Strategies for Counselors Transitioning Back to In-Person Care

COVID-19 required non-essential businesses to shut down, including psychological and addiction services. As vaccination rollouts ensure more people received vaccination against COVID-19 and states relax their quarantine regulations, you may ask yourself if it is safe to re-open your practice. The American Psychological Association promotes the continued use of telehealth services and outlines ways to re-open your practice safely posted on their website.

You can feel unsure and question whether it is time to re-open and see your clients face-to-face safely. There are ways to make sure you, your staff, and your patients remain safe while in your office. The Centers for Disease Control (CDC) have created guidelines for businesses to re-open safely. The procedures include hygiene, staff, and patient safety.

Tips for When to Re-open

The decision to resume face-to-face sessions should consider the age of those you see, how your community deals with COVID-19, and all personal and professional risks. Other aspects to consider are:

• Any underlying condition you, a family member, or a patient may have
• The demographics of your patient population; their work, health, or any behaviors that could place you at an increased risk
• Consider the size of your office, the air conditioning or heating ventilation, and space shared with others

Review Forms

Before you start taking patients in your office, review your malpractice insurance and your patient consent forms. Make sure your malpractice insurance will cover any incidents of COVID-19. Your patient forms should reflect the increased risk of face-to-face treatment and include information about COVID-19. If a patient agrees to your terms for resuming in-person therapy, they will sign the forms signaling they give informed consent. Have clients fill out forms that release you from COVID-19 liability and necessitate the patient to say whether they have COVID-19 or any symptoms.

Before you decide to re-open, send an email to your patients informing them of your decision to resume face-to-face sessions. Include in your email your safety precautions, new policy, procedures, and any form they need to sign before they come to your office.

Regulate In-Person Treatment

Some patients can insist on seeing you in your office; you are not ethically obligated to see them in person. After reviewing their chart, you can decide whether or not they require a face-to-face appointment. Encourage your patients to continue telehealth appointments if you feel it is best for you, your staff, and others. Take into consideration if the patient is sick, visits places that increase their risk of catching COVID-19, if they are at an increased risk of catching the disease (health issues), their workspace, or has traveled recently.

Review your patients’ charts and think about which patients would benefit from face-to-face therapy. Once you determine, this subset of patients offers them the option of resuming in-person treatment. As you become more comfortable with patients in the office, you can slowly invite other patients to return to in-person therapy.

Protect Your Space

As you begin to accept patients in your office, take an inventory of the safety precautions you have in place.

• Make sure you have enough personal protective equipment (PPE)  available to you and your staff. Allow yourself extra PPE to be open to clients who don’t have masks.
• Take temperatures of your staff and patients each day or time they come to see you.
• Update your policies and procedures to reflect COVID-19 regulations and your safety precautions.

The CDC’s guidelines for cleanliness include regular disinfecting of all public spaces and any other spaces or objects that were used or touched. Thoroughly clean your office every day. Cleansers with soap, bleach, or detergent are the best at breaking down the virus. You can also:

• Hang signs requesting patients to practice hand hygiene once they enter the office.
• Implement a screening procedure that includes disclosing symptoms of COVID-19.
• Place hand sanitizer in public spaces and at the entrance to your therapy space.
• Have tissues available.
• Adapt your seating to allow for 6 feet of space between you and your patient.
• Your waiting area is another spot to consider. Do you want patients to wait inside or wait in their car or outside space? Let your patients know beforehand.
• Limit the number of people who may enter the office. You can determine if you will allow a visitor to attend the session. In some cases, like family therapy or couple therapy, it is vital to have those involved in a face-to-face session. You can apply the same policies and procedures to the visitors as you do to patients and staff.

Employees should also practice proper health measures. Ways to decrease the risk of infection are:

• Implement a policy that discourages them come to work if they are sick. You may have success with this request if you also provide more sick time.
• If an employee doesn’t need to work in the office, continue telework policies
• Avoid sharing keyboards, phones, or other equipment
• Make available PPE, tissues, and trash cans
• Limit travel

Have a COVID-19 Infection Plan

Even if you are safe and try to ensure your patients and staff follow your policies and procedures, there’s a risk someone can enter your office with the illness. The CDC recommends the following steps to help you with a possible COVID-19 infection:

• Inform employees and patients of possible contact with a person diagnosed with COVID-19
• Have exposed employees quarantine for at least seven days, optimally 14 days
• Provide telework options for those possibly infected
• Follow the Public Health Recommendations for community-related exposure

With the proper safety precautions, you can re-open your practice and see clients face-to-face again.

The decision to resume in-person therapy treatment can lead you to consider what is best for you, your patients, and your employees. Mitigating the potential for harm is vital for a successful re-opening. Following the health and safety protocols set forth by the CDC and Public Health officials creates a secure environment. When you decide to resume therapy in person, review your patient charts and determine who will benefit from in-person care. Re-opening your office in a way you feel comfortable with is your right as a provider. Take the time you need to prepare yourself, your employees, and your patients for the new policies and procedures. The focus of your re-opening should reflect your commitment to patient care and safety. At Alta Centers, we believe patients deserve the highest level of care. Our location in Los Angeles allows us to provide a healthy community environment that includes safety. Call (888) 202-2583.