Planning for Death or Incapacitation – What Therapists Need to Do: An interview with Dr. Robyn Miller, Ph.D.
Curt and Katie chat with Dr. Robyn Miller, Ph.D., of Theraclosure about professional wills and what therapists need to do to effectively plan for their own incapacity or death. She shares her experience stepping in as a practice executor for colleagues, the trauma that can result when therapists disappear without explanation, and the systems she’s created through her program to provide compassionate and organized transitions for patients. This is a conversation about professional wills, ethical responsibilities, and why planning for the worst brings peace of mind.
Click here to scroll to the podcast transcript.Transcript
(Show notes provided in collaboration with Otter.ai and ChatGPT.)
An Interview with Robyn Miller, Ph.D.
Robyn Miller, Ph.D. is a clinical psychologist practicing in Maryland since 2002, and she is the founder of TheraClosure, LLC, the first psychotherapist professional executor service. Dr. Miller trained at the Massachusetts Mental Health Center/Harvard Medical School and at Harvard University Counseling Center. She earned a Ph.D. from University of Rochester, and a B.A. from Tufts University. Psychotherapy interests include menopause transitions, eating and mood disorders, and trauma. Dr. Miller writes and trains clinicians on professional wills and the role of practice executor.
In this podcast episode, we talk about planning for a therapist’s unexpected absence, incapacity, or death
Too many therapists avoid thinking about what will happen to their clients if they can no longer practice due to sudden illness, incapacitation, or death. Dr. Robyn Miller joins Curt and Katie to discuss why it’s essential to have a professional will, and how to make sure you’re not leaving your clients without closure or support.
“I know [planning for our eventual death] is something most of us want to avoid, but my hope is in talking more about this, it can provide us with peace of mind, rather than anxiety or fear about the future. We can kind of know: Done it. We’ve done the right thing. We have a plan in place, and then we can relax.” – Dr. Robyn Miller
Why Therapists Must Plan for Death or Incapacitation
- The emotional and ethical risks of leaving clients without closure
- How many therapists make the mistake of ignoring this planning altogether
- Why this is a clinical—not just administrative—issue
What Goes into a Professional Will for Therapists
- Key elements: client notification, record management, referrals
- How to write clear, trauma-informed instructions for an executor
- Why a trusted colleague may not be the best executor, especially without a plan
The Role and Burden of a Practice Executor
- What it means to step in when a therapist can’t continue their work
- Real-world examples of handling patient outreach, records, and referrals
- Emotional, ethical, and time-consuming responsibilities involved
Creating a Plan that’s Clinically Thoughtful
“I think it’s hard, you know, as therapists. I think on one hand, we appreciate…that we forge these really powerful and meaningful bonds with people…You are important to your patient, and [it] does require us to to acknowledge that and then think about how to responsibly shepherd them from the care that you’ve…devoted so much into providing them to an absolute sort of nothingness where they then don’t know where to go, don’t know how to get help, might fall through the cracks..” – Dr. Robyn Miller
- Why some client populations need extra consideration in these plans
- Common mistakes therapists make with passwords, records, or contact lists
- The clinical benefits of giving clients an opportunity to say goodbye
Systemic Issues and Professional Responsibility
- How ethical codes call on therapists to plan for client care
- What happens when therapists don’t have a practice executor in place
- How Thera Closure supports therapists with both planning and execution of their professional weill
Action Steps for Modern Therapists:
- Create a comprehensive professional will that includes plans for client notification, referrals, and record handling.
- Identify and confirm a practice executor who can carry out your professional will.
- Share your will and executor information with your personal representative (such as a family member or partner).
- Consider enrolling in Theraclosure for professional executor support.
- Reach out to Thera Closure for a free consultation or to get started with a professional will template.
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
Instagram: @theraclosure
Relevant Episodes of MTSG Podcast:
Therapists Are Not Robots: How We Can Show Humanity in the Room
REPLAY – Therapists Are Not Robots: How We Can Show Humanity in the Room
Suicidal Therapists, An interview with Norine Vander Hooven, LCSW
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
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Connect with the Modern Therapist Community:
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Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
… 0:00
(Opening Advertisement)
Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.
Curt Widhalm 0:17
Welcome back, modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the things that go on in our practices, the things that go on in our lives, the things that we do to manage our practices. And while this is the Modern Therapist’s Survival Guide, this is an episode where we’re going to talk about planning for our own deaths, our own end of life, our own potential incapacitations, what we do with our practices, how we manage our clients, especially if those things are untimely. And along with this, this is an episode where we might talk about some things that might be difficult content. So listen to this episode with the right kind of care for yourself, and helping us in this conversation is Dr. Robyn Miller has a wonderful Theraclosure program, and here to talk to us about how to plan for the stuff that we don’t actually really want to talk about. So thank you very much for joining us today.
Dr. Robyn Miller 1:23
Thank you so much for having me Curt. I know it’s this is something most of us want to avoid, but my hope is in talking more about this, it can provide us with peace of mind, rather than anxiety or fear about the future. We can kind of know, done it. We’ve done the right thing. We have a plan in place, and then we can relax.
Katie Vernoy 1:46
This is a conversation I’ve wanted to have for quite some time. I had a close colleague who died. I also had another colleague who actually was on the podcast, a friend and colleague who had been faced with pancreatic cancer. We’ll link to Patty’s episode in the show notes over at mtsgpodcast.com. But before we get started, I wanted to ask you the question that we ask all of our guests, which is, who are you and what are you putting out into the world?
Dr. Robyn Miller 2:12
So I’m a psychologist. I have been in private practice in Bethesda, Maryland for almost 25 years, and that’s what I love to do. I’ll be in that really intimate and intense relationship with people that is so special and so powerful and meaningful. But in the course of doing what I love to do, I unfortunately had to step in for two close colleagues who were facing tragedies, and in the role of practice executor really had to trial by fire, learn what patients needed and how to provide that and as well as kind of the bigger picture. And so that has become a mission of mine, though we don’t want to think about it, really spreading the word to therapists about how important it is that we do consider our own mortality. If we value the relationship with our patients, and we think it has the power to be therapeutic, we have to also appreciate that it has the power to be harmful if it’s interrupted in a traumatic way. So that’s where I’m coming from.
Curt Widhalm 3:28
I’m guessing most people who get into this kind of a role, their first experience with it is not by necessarily well planned out intention. This is something that I want to do, but kind of, I think, like a lot of what I see with colleagues that I know, which is, hey, just in case anything happens, please. And I’m guessing, through a lot of that process, and since this is a podcast, and people can’t see things, Dr. Miller is nodding along very much. So I’m guessing that there are lots of things that you’ve learned along the way that are just mistakes that people make along this and so in helping our audience not have to make those same mistakes or learn things the hard way, what do you find that people generally get wrong in this kind of a process?
Dr. Robyn Miller 4:21
Well, the biggest thing is just not addressing it at all. That is the biggest get it wrong, where it really leaves, not only your patients, to face a, you know, blank door or a blank screen, if you’re doing video calls, wondering kind of what happened? Did you just give up on me? Are you, you know, you don’t care about me anymore. That kind of, you know, feeling of rejection that someone has to process until they eventually may share the news. They just doing something is the first, you know, good step. But that being said, when people you know say, Okay, I want to do the right thing, what is that? Our field has typically really left it up to each person to kind of figure out themselves, what that means, and even if you’ve had some ethics training, it’s typically pitched as an administrative matter that you need to be sure to fill out that paper at work and put it away for your practice. People don’t understand the clinical role of it, the importance of thinking clinically and bringing a clinical perspective to the interaction with patients that you’re going to be telling you know, a tragic, shocking news to and then how to help them move forward. So exactly what you said, Curt about this, you know, I think this historically has been as it was for me with my friend when we set this up, you know, more than 20 years ago. I’ll do it for you. You do it for me? Yeah, sure. And you know, we trusted each other and knew each other clinically, so already that was, you know, something powerful and good, and I was able to use that moving forward. But there was so much we hadn’t thought about and we hadn’t put into place, and so many challenges that come up without that written, very clear, actionable plan that really needs to be much more comprehensive than people realize, so that you can access passwords, so you can get into the information that you need to make those calls. The list goes on and on.
Katie Vernoy 6:35
So before we get into the logistics, I really liked what you were saying about the clinical elements of it, because it feels like for therapists, that’s the first thing that we’re going to think about if this responsibility falls to us. How do I interact with clients clinically? We don’t need to go into it deeply. We’ve got other conversations about it. But I’m curious what your thoughts are on how how we think about the clinical elements of our incapacity or death?
Dr. Robyn Miller 7:08
So I think we have a few responsibilities. One is to know our clients, the kind of practice we have. So someone who has a practice full of people with grief and loss or trauma, they are going to really need to plan very carefully for each patient, knowing that that’s their vulnerability. They might plan in a different way than someone who sees people you know, for three sessions for an evaluation or a short term kind of course of treatment. So knowing your style, knowing your what you bring to the table, what you believe about and use the relationship as part of your treatment. The more the relationship is part of the treatment, the more comprehensively you need to think about the impact that your sudden absence will have on this person who is reliant on you, who you mean a lot to. And I think it’s hard you know, as therapists, I think on one hand, we appreciate you know, that we forge these really powerful and meaningful bonds with people, but on the other you know, either out of being self deprecating, or, you know, we kind of go, well, they’ll be okay. You know, they’re high functioning. They’re they’re, you know, people will be okay. And that may be true depending on your measure, but you are important as a therapist, you are important to your patient, and does require us to to acknowledge that and then think about how to responsibly shepherd them from the care that you’ve trained for and devoted so much into providing them to an absolute sort of nothingness where they then don’t know where to go, don’t know how to get help, might fall through the cracks. Some are feeling burned, and I had one person tell me when I had to notify her, very sadly about her therapist’s loss. She said, I will never see another therapist again. I poured my heart out to this person for 12 years, and now I’m supposed to go see someone else? Clearly, you know, coming from a place of trauma and a very painful reaction that that person later sent me an email, sort of apologizing, and, you know, saying they regret that reaction. But of course, it’s understandable. It’s an abandonment. So really, what I am talking about is, you know, though, of course, none of us can help it. We’re not intentionally abandoning people, and of course, we can’t promise to be everything for everyone all the time. We are creating relationships where people expect us to be there, and we hold their secrets and we hold their history, and we hold a whole lot, and we want to prevent them from feeling rejected and from the loss of all the therapeutic benefits that we’ve worked so hard on in the treatment. Because if they feel like we didn’t care, we didn’t care enough to put a plan in place. We didn’t care enough to leave referrals. We didn’t care enough to make sure their records are secure and that they might be able to have access to them the next time. Then it it affects how they hold the therapist and the therapy moving forward, and it can be damaging to them. I have had people tell me, you know, I love my therapist so much, but I was so angry that I never got a call that he hadn’t had anything in place that no one even told me that he died, and I found out two months later, so angry, how could he not have cared enough about me to have any thought in mind? And so you know that part of the clinical piece is also like, what do you want to leave people with if a tragedy happens. You want them to, sure, feel sad and mourn and it’s difficult, but do they have to be traumatized at the same time? Does it have to be a traumatic loss, or can it just be a sad loss? They’re different.
… 11:34
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Curt Widhalm 11:37
I’m thinking about the number of clients on therapist’s caseload that could potentially be there, as well as significant people that could have been treated in the past. And it sounds like there could be the potential to end up having to write a lot to whoever is the executor of the professional will about each and every one of these clients. That takes a lot of thoughtfulness to be able to convey that beyond just saying, hey, contact this person. Let them know that I’m dead and I’m no longer a resource.
Dr. Robyn Miller 12:13
Yeah, there are so many things involved in being the practice executor, and especially if you are doing it for someone that you do have a close relationship with, as has happened to me the first time where my very closest therapist friend and peer supervision partner of 17 years, got sick and died seven weeks later. And in the tragedy of that, and reeling emotionally with my own loss of her, then I did have to not only call 30 weekly patients and tell them as sensitively as possible, while holding back my own feelings as much as I could about this loss, and then help them with referrals and try and provide some support. And many of them called me multiple times. They wanted to know updates before she died. They wanted to know whether they could attend a memorial service. They wanted to, you know, have some way of communicating gratitude. So I was in touch with them a lot during this period leading up to her death, and then afterwards, and then exactly what you’re saying past patients too often come back. And each jurisdiction has different laws about what our obligations are, not only about record retention, but notification when the custody of the record changes. So for example, I had to write all the past patients saying, I’m writing to inform you that the medical records from the practice of Dr B have been transferred to my custody, and if you should need access to them in the future, feel free to reach out to me and please let me know if you’d like more information. I wasn’t going to put it in the letter to people who maybe hadn’t seen her in six years, but had to get you know that, so that they knew where to find their letter their medical records. So there’s a lot of work to be done for current and past patients as well, and then finding the referrals. As you can imagine, I hear so many people just looking for a therapist, who say I called 10 people and no one has openings, and I can’t find anyone. The practice executor needs to step in and find good matches with availability for all those people all at once. I mean, it’s a huge, time consuming job. The alternative and what happens when people either don’t have a will or haven’t really specified what they want someone to do. The minimum that happens all the time is something happens to a therapist their neighbor, at least, if we’re talking about physical office space, their their neighbor puts a note on the door saying patients contact this other therapist for information, and then they may or may not call the other therapist. Some just won’t. And I have an experience with a man who just never did he thought, Oh, she probably had an emergency. I’ll come back next week. And this was someone that I had learned in a different situation, that his therapist had died, and I called and reached out to him, and he had said, Oh, I saw a note on the door, and I just didn’t call. And was devastated to kind of hear this, but in any effect, but the minimum is they might get a notice by a note on the door, and then they might get from a colleague, here’s a list of three people in the community, I suggest three people who are probably not the right fit or suited for the right, you know, diagnosis or issue, and may not have any openings at all, but you’ve done your duty. If you’ve said, here’s a couple names. So to do it right, you know is, I think, really thinking about each person and what they need, and as much as you can ahead of time and writing your will, have a good list of referrals, lots of people who you respect in the community that you would want your executor to be able to reach out to and say, Hey, do you have the capacity to take one of these patients from this practice? and to go through a list and try and find the matches. And alternatively, you know, as the practice executor, we have to tap into our own networks and find our own referrals to try to match people with but I think that is a very caring thing to do. And one of the things that people who just think about a professional will as an administrative matter don’t really think about, and so it’s very, very time consuming and really intensive, and is kind of the whole first phase of stepping in as a practice executor is to take care of current patients. That’s the very first thing priority that needs to happen. Then there are other steps that happen as well. But the first thing is, you know, getting all that current patients need in place for them.
Katie Vernoy 17:41
As you’re talking, it seems like there is a lot of work to do this really well, and there’s a lot of thought that can go into it and and best practices have potentially a dynamic professional will that has some sort of information about current clients or different as things change, the will gets updated, all those kinds of things. And so I think we can, can talk about that again in a minute, but I’m curious about kind of the bare bones. What are the ethical obligations? What are the what are the things that, if we can’t get all the way to best practices, what do we need to make sure that we’re doing right away, that we’re doing at a minimum when we’re planning for the unexpected.
Dr. Robyn Miller 18:24
So, when we’re planning, we need to create a professional will. That’s a document that is really for your personal representative, because your practice goes to your estate. They immediately, they are the ones who actually own your practice now, but they are probably not the people you want to have to deal with it and to interface with your patients, because they’re not prepared and they’re grieving, and it’s a huge burden to leave to family. So a professional will kind of says, Hey, personal representative, I want this colleague who has agreed to be notified as soon as something happens to me, and they’re going to step in and take care of my practice, they are going to notify all my patients, they’re going to try to provide them with referrals, and they are going to ensure the confidentiality of all the medical records. Those are the minimum that’s the most important pieces of your ethical obligation to your current patients and to the confidentiality of their records.
Curt Widhalm 19:36
So I’m sure at this point, many listeners are saying, what are the nuts and bolts that also go into this? Because there’s okay my surviving partner now needs to say, hey, therapist friends, go execute this. And what should we leave behind for our therapist friends to be able to actually be able to do this with all of the intention that you’re suggesting that we do here.
Dr. Robyn Miller 20:06
So I encourage people to really think about your highest functioning patient and your lowest functioning patient. Hold them in your mind like don’t think about this abstractly. Think about your practice and your own patients, and what will happen to each of these two people if you do not show up tomorrow, if you don’t answer their calls, if you don’t reply to their emails, what are they going to feel? What are they going to need? What are they going to do? Some patients may become suicidal. Some patients may get very withdrawn. Some patients might get very angry. You know, they’re waiting, waiting, waiting. And I have recently interviewed a whole number of therapists who have lost their own therapists in traumatic situations. So they are, you know, really on the inside, and they are telling me, you know, with such despair, even remembering it sometimes 25 years later, tears in their eyes about the pain that that period of time where they didn’t know what happened to their therapist, and where were they, and that anxiety and often feeling rejected that comes, that how terrible that really has been. So thinking about, how are your patients going to react? What do they need? How do you want them to be informed? Who is going to do that? The who is huge. It takes a huge amount of time, and a lot of it is very urgent. For example, you want to get to patients as quickly as possible, if you can, so that they aren’t banging on the door or waiting for someone to show up. But I reached out to people whose appointments were coming up tomorrow the day after first saying if I couldn’t reach them, leaving a message saying I’m covering for Dr B, and unfortunately, we need to cancel her appointment that’s scheduled for tomorrow, please call me. You know that would be the first message that I would leave and the only information that would be left. But then, when you’re speaking to people, then it’s okay what do you want them to be told? How much medical information would you want shared with your patients? Some people want nothing. Only say it was a medical issue. Other people, like my friend said, say that it is terminal pancreatic cancer. I want them to know there is no hope. I don’t want them to fantasize that I’m going to be okay. I want them to know what it is. And so people have their personal preferences. You want to communicate that, and it may have a lot to do with your style, in how you interact with your patients anyway, in the therapy. So you want to have that said you want to put down would you be comfortable having patients come to your memorial service? Because patients will ask, what happened? Can I come? Is there a service? So you want your representative to know your wishes. You want them to know, where are your records? How do they access them? If they’re electronic, what are your passwords? How do they get the two factor authentication that so many of us have now? How are you going to update your passwords? Even if you make a list of them somewhere, are you going to remember every time you’re prompted to update your password, to go back to that list and update it. You don’t want to make a plan, and then somebody can’t get to your schedule or your patient contact list. So really thinking through the fine details about how’s it going to work? People who keep paper calendars, you know, how is the executor gonna get your schedule. Thinking it through in great detail. If you have a group practice, what’s gonna happen to not only your patients but your employees? Who’s gonna pay the rent, keep the lights on and do payroll until your estate can figure out whether to sell your practice, or whether the employees are going to buy it or step in. So you want to appoint an administrator who, on your death, agrees to step in and do the basics so that your entire practice isn’t, you know, completely unable to run the very next day. All the details take it all the way through, about what happens if you’re not there.
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Katie Vernoy 24:52
How much of this gets written into a professional will, and how much is whether it’s like a group practice standard operation procedures. Or in a personal will, or, like, where does all this information go? Because it seems like if something happens suddenly, there’s very basic information that needs to be shared immediately. If it’s something that’s a diagnosis, even if it’s a short period of time, like weeks, there’s still an opportunity, potentially, to have some conversations and talk through the caseload and talk to your executor about what you can do. And so to me, it’s Where can this information be housed? Because it sounds like we’re talking about a pretty long document, potentially with client information, which I don’t think was what you’re saying. So where does all of it go?
Dr. Robyn Miller 25:37
So a professional will is not your last will and testament. It’s actually not even a legal contract, unless both people sign it, your executor. So a lot of people say, I’m gonna appoint my professional neighbor to be my executor. Well, if they don’t sign that, they actually have no responsibility. And a lot of this operates on good faith, and most of us in good faith want to step up for our friends and colleagues and to do our best, but without realizing how much is involved and how much work. So even if someone says, I’m going to do all this for you, they may be on vacation, they may have their own personal crisis. They may be overwhelmed with their own patient emergencies and not have the time to do all these best practices, and they might, you know, have to do the minimum, and sometimes that’s the best we can do. That’s just life. But you can set down as best as you can what you want people to do, and that’s what the professional will is for. So you document, not patient details, not patient identifying information. You could put down patient initials or a birth date or a code number if you want your practice executor to know specific information about patients and how they should be handled, but don’t put identifying information in there. But you do want to specify exactly what I’ve been through already, kind of all your preferences and referrals and who needs to be notified and how you want it handled, and where the records are and where they can find the passwords and all of those things, and you want to give a copy to your personal representative, your partner, your best friend, whoever is going to be the first person to learn that something happened to you. They need to know that one of the first things they have to do in their grief is to contact the practice executor and say you’re on, some tragedy has happened now here’s the document. They should have it too. The practice executor should have their own copy. But once they’re notified, then they’re going to look at that and they’re going to say, Okay, what did I agree to? What am I going to do? How am I going to step in and they’re going to take over and do all of those things. And with EHRs, it’s easier than it used to be, because we can access calendars and contacts and client files without actually going into someone’s office. So you know, you want to be sure that you set someone up to have the information they need to access that. And also, if you have paper then you need to have a plan in place where someone can go and get your paper, files and documents.
Curt Widhalm 28:35
Beyond kind of the situations where there’s been no plan in place, what kinds of things have you come across that have surprised you in this kind of work, either things that were thought to be well intentioned, that didn’t quite play out well, or things that were brilliantly thought out that you hadn’t considered before?
Dr. Robyn Miller 28:55
Yeah, absolutely. So one of the saddest situations I’ve come across a few times is people get notified by text message that their therapist has died by someone who thinks they already know. How awful. Can you imagine? I’m so sorry to hear. What a loss. Wait, what are you talking to me? I don’t know what you’re referring to. Oh, wait, you didn’t know your therapist died. How. How tragic. So that I’ve heard that story a couple of times when there’s no plan, when someone doesn’t ever hear from anyone ever again, and they find out like on a list serve, or an obituary, or never, what happened to their therapist. I have heard so many people never know what happened to their medical records, where they are. You know, there are stories of therapists who, you know, have kept boxes of records in their basement for 40 years. What happens if you’re not there tomorrow? Who is going to get rid of those records safely and securely? And do they even know about the rules of confidentiality, or are they going to put them on the curb? You know, your state’s then open to liability because your records are not handled according to law. So there are so many, you know, really surprising things that have been unfortunate. And then I’ve also heard stories where people have had the opportunity to say goodbye, if possible. And of course, that’s not always or often possible, but when there’s a chance to say goodbye, even a phone call, a brief phone call, or a last short visit, an opportunity to see the therapist, to say what they’ve meant to them, that means a lot. And I have heard people say my therapist handled it beautifully. It was a tragic situation, and it was really painful and hard for me, but she handled it beautifully. What more could I have asked? You know, people are not expecting your therapist to do everything in the world for you, but there is kind of a minimum of care given what we do and how vulnerable people are in our work that I think needs to be happen, needs to happen. So there are some really lovely and thoughtful situations that I’ve
Katie Vernoy 31:35
learned about. So you created a program called Thera closure. What is it and how does it work?
Dr. Robyn Miller 31:41
Well, having we had the experience a couple times, and seeing how challenging it is, I started to give some talks, and the reactions I got from other therapists were like, oh my god, I never thought about this, or I don’t know how to do that, or I don’t know who to ask. And so I work to find solutions to all of these obstacles, because I, you know, I did a survey, and almost 70% of therapists don’t have a will, even though it’s in our ethics across disciplines, no matter what your training, this is part of our obligation. So how come so many people don’t do it? Well, it’s hard. It’s really hard and overwhelming and confusing. So wanted to simplify all of that for people. So Theraclosure is a therapist’s professional executor service where people who would like to enroll, we meet with them for an hour. We really want to know you and your style and the kind of patients you see and how you relate to them. And then we go through all the details of your practice, many of the things I’ve talked about today, about how to get access in very detailed, concrete ways, to all your information, to your preferences and so forth. We put all of that into a professional will that the therapist reviews, makes sure it’s what you want it to be, and then you sign it, and we sign it. And so now it’s a contract where we are on retainer as your practice executor. We are named as the practice executor. You don’t have to beg a friend. You don’t have to promise a friend. You aren’t going to be you know, worried about whether someone is too busy to actually do all the things that you really hope that they would do. We provide that service so people can be completely at ease knowing that if we were notified by your personal rep that something happened to you, we are immediately available and have the time and the resources and the capacity and are not, you know, bogged down by personal, devastating grief that really interferes with the ability of a good friend to do this, you know, job. We can step in with expertise and professionalism and do all those things. We can go to the EHR and we have a solution for paper records as well. But we can log in. We have a password manager that we give you that tracks all the passwords so you don’t have to worry about making sure to update them all the time. Then we go into the EHR. We look at your calendar, we start calling people in order of their upcoming appointments, so that we hopefully catch them before they are banging at the door. We talk to them in a clinically minded manner. We are not taking them on as patients ourselves, but we’re using our clinical skills to assess how they’re handling the news, what they need. We are, you know, available to support them until we’re able to connect them with a good referral. We tap into the referrals you left. If necessary we use our own networks to find referrals for people once the current patients are taken care of in that way, we move to notifying all the past patients, taking custody of the records. And then we go a step further, and we also handle all the administrative aspects of the practice. So if you are owed money for services rendered, who’s going to send out those bills, or is your estate kind of forfeit what you’re owed? We will do that, and we will close down all of your auto pays that are you know related to your practice, and we will change over your voicemail and your internet letting anybody know that if they’re looking for your practice they should come to us. We will notify licensing boards, malpractice insurance. We will do everything we can to help your personal representative with the practice and business related things so that they can grieve, and your practice is in the hands of people who know what needs to be done to close it appropriately.
Curt Widhalm 36:14
Where can people find out more about you? I know we usually do this at the end of the episode, and I’ve talked about professional wills and stuff before, and in retrospect, I spoke about 2% of the considerations that people should have in their professional wills. And I am so glad to be a part of this conversation, and will be immediately coming back to my group practice and saying, Hey, we have a whole bunch of stuff that we have to change going on here. So any people, including maybe people who are on this podcast, where can we find out more about Theraclosure?
Dr. Robyn Miller 36:52
So we have lots of information on our website, which is Theraclosure, T, H, E, R, A, closure, C, L, O, S, U, R, E .com, you can read all about us. You can see exactly what we do and how we work and what we are promising. We are we have a yearly fee to keep us on retainer the first year there’s a small additional fee for the one hour consultation and the creation of the professional will that is on file and that names us as the practice executor. And then each year, there’s a fee to retain us, and you have access to the client portal. You can update your information anytime you want, as you know your caseload changes, there may be specifics that you want to update. We remind you a couple times a year to do that. You don’t have to worry about finding a template on the internet and whether it’s actually legal or whether it’s going to suit your practice. You don’t have to pay $1,500 to an attorney to write the will for you, but do nothing else. You still, then would have to find someone to do all of the work for you, and we do all that. So it’s a fixed cost up front where you know exactly what your obligation is, and there’s not going to be any surprise to your estate, because if you do it in an informal arrangement, sometimes the colleague will bill the estate hourly for the work as a professional executor. And lots of people make this agreement in writing, even because people think, Oh, it’ll take two or three hours. So of course, my state will compensate you for your time not realizing that it’s going to take 20 or 40 hours to actually do all the things that I’ve described, and then your estate is going to get a $10,000 or $15,000 bill that they owe your colleague who just spent 40 hours working on your behalf. So in order to avoid that, you know, it’s you can kind of control a small cost up front to know that everything would be taken care of in the event of of an accident.
Curt Widhalm 39:03
And we will include a link to Theraclosure in our show notes over at mtsgpodcast.com. Follow us on our social media, join our Facebook group, the Modern Therapist Group, to continue on or start this conversation if you haven’t started thinking about this already, and until next time, I’m Curt Widhalm with Katie Vernoy and Dr Robyn Miller.
Dr. Robyn Miller 39:27
Thank you so much. Can I add one more thing before we go? I am happy to provide for listeners either a template of a professional will or a free consultation to you know, see if Theraclosure is right for you, and to give you any tips if you want to handle it on your own, so feel free to reach out to me and let me know you heard about us from this podcast.
Curt Widhalm 39:51
Wonderful. Thank you so much.
… 39:52
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