a trauma history.

You are fortunate to have a continuity plan. From what I'm reading, that should be the norm.

[Waterbear]

Please excuse me if this is obvious, but which country are you from? I have experience of the UK situation and ethical standards as I lost my T abruptly earlier in the year, so can offer some input of you are in the UK...

[Omers]

T1 shared an office space with another T who was tragically killed in a car accident. That T had not made any arrangements for their clients. T1 called them all to tell them of the accident and attempted to offer referrals if needed.

If something happened to one of the T’s I see then another T in the building would reach out to their clients if no other arrangements had been made.

[Folding]

Originally Posted by Waterbear

Please excuse me if this is obvious, but which country are you from? I have experience of the UK situation and ethical standards as I lost my T abruptly earlier in the year, so can offer some input of you are in the UK...

I'm so sorry you've experienced such a loss. I'm not in the UK but I am interested in hearing your experience if you feel comfortable sharing.

[Folding]

Originally Posted by Omers

T1 shared an office space with another T who was tragically killed in a car accident. That T had not made any arrangements for their clients. T1 called them all to tell them of the accident and attempted to offer referrals if needed.

If something happened to one of the T’s I see then another T in the building would reach out to their clients if no other arrangements had been made.

I'm so relieved to hear that your T's have someone that would notify clients and that your prior T took care of that for their office mate. I feel like this is a part of therapy that the potential impact on the client isn't consider often enough, or maybe thoroughly enough.