Resuming “In-Person” Therapy
What can I do to prepare for reopening my practice and resume “in-person” therapy? This question is at an ultimate rise among mental health professionals. It has been about 6 months since states began to lift the “stay at home order”. As a result, many are desiring to regain some normalcy in their lives that includes being face to face.
With all the information at your disposal, it can be overwhelming figuring out where to begin in making such a transition. Moreover, we understand and want to provide you with a framework to get you started on your journey. One that weighs the pros and cons and provides a starting place to move forward.
The Gap Between What it Has Been and Where it is Going
In most cases, it was with minimal consideration clinicians were forced to abruptly transition to TeleMental Health services. Now having adjusted to the change, many have come to enjoy the flexibility of working remotely.
Although it is with assumption, we would venture to say there are numerous reasons to remain virtual. The fact remains, clients prefer “in-person” services. It is just something about being face to face that brings a unique dynamic to therapy.
While there are recommendations to continue providing therapy remotely to reduce transmission, it is not mandatory. Resuming “in-person” therapy is within the scope of legal and ethical guidelines. With the stipulation that each provider has a plan in place and follows local, state, and federal guidelines established.
We must be clear: Although we are providing information compiled from various healthcare related associations and government agencies, we are not advocating one way or another. It is imperative that you plan, plan, plan and remain up to date with guidelines surrounding COVID-19.
What to Consider in Planning to Resuming “In-Person” Therapy
As mentioned above, having a plan is key to resuming “in-person” therapy. To emphasize, here are the Top 5 considerations we found to be most critical to making the best decision for you and your practice.
1. Start with You!
It is imperative that you start with yourself in considering the change. Process through your feelings, discomforts, and risks. With this in mind, consider the boundaries and what would make you most confident and effective as you take steps forward. There is no guarantee that you will not contract the virus from a client. However, the probability increases as does your exposure to other people.
2. You are a person too.
The same compassion you extend to your clients, you must first extend to yourself. Additionally, we are always reminded of this truth when we take a flight, “Put Your Air Mask on First”. You must help yourself first before you can help anyone else and your clients will be better off if you do so.
3. Your practice is a business, as well as a service.
Assess the needs of your business. Specifically, be secure in what your needs are personally and as a business owner. This can empower you in maintaining a practice that operates successful.
- Conduct a financial analysis. This will assist in determining hours of operation, business financial health, new business expenses and establishing financial goals.
- Create a timeline. Consider how long the timeline will take and how you will do it. Then consider the volume of your practice. Lastly, factor in turnover rates of clients. As you plan, maintain a mindset that always attempts to minimize exposure. Take it slow!
- Consider the dynamics of your practice. The route you take will look quite different as a solo practitioner than if you are in a group practice. Creating a schedule and following social distancing protocols will depend on the traffic within the practice. Consider the type of therapy you provide and how it will impact social distancing.
- Consider the location of your practice. Be informed of COVID-19 “high exposure” areas.
- Building protocols. Firstly, inquire and consider the protocols for the building where you rent. It is critical that your operation protocols align with local, state, and federal regulations. Secondly, check with your health department to ensure you are operating appropriately. Finally, discuss ventilation with rental owner to ensure the ventilation within the building is safe.
4. Assess the risks or “in-person” therapy, determine readiness, and set policies.
Determine if it is necessary for you to resume practicing “in-person”. Your first obligation is your duty to “do no harm”. Thus, using your clinical judgement, you must decide what would be most beneficial to your clients. Execute diligence in your documentation in whatever are your findings.
- Update your Intake Paperwork and Liability Waiver. Update policies and procedures to reflect best practices established by healthcare related associations and government agencies. Specifically, consider what new office rules you will need to implement. Determine what you will require of your clients and the protocols in place (i.e. COVID-19 screenings, COVID-19 testing, when client has tested positive, clients commitment to reduce exposure outside of sessions, persons allowed in sessions, etc.).
- Financial sustainability. Consider if you will need to update/change cancelation fee schedule. Check with your liability insurance to ensure you have the appropriate coverage.
- Social Distancing Protocols. Refer to the CDC and WHO guidelines to create sustainable plans and policies for social distancing and reduction of exposure. Additionally, determine how you will create a therapeutic space that accounts for social distancing and clients therapeutic experience. Create a plan that accounts for waiting areas, time between clients, etc.
- Signage. It will be helpful for your clients to have “reminder” signage throughout your practice that identifies your protocols and procedures as they relate to COVID-19.
5. Safe-Proofing Your Practice For “In-Person” Therapy
This is the most critical step and will take the most planning and consideration.
- Best practice is to use CDC approved cleaning products. Cleaning products must follow the EPA-Approved disinfectants, classified as EPA-List N: Disinfectants for Coronavirus (COVID-19). If unavailable, the CDC approves bleach products can be used. However, must be diluted with water and replenished every 24-hours. For more information visit the CDC website.
- Sanitizing versus Cleaning. There will be equal time given to sanitizing and cleaning, it will just look different. The sanitizing/cleaning schedule will vary depending on the office usage. Determine what areas and objects will be exposed to clients to determine the amount of housekeeping necessary. Then, determine what you will outsource and do yourself.
- Consider financial sustainability. Determine the cost of supplies and time allotted to cleaning. These factors may create more of a financial need/burden.
- Consider alternative options. Create more ventilation in your office by opening windows. To maintain productivity consider supplying masks to clients, if necessary. Overall, get creative with your furniture. For instance, increase “easy to clean” surfaces. Also, you can update your website and marketing language. The CDC has a self-screen widget you can add to your website to make the screening process easier for clients.
When considering resuming “in-person” therapy there are many factors to consider. Therefore, evaluate what is currently working, what are you lacking, and what is most valuable in your practice. Furthermore, the key to making the best decision stands in weighing what is most beneficial for you, your business, and your clientele.
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