An Interview with a Client
Professional Clinical Wills recently had the privilege of speaking with a client who went through an incredibly difficult and unexpected experience, the very kind of situation we exist to help prevent. Their therapist stopped practising suddenly, and while a clinical will was activated, it did not provide the care, continuity, and protection the client needed at such a vulnerable time.
The experience had a lasting emotional impact on the client and highlights how profoundly endings, especially unplanned ones, can affect our clients. To protect confidentiality, we have used the names Chris (the client) and Alex (the therapist). In this interview, Chris shares what it was like to learn of their therapist’s sudden death and the impact it had on them.
We offer this account as an invitation for clinicians to reflect on our professional and ethical responsibility to plan for unforeseen endings, and to consider how the robustness of our clinical wills can shape clients’ experiences at some of the most vulnerable moments of their lives.
How long had you been working with your therapist?
Chris: I had been working with Alex for around 10 years, initially for two sessions a week and then later weekly sessions.
What did that therapeutic relationship mean to you?
Chris: The relationship was possibly the most significant relationship I have had with anyone.
What role did your therapist play in your life at that time?
Chris: They were a critical and central role in my life throughout therapy. However, and with hindsight, thankfully, at the time of their death, we had been working towards a change as I was planning on moving away from the area where they practiced. We talked about my move but not about how it would affect our relationship or what sessions would look like going forward. We had not discussed finishing sessions, I think I was avoiding bringing it up as endings are hard for me.
How did you find out about your therapist’s death?
Chris: Initially, I got a text message from a number I did not recognise. They said they were a colleague of Alex and informed me Alex was not able to see clients and would not be seeing clients for the foreseeable future. I replied saying thank you for letting me know and I asked if they could pass on my sincere thanks and best wishes to Alex. At that point I assumed that was the end of our sessions, that Alex was unwell and would not return to seeing clients. But in my mind, I thought this was a temporary pause and they would be in contact in the future when they were well again. At this point I was sent some information about other therapists I could contact by the person who sent the text message.
So, you were not told your therapist had died?
Chris: No, just that they were not able to see clients for the foreseeable future. There was no indication what had happened so I assumed Alex was unwell, which at the time might have been the case, I don’t know.
How did you find out your therapist had died?
Chris: I found out through a friend (who is also a therapist and was aware of the situation) that my therapist had died and under very distressing circumstances. They just happened to come across the news in a local media report. Thankfully they saw it first and were able to break the news to me at a time when they knew I could be supported.
I then sent a text message to the person who had contacted me, asking if I could speak with them. I wanted them to confirm my therapist had died, I was in shock and I don’t think I really believed the news, I needed to know if this was true and if they could give me any more information.
What a shock that must have been, can you tell me what you were feeling?
Chris: I was very confused, and upset. I worried about Alex, wondering if they had been unwell when we were working together? I then felt a sense of guilt that I had brought my stuff to them but all the time they might have been in pain.
I had a real sense of loss and concern about what was wrong with them, and a confusion about how this could happen, that they could die so suddenly and without there being any awareness from me. That made me feel guilty that I had not noticed their illness.
What did you do with those feelings, where did you take them?
Chris: I reached out to the only contact I had for my therapist, the person that texted me, I asked if they could give me any more information. I respected Alex’s privacy but, trying to make sense of the situation, I thought knowing more about what happened would help me process my feelings.
It was only then I realised this person was another therapist as they offered to see me for a session. I was reluctant as I did not feel right discussing my feelings with, to me, a stranger. There was also no transparency around when or where the session would be and if there would be a fee. I declined the session.
So did they help you find another practitioner?
Chris: Not really, they sent me the number of a generic practice in a location that is very expensive. I had been seeing Alex at their home practice out of town and on a lower rate. It was also not a practice suitable for what I was working on. It just did not feel very considered or thought through.
I also felt that the work I had done with Alex over 10 years could not be replicated with someone else. I didn’t want to start again and go over my entire backstory.
What were you told about the notes and personal data your therapist held on you?
Chris: Nothing was said about my notes. I knew there were notes, and I had provided personal material over the years, but I had no idea what happened to them.
Did that worry you?
Chris: Yes I was concerned because there was some highly personal and sensitive information in the notes. No information had ever been given to me about what would happen to my notes in a situation like this. I had placed a lot of trust in my therapist, and by implication I trusted whoever Alex had chosen to close down their practice. I assumed it would be handled appropriately. However, even years later, I still wonder whether my deeply personal information is sitting in a filing cabinet or on a hard drive somewhere. To this day I don’t know where it went.
Were you given any guidance or support after their death?
Chris: Very little. Other than a referral to a generic practice. I felt quite angry at how little thought had gone into the referral. There was no explanation as to why these particular people were suggested. It felt dismissive and unconsidered, as though my needs as a client had not been thought about. I don’t know if that was because my therapist did not make plans or if it was the actions of the person they had chosen to deal with their practice in their absence. Either way, it didn’t feel good.
You talked about feeling confusion, tell me a little more about what was confusing and how you handled that?
Chris: I didn’t know who the person contacting me was, they did not identify themselves as being another therapist. I had been seeing my therapist for over 10 years so I would have liked perhaps a bit more information about what had happened to them. I understood about respecting their privacy and even if they could not have told me, just the way in which that was conveyed could have been handled with more sensitivity. I would have also liked to be told what happened to my notes, even if it was just to say they would be confidentially destroyed.
How did the sudden loss of your therapist affect you emotionally or practically?
Chris: I was coming towards the end of therapy anyway. In a strange way, this forced something that was going to happen eventually. It brought about the ending of therapy, the choice was taken away from me and I didn’t have to make the decision myself. That said, I would have preferred it not to have happened this way.
Did you feel there was anyone responsible for checking in with you?
Chris: No, there was no on checking in, but I was fortunate to have a good support system around me that I could talk to.
How did this experience affect your trust in therapy or mental health systems?
Chris: It really shook my trust, especially when I found out the circumstances of my therapist’s death. I think I would have lost faith in psychotherapy altogether but for talking to a friend who made the observation that despite how Alex helped me, they were not able to help themselves. This helped me remember we are all human, and we all have our struggles. Even those who might seem to be ok can still be in pain. This helped me come to terms with what happened.
What was lost for you when the therapeutic relationship ended this way?
Chris: I felt that ten years of work was, not lost as we had still done that work together, but I lost the person who knew all those things about me. I lost an important point of contact. I felt a huge sense of grief, loss and guilt.
Tell me more about the guilt you felt?
Chris: Although I did not know it at the time, my therapist was clearly struggling when I was having sessions, yet they were always available and willing to help me, even while being in pain themselves.
I wished I could have helped them in the way they helped me. I know that’s not how that relationship works. But therapy is like holding up a mirror to yourself — and when the mirror starts cracking, it’s human to worry about the mirror too.
I also think the greatest sadness was I was not able to say thank you to Alex so they could know how much they had done for me.
What helped you get through the period immediately afterward?
Chris: My partner was very understanding and supportive. I was in shock and I had so many questions that I knew would never be answered.
Did you seek another counsellor?
Chris: No. I didn’t want to open up a new relationship just to process what had happened.
So how did you process it?
Chris: With time. I also tried to find out more about the circumstances of their death because it was in the local news. I contacted the coroner’s court, but they wouldn’t disclose any information. That left me with a lot of anger because I still had unanswered questions.
Looking back, what do you wish had been handled differently?
Chris: Firstly, I wish Alex had not died, secondly, I wish I could have said thank you, and thirdly, if it did happen, I would have liked more thought placed on who I contact for support.
Even in these extreme circumstances I would have liked to feel that my needs had been considered when recommending other therapists. This would have made a difference. And of course, I still do not know what happened to all the information Alex held about me, was it destroyed or kept?
What do you think people misunderstand about losing a therapist this way?
Chris: Clients need a sense of closure and an appropriate ending. That ending doesn’t have to mean “here is another therapist.” It could be the opportunity to say thank you or goodbye.
Would you have wanted to attend their funeral or memorial service?
Chris: Yes, if that had been appropriate for the family. At the very least, I would have liked to send flowers or for Alex’s family to know that they were appreciated beyond their immediate circle, that their work meant a lot to people.
I later found out a bench had been placed in a local park in Alex’s memory. I visited it and left some flowers. It felt cathartic and gave me an opportunity to say thank you in a place I felt close to Alex. Their family had chosen the spot so presumably it was somewhere Alex liked.
What would you want clinicians or organisations to understand about the impact on clients?
Chris: It is incredibly important for clinicians to think seriously about the provisions they put in place to support clients if they are unable to practise. This is a really important part of being a therapist, and I am honestly astonished that it is not more thoroughly regulated.
I was fortunate that I could process what happened. What about people who aren’t? Being told “here’s a number” does not meet the needs of the client that might have struggled to find a therapist in the first place, took a risk to start opening up and then have to do that again having lost the one person they trusted. I think therapists perhaps lose sight of what it is like to be a client sometimes.
How are you feeling right now after talking about this?
Chris: A bit rattled. Even though this happened a number of years ago, it’s still with me. I wish it had been handled differently. It’s sad to think that if Alex knew this was part of their legacy, they would probably feel quite sad about what happened.
Their real legacy is the work we did together. I have to remind myself to hold onto that, rather than focusing on how it ended. I am sad that I never got to thank Alex for the work we did and how they transformed my life. There were some things I had planned to do when we ended but I didn’t get a chance to do that.
Are you happy to share these with me?
Chris: Yes, that would be nice, thank you. I had found a card, probably only a few years into our work that I knew I wanted to give to Alex at the end of our time working together as it reminded me of something they said. There was also a song that I wanted to play that had lyrics that really represented the change that had come about because of our sessions.
Do you have any final thoughts about what we have spoken about today?
Chris: I remember my therapist saying when they took on clients they always thought about how long the therapy would last as they wanted to be around for the client as long as they needed. This was reassuring for me to know that it was an enduring relationship and I got the sense they would be there for as long as I needed them and after.
They intended to be around for me, but it just goes to show, you never know how life is going to happen. It is testament to the work we did that I am now in a place where I can deal with what happened, had it been earlier in my work, I’m not sure how I would have coped with this.
Thank you so much Chris for all that you have shared.
If you would like to hear the song Chris wanted to play to Alex in their final session it can be listened to here: The Shapeshifters - Lola's Theme (Radio Edit)