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 stay-at-home orders. 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 to figure 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. 

Evaluate if you and your clients can continue remotely.

In most cases, it was with minimal consideration that 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. Providers who choose to do so should plan ahead and stay up-to-date with local, state, and federal guidelines.

What to Consider to Resume In-Person Therapy

As mentioned above, having a plan is key to resuming in-person therapy. Here are a fewconsiderations 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 that would make you the most confident and effective as you take steps forward.

The same compassion you extend to your clients, you must first extend to yourself. 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. Your clients will be better off if you do so.

2. Update your policies and protocols.

Assess the needs of your therapy 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 successfully.

• 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.
• Assess building protocols. Inquire about and consider the protocols for the building where you rent. It is critical that your operation protocols align with local, state, and federal regulations. Check with your health department to ensure you are operating appropriately. Finally, discuss ventilation with rental owners to ensure the ventilation within the building is safe.
• Create new policies. Consider what new office rules you will need to implement. Determine what you will require of your clients and the protocols in place, such as temperature checks, notification of positive COVID-19 test results, or the number of people allowed in a session.

3. Update your paperwork.

Update policies and procedures to reflect best practices established by healthcare related associations and government agencies.

• Update your intake paperwork. What do you need to know to make informed decisions about your in-person interactions?
• Consider your liability waiver. Check with your liability insurance to ensure you have the appropriate coverage and if there are suggested updates to your waiver.
• Cancellation policy. How do you want to incorporate COVID-19 into your cancellation policy?
• Social Distancing Protocols. Refer to COVID-19 guidelines from Centers for Disease Control to create sustainable plans and policies to reduce your risk. Additionally, determine how you will create a therapeutic space that helps clients feel safe. Create a plan that accounts for waiting areas, time between clients, and how clients enter and leave the building.
• Add 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.

4. Buy additional safety and cleaning supplies.

Once you are back in-person, provide things like hand sanitizer that will help both you and your clients feel safe.

• Buy CDC-approved cleaning products approved by Centers for Disease Control. 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, they must be diluted with water and replenished every 24-hours.
• Sanitizing versus Cleaning. Sometimes you will want to clean surfaces as best as you can in quick time, and other times you will want to more carefully sanitize your office. Determine a set schedule for when you will do each. Consider what areas and objects will be exposed to clients to determine the amount of housekeeping necessary. Then, determine what you will outsource and what you will do yourself.
• Consider financial impacts of cleaning. How much can you set aside to buy new cleaning supplies. Will you have to schedule fewer appointments so you can have more time in-between sessions to sanitize or clean your office?
• Get creative with your space. Create more ventilation in your office by opening windows that you can open without creating a risk to privacy. Change up your furniture to make it easier to clean. Move out shelves to allow you and your client to sit a little further apart.

As you resume in-person therapy, keep evaluating what is working, what makes you feel safest and what is most valuable to you and your practice.

See more helpful tips for therapists here.