Over the past several months as we have adjusted to the COVID-19 pandemic, we have gone through some incredible changes. The way we do private practice has shifted, and needless to say, we are doing things much differently in terms of our contact with clients and how we conduct our sessions.
As many of us are making the transition back to the office after several weeks of doing exclusively online therapy, we're rethinking things a bit. We're thinking about things not only from a health and safety standpoint but also in terms of our ongoing business models. There are some general guidelines we can follow (tons of information from APA and other organizations), but ultimately the decisions have to be made by the practice owner and their staff about when and how to do all this.
The truth is, and we all know this, COVID is going to be with us for a while. It has changed our “normal.” But the silver lining might just be that it is causing us to think more creatively about how we do business and provide our services that are so needed. In fact, for some, it has opened up opportunities to serve in new ways.
For many clinicians, the switch to conducting sessions via telehealth was a new challenge. In that sense, it has been good for many to learn the technology and some new skill sets. Fortunately with our professions as mental health clinicians, the shift to telehealth has been fairly easy for most. Although not the same as in-person therapy, virtual and video sessions are clinically effective. And the truth of the matter is that conducting telehealth sessions is probably going to be much more of the “new normal.” I think it is here to stay.
Making the decision to see clients again in your office needs to be an informed decision. Although the exact time to do that is uncertain for sure, it can be data-driven to some degree. The concentration of COVID cases is, of course, varied depending on location, so it is important to know the data for your area. If the number of COVID case concentration is high, it is probably a good idea to hold off transitioning back to the office for in-person sessions.
Use your local and state guidelines as a baseline, and allow your own sense of things to be a guide as well. If you are uncomfortable with seeing clients in person, it is okay to “follow your gut” and hold off on things for a while; continue with online/telehealth sessions.
It’s fairly obvious that during this whole COVID-19 season we are in, people are expecting that things will be different. They expect that there will be changes in our policies and procedures. We have to communicate this to them in different ways.
Consider calling each of your clients to let them know of the changes in your office policies around seeing clients in person (wearing masks, waiting their cars, etc.). Create signage for your office door that notifies people of the changes in policy.
This can actually be a “win-win” for both clinicians and clients. As we have discovered during the COVID-19 pandemic, where many of us were doing all telehealth sessions, it was more convenient for both clinician and clients in terms of commuting and getting to sessions.
Many insurance companies have made telehealth a permanent option for their policyholders. Being able to offer this to clients as an ongoing option makes sense on many fronts. It also has the advantage of less exposure to potential spread of the virus.
Make sure, too, that you communicate to your clients that if they are not feeling well, have a fever, or have been potentially exposed to people with the virus, that you will not see them in-person. Stick to online sessions.
Taking client’s temperatures and requiring that they wear masks is an option. Again, you will need to follow local and state guidelines for that and what you feel is best for your client’s and your safety.
The other thing we have to consider for our offices is the time it takes and ways in which we are keeping our offices clean and disinfected. We have to allow for extra time between sessions and be able to manage the flow of people in our offices to make this happen. It is a good idea to add a greater buffer time between sessions. This not only will give you time for cleaning and disinfecting between sessions, but it will also limit the amount of contact your clients might have with each other between sessions.
Evaluate where you sit in conjunction with your clients. Look at rearranging things so that you are six feet apart if you are not so already. Depending on the size of your waiting area, you may need to remove chairs. Encourage your clients to wait in their cars until you are ready to see them, and simply call them when you are ready.
Another part of keeping things safe is doing your best to make things as touchless as possible; for example, having paper towels or tissues to use for door knobs along with having hand sanitizer available for clients and for yourself.
For intakes and paperwork, take advantage of the client portal in TherapyNotes™ and have clients do as much as possible online before coming to the office.
One thing to keep in mind is the importance of drawing on supports during times of transition and crisis. As you think about transitioning back to the office, find out what colleagues in your area are doing. Checking with other practice owners about their plans can give a sense of support and give you the opportunity to share ideas and information.
During these strange times we find ourselves in, it is important to embrace the changes that are occurring. Now more than ever, your services are needed. I am reminded of the Fred Rogers quote about looking for the helpers in times of crisis. We are helpers.
Remember to allow yourself some flexibility and be willing to do what is best to keep your clients and yourself safe. Pay attention to self-care and do what you feel is best for your practice and your clients. If you are uncomfortable about going back to the office, wait if you can. Your clients need you at your best. Educate yourself and follow the best practices based on data and research.
* The content of this post is intended to serve as general advice and information. It is not to be taken as legal advice and may not account for all rules and regulations in every jurisdiction. For legal advice, please contact an attorney.