Originally posted on Therapy Reimagined (https://therapyreimagined.com/now-what-blog/)
Each one of us has had to scramble to shift and change as our world has gone into crisis. Many of us have made a full switch to virtual meetings and sessions. There are economic uncertainties and there is emotional fall-out that we are navigating at the same time as our clients and colleagues. It can be hard to know what to do next, especially if you feel like you’re just hanging on.
Here are some ideas to help improve the circumstances while we settle into a new normal for a while.
Put on pants.
I have seen a lot of social posts reminding people what day it is, to take a shower, and celebrating that pants and bras are a thing of the past. After I giggle a bit, I worry that we are cosigning on practices that lead to depression and anxiety. Now, I’m not going to say that I’m showering every single day (or deny that I’m wearing yoga pants right now), but I did get up and get ready for work today. Now more than ever, it is so important for us to create schedules and structure around our work days. It may be the most disconnected schedule in the world if you’re sharing childcare or house chores, but a schedule is really important regardless. When the whole day (or week) feels the same, not only might you feel off-kilter, but it is really hard to separate work time from home time. Create a start and end to “working,” with rituals such as turning off your laptop or changing from your work yoga pants to your sweats. Create some boundaries or distinction however you can, so you can get some rest and distance from work.
Figure out how much you can actually do.
I have seen such a wide spectrum of responses to the global pandemic and quarantine. Some people are hunkering down and focusing on self-care. Others are hyper-productive and putting out 27,000 new products to support us during this time. And, of course, there is every response in between those two extremes. Right now, it may make sense to assess on a daily or weekly basis how you’re feeling, what your instincts are, and how you’d like to approach work at this time. There are no right answers. You can be productive or not. You can add services or just solidify the ones you’re already doing. The only wrong answer is to mindlessly follow someone else’s response and beat yourself up for being less productive or less in touch with your feelings or something. Your response is unique, plan based on that, not what others are telling you that you should do.
Focus on your clients for your sanity and your bottom line.
When we face a crisis, our natural instincts are (and often should be) self-preservation. When that lasts beyond us making our way to “safety” – and we are small business owners – we can find ourselves losing clients. I’m assuming that many of you made the move to 100% telehealth with some level of success and some level of client retention. As you settle in to your new platform and your new schedule, it is now time to make sure that your clients have actually come along with you for the ride and are in for the duration.
Check in personally and provide extra support for their additional needs during this crisis. I’m talking about offering check in or coaching calls, support groups, worksheets, reading, and any practical tools you can create for them during this time. It can even make sense to reach out to clients who didn’t initially come over to telehealth. They may be more receptive now that the timeline has lengthened (and they are stuck home with that one family member) AND you may be more able to speak about benefits and help them with the transition now that things are calming down on your end. Reach out person to person. Go beyond emails and messaging and pick up the phone, if you can. The more clients you’re able to serve (and retain), the better you will feel and the healthier your bottom line will be.
But don’t only focus on others.
On the flipside of folks in survival-mode taking care of themselves (and potentially forgetting their clients’ perspectives), I see a lot of people reaching out and wanting to volunteer. This is an amazing instinct, a generous act, and a wonderful opportunity to find meaning during the pandemic. That being said, go back to your self-assessment. If you overcommit right now, you might have less bandwidth for your on-going clients (who are paying you to be there for them long-term). Take a hard look at what you can actually do for others during this time. You have additional needs too. You may want to give more, but you may not be able to. Sort out what you can safely do. Maintain your own resilience so you can support your clients and maybe some others.
Clean up your systems.
For many, the first system you probably had to shift for COVID-19 was your telehealth platform. I was lucky to have a chosen secure video system that was working for me (and a backup actually), but I definitely had to bone up on how to instruct clients on its use and make sure I was following all of the L&E rules. I’m cleaning that up now.
Hopefully most of you have fully made that transition at this point, but I hate to say it, this is likely not your last transition. Some clinicians are finding holes in their systems OR are having to create completely new systems for an online practice. This can be the time to slow down and be thoughtful about how you want your therapy business to run.
To start, fully maximize your Electronic Health Record or Practice Management System. Many systems have integrated forms and payment systems. Make sure you are able to get intake paperwork completed, efficiently do your notes, flexibly schedule and perform telehealth, and get paid for each of your sessions, virtually. If you haven’t yet moved to an EHR or practice management system, this could be your golden opportunity. Get all of your clients’ information in, set up your progress notes templates, individualize your practice forms, and get your payment processor working. The more seamless your system is from a client side, the more they will be reassured that you’re taking care of them, especially during this time of confusion and chaos.
This is also a time to update your policies and procedures to include those pesky new things that we keep learning, especially now. Review your intake forms and policies to make sure you’ve included a telehealth consent, obtained all the information you need to perform telehealth, and that you’ve reviewed the other common policies that people often leave out (like your court policy, social media policy, cancellation policy, etc.).
Now I realize in the last section I have added productive activities to your list (which is not necessarily helpful if you’re already feeling overwhelmed). Just remember, you don’t need to do all of these things at once. In fact, I don’t think you should. Create tasks lists and reasonable expectations, so that you chip away at these items one at a time, with the energy you have. Go back and read the self-assessment section if I’ve derailed this conversation for you.
Connect with people outside of your house.
We need community now more than ever. I have reached out to colleagues, clients, and friends during this time to see how they are doing. Some are powering along and feel good (all things considered). But there are some who have hidden away and feel hopeless. There are some truly awful choices that our colleagues are facing and some difficult times ahead. I have no doubt. However, as a group, #moderntherapists are resourceful, supportive, and willing to stand up and advocate for change. I have been so impressed by clinicians who are creating campaigns to get insurance coverage for telehealth, to roll back fee decreases, and who are keeping abreast on the changing landscape of HIPAA, technology, and the economy. There are so many intelligent individuals in our community who may have the exact answer you need – you just need to ask.