Ethics Committee Chair — Katie (Wren) Busse, MS, Registered AMFT

Returning to the Office and Face-to-Face Sessions

As mental health professionals have been considered essential workers, our private practices and treatment centers were exempt from closure as part of the “stay-at-home” order issued due to the COVID-19 pandemic. However, many of us still made the decision to close our physical business doors and transition to offering predominantly (or exclusively) telehealth services. With the reducing restrictions and reopening of non-essential businesses, many clinicians may be considering the return to in-person sessions.

So whether you’re planning to return to the office this week, in two months, or next year, there’s a few important things to consider before doing so. The following questions may help you decide if this is the right decision for you:

• Are you at high-risk? Are your client’s at high risk?
• Is it possible you’ve been exposed and could spread it to others?
• Do your client’s come into contact with people who are sick? (I.e., medical professional, first responders, caregivers, etc.)
• Does your office accommodate social distancing? Can you keep your office adequately cleaned?
• Are you going to ask clients to wear masks during sessions?
  • Wearing masks reduces the spread of the virus into the air, but can limit your ability to see a client’s expressions and hear tone.

So you’ve picked a date and made the decision to return to in-person sessions — let’s talk about providing a new informed consent that directly discusses this return. Below is a non-exhaustive list of information you may want to include or questions you may want to answer as part of your informed consent:

• The risks of returning in-person.
• The option for the client to continue seeing you through telehealth.
• Disclaimer that you reserve the right to transition back to exclusively telehealth.
• If the client or someone in their household gets sick, the client will only be seen through telehealth.
• Outline the client’s responsibility to minimize their exposure between sessions.
• Your protocols for keeping your office safe and clean that may include:
  • Wearing masks in the common areas.
  • Washing hands or using hand sanitizer.
  • Encouraging clients to avoid touching their face and if they do, how they can disinfect their hands.
  • How to observe social distancing in your office and avoid physical contact with others.
  • Requesting clients not to show up early to their appointment. You may want them to text you when they arrive so they can avoid sitting in the waiting room.
  • Will you require temperature checks before sessions? If so, what is the protocol if the client has a temperature?
• Disclaimer that you may be required to notify health officials if they test positive for COVID-19, but will try to keep information disclosed to a minimum.

Before you reopen your doors to clients, review CDC guidelines regarding reopening your business and best practices for safety. Also remember, you reserve the right to allow only some clients back into the office, such as clients whose needs are not met as well through telehealth. With all this being said, it’s a fine balance between client care and overall safety — just remember to use your best judgement and stay informed when returning to in-person sessions.

Disclaimer: The preceding article does not constitute legal advice. Always consult with a CAMFT attorney or another legal professional for any legal or ethical questions you may have. For Additional Information: https://www.camft.org/Resources/Resources-for-Members-During-COVID-19#6a. https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/businesses-employers.html.

Katie Busse is a Registered Associate Marriage and Family Therapist 111673 in private practice under Kent Toussaint, LMFT 44685 at Teen Therapy Center in Woodland Hills. She works with preteens to adults and their families in addressing challenges such as anxiety, depression, anger, and family conflict. Learn more about Katie by visiting her website at www.katiebussetherapy.com. She can be reached at 747.217.2257 or katie@teentherapycenter.org.