When will Wellspring return to in person therapy sessions?

When the COVID pandemic came to the forefront in at the end of March 2020, Wellspring was able to make a shift for the health and safety of our clients and clinicians immediately to telehealth.  Telehealth has proven to be an equally effective way of receiving mental health services as a platform and in convenience.  The challenges of telehealth have included technology difficulties, clients not having an available private space, and in general the desire for humans to see each other in-person when they interact.

During the initial Phase One re-entry in June, Wellspring began offering the option of some clients to be seen in-person.  However, the surge began and it was necessary to shut down in-person sessions again to ensure the health and safety of all.  As we enter in the fall, and public school is beginning the process of opening up, inquiries have begun about when Wellspring will reopen to in-person sessions.

In order to answer the timing of reopening, please consider the following concerns that extend beyond health and safety as to why returning to in-person sessions is slow.

Confidentiality and the potential of contact tracing (tracking with whom a COVID positive person had contact) if a client or clinician are infected.  Wellspring is required to report COVID cases and confirm exposure in the event of someone who receives or provides services.  This contact tracing breaches the confidentiality of the client who received services. 

Psychotherapy is built on a promise; you bring your suffering to this private place and I will work with you to keep you safe and help you heal. That promise is changed by necessary viral precautions. I promise to keep this private changes to a promise to keep it private unless someone gets sick and I need to contact the local health department (Essig, 2020).

Capacity to ensure proper cleanliness and screening are executed. Delivering mental health counseling sessions requires an additional 30-40 minutes per client, which can include research, notes, care coordination, consultation, etc. Adding cleaning between sessions, protocols like screening, and taking temperatures, is added burden of responsibility on the clinicians that distracts from their primary focus of mental health care. 

As should be clear, mid-pandemic in-person psychotherapy unavoidably increases risks of viral infection for both patients/clients and therapists. There is a growing consensus, as reported in the Wall Street Journal, that ‘the major culprit is close-up, person-to-person interactions for extended periods.’ That is pretty much an accurate description of an in-person psychotherapy session. We meet inside for extended periods of time in relatively close quarters (Essig, 2020).

Even the best in-office mitigation strategies, by design and definition, can only mitigate risk (Essig, 2020).

Psychological safety maps to physical safety. In order to maintain psychological safety, all must experience physical safety. COVID risks can only be mitigated, not eliminated at this time. This risk can impact both the provider and receiver of mental health services. 

The main problem is that necessary procedures for viral safety inevitably undermines fundamental experiences of psychological safety so necessary for effective psychotherapy. Like two people tethered together to keep each other safe while scaling a cliff, the experience of mid-pandemic in-person psychotherapy will be replete with dangers requiring constant vigilance and inter-dependence (Essig, 2020).

Wellspring is a nonprofit organization that must steward financial and human resources. The current pandemic has also caused a mental health crisis. Risking the organization’s viability or clinicians’ health would diminish our ability to provide services in general. Currently, telehealth is the safest way forward in all respects to preserve Wellspring’s ability to restore hearts and minds without interruption.

In consideration of all these factors, Wellspring will open in-person sessions when there is full confidence we are making the best decision for our clients, therapists, staff, and our organization.  Our leadership will continue to stay informed.  In the meantime, we will continue to fulfill our mission of counseling and education. 

If you’d like to read more about “The New Normal” in Miami-Dade County, visit MiamiDade.org

References

Essig, T. (2020, June 27). Want To See Your Therapist In-Person Mid-Pandemic? Think Again. Retrieved September 22, 2020, from https://www.forbes.com/sites/toddessig/2020/06/27/want-to-see-your-therapist-in-person-mid-pandemic-think-again/