Five Considerations for Returning to In-Person Sessions

The world is changing again. With lotteries to promote vaccinations springing up across the country, a patchwork of mask-mandates that vary city by city, and millions of Americans hopping on airplanes once more, developing a personal and professional plan for returning to in-person activities is imminent.

We’ve seen the desire to return to in-person therapy trend upwards, too. Since March of this year, new clients coming to SonderMind who want to see a therapist in person vastly outnumber those who are looking solely for Video Telehealth.

Deciding when and if you are ready to offer in-person sessions is an individual decision. The first place to start is reviewing the most recent CDC guidelines, as well as your local and state guidelines. It’s also important to acknowledge that your clients may have a range of comfort levels regarding the pace at which the world is re-opening. With that in mind, here are five considerations for returning to in-person sessions. 

1. Prepare for the transition 

Before adding in-person sessions back to your practice, we recommend that you also take a look at the American Psychological Association’s (APA) guidance on the topic. You’ll want to consider the risks and policies you’d like to implement to keep yourself and your clients safe. Developing a clear office plan around masks, sick cancellations, and other precautions you may be adjusting can help reduce post-pandemic anxiety from the get-go. 

Lisa Elsey, MA, LPC, has been in private practice with SonderMind since 2019. She jumped into telehealth as soon as the lockdown began in 2020 but has slowly been reintroducing in-person sessions, especially for her family clients with young children. 

Before scheduling an in-person session, Lisa has a conversation on the phone or in a telehealth session where she discusses her requirements and sets expectations with the client to prioritize both safety and comfort during the session. 

Her philosophy has been to adapt her policies as new information comes out. For example, she implemented handwashing, more rigorous toy cleaning, and mask wearing right away. Her landlord also took steps to ensure the building was up to “coronavirus code.” As new information about the virus came out, she made changes accordingly. 

“Your clients will do what you want them to do — if they really want to come in person,” she found.

2. Find an office 

Lisa shared that one of the benefits of returning to her office was that clients now have the option for a protected, private space away from their home, where they can open up without the risk of being overheard. 

If your clients have been grappling with similar privacy issues and concerns, returning to an office can be a great catalyst for change. And it can be done safely. 

“My office is designed and set up in a way that we are at least actually eight feet apart, and that was true before the pandemic,” Lisa shared. “I let people know that you can sit really far away from me, the windows are open, the building has all the new filters in it. I talk about what the building has done and what I have done.” 

If you already have office space, taking steps like Lisa can help make clients and yourself feel safe and secure. Consider having disposable masks and hand sanitizer on-site, as well as visible signage about the new policies in place. The APA offers a great checklist of office supplies here.

If you don’t have an office yet, here are some things to look for in your office hunt: 

• Location: Is it a central area for your local clients or a bit of a drive? Is there free or readily available parking? 
• Security: Does it feel safe, physically? Will you be able to conduct HIPAA-compliant sessions free of eavesdropping neighbors? 
• Technology: Does it meet your digital needs (printer or WiFi)? 
• Comfort: Does the space feel comfortable and warm? Are there windows? What is important to make your clients feel comfortable opening up?
• Rental structure: There are lots of different types of leasing options these days. More and more “WeWork” style co-ops are popping up, where you can pay a membership fee and rent for a day or by the hour. If you have a fuller caseload, you may want to consider finding your own place. 

Lastly, see if you can take a tour! 

3. Update your online profiles and let current clients know 

Once you’ve secured your office space, the next step is to update your website and any online profiles you have. For SonderMind providers, check out our how-to article on updating your provider profile here. You’ll also want to let current clients know about your new options. 

4. Create a new routine

Before the pandemic, only 1 in 5 workers who could perform their job functions entirely from home were actually doing so. By December 2020, that more than tripled, with 71% of those workers actively working remotely. 

While this adaptability was an absolute necessity, it didn’t take long for us to collectively realize the toll of screen fatigue. For many mental health professionals, the pandemic brought on more clients, leading to back-to-back sessions, compassion fatigue, and therapist burnout. Returning to in-person work can be a positive step to help separate work from home life and bring back that much needed balance. 

For Lisa, who works with young children, she found that “it’s more productive to be in an office setting than on a screen.”

“As much as I appreciate the pros of telehealth, and that I was able to keep my business going, and that I was helping people with their mental health needs, you cannot replace the energy you feel in person without being in person,” she said.

Lisa also shared that the pandemic taught her about herself. She had to learn to live with this new virus and how to move forward in life. She found creating a new routine, like returning to in-person sessions, was also helpful for her clients. Lisa was pleased to have a few clients admit that it felt good to go out to therapy before going back home.

5. Strengthen the therapeutic alliance

Returning to in-person sessions can help improve the therapeutic alliance — the relationship between you and your client. Advantages include being able to read body language, fewer distractions, and talking freely. 

When Lisa returned to in-person sessions, she said she was reminded of the value of what the profession offers others and why she became a therapist. “You can’t reach through the screen and offer them a tissue,” she concluded. 

What the future holds

While it’s important to acknowledge the benefits of in-person therapy, a hybrid approach to care will likely be around for a while. Virtual therapy or Video Telehealth offers many clients logistical ease by not having to identify childcare or transportation to or from therapy. Some clients are also just more comfortable opening up in their own personal space. 

Lisa shared that her mixed approach has reduced no-shows and late sessions. For example, if a client isn’t feeling well enough to meet in person, she can now offer them virtual care. Being able to shift and offer this option means fewer cancellations and easier access to care — a win-win for both. 

Sources: 

Lisa Elsey, MA, LPC, licensed therapist, Wheat Ridge, Colorado.

Parker, K., Menasche Horowitz, J., & Minkin, R. (2020). How the Coronavirus Outbreak Has – and Hasn’t – Changed the Way Americans Work. Pew Research Center.