We decided on March 16 to suspend our in-office therapy sessions. That day started no differently than any other Monday, yet there was a feeling of uncertainty in the air. News of COVID-19 and shutdowns was moving through the country, and Phoenix, at a record pace. We were all having trouble keeping up with all of the information, updates, and recommendations. Each of us practiced our own methods of social distancing and sterilization as best we could. We discussed our office logistics briefly and wondered about our clients who worked in hospitals and medical practices. We went through the morning with a “Let’s see how the day plays out.” mentality. Then the universe provided us with the answer. Dr. Fielder found out that she could have potentially been exposed to COVID-19. By lunch, we decided to shut down the office and transition to remote sessions indefinitely. Of course, back then we thought ‘indefinitely’ meant a couple of weeks. How naïve and full of hope we were then!
We were ALL reluctant to transition to telehealth for different reasons. I think that most seasoned mental health professionals will tell you that there is no substitute for a face to face session. A therapy office is a safe space for an individual to parse through their complex emotions away from their day-to-day life. A psychologist relies on body language as heavily as the conversation during a session. There is less distraction in the office; both the client and the therapist can focus on their work for the entire length of the session. There is an intuitiveness that develops along with the relationship between a client and psychologist that cannot be replicated over the phone or online. But, like the rest of the world, we were going to have to adapt. Telehealth may not have been our first choice, but when you’re facing a nationwide pandemic as well as the future of your practice, you make do.
We moved to a total telehealth platform in less than 24-hours and were able to incorporate a HIPAA compliant online component less than 72-hours after suspending in-office sessions. This was huge for us. Although we are all pretty tech-savvy, being able to convert an entire practice from one format to another in a matter of days was no small feat. Fortunately, we don’t just say that we are a team at Anxiety Resource Center, we believe it to our very core. We each tackled an aspect of the transition. There were clients to contact and updates to post on our website and social media accounts. There were video platforms to research and test. There were paperwork and policies to update specifically for the changeover. We even needed to make sure that we updated our outgoing phone message to reflect our current status. On its face, it seemed daunting, but once we put our heads down and got to work, it all got done. It was not without its hiccups and technical difficulties, but we were able to give ourselves and each other a little grace. A sense of humor was worth its weight in gold throughout the process, and we made sure to keep ours intact. Fortunately for us, our clients are, for lack of a better term, AWESOME, and they took each and every mishap in stride, right along with us.
What shocked us more than how quickly we were able to switch over everything about our practice was the fact that it didn’t take long for both Dr. Fielder and Dr. Huser to adapt to, and even begin to enjoy telehealth sessions. They were in no way a substitute for the real thing, but being able to see their clients over their computer or phone screens was a far better option than nothing at all. As they lost the ability to see their clients in person, they both went out of their way to connect using other methods. They consistently sent out texts to check in with their clients, and we sent out regular emails to inform them of every COVID-19 related change to our practice as they were happening. Even though we were unable to have physical contact, we worked tirelessly to maintain a sense of connection.
COVID-19 has highlighted the importance of telehealth as well as the variety of therapy apps that have become popular. The ability to get access to psychological support in the thick of a pandemic has proven to be vital over the past several weeks. This virus has tapped into our ancient brain mechanisms, and try as we might, sometimes it’s nearly impossible for our minds to wind down from their extremely heightened survival mode. Reaching out to an objective, compassionate mental health professional who can validate your feelings as well as offer the rationale behind those feelings is necessary in these unprecedented times. Fortunately, the government realized that psychological support was a necessity and began to loosen some HIPAA restrictions to allow greater access to virtual platforms for counselors and psychologists. Along those lines, some tech companies began to offer their platforms at reduced costs for mental health professionals. It felt as though we were all transitioning to a virtual existence at the same time.
As the weeks passed, we also understood that switching to a solely remote treatment option did not work for everyone. There are issues with telehealth appointments in the time of shelter at home. It is nearly impossible for some of our clients to have privacy in their homes. Carving out time for a session in between working from home and homeschooling children simply could not happen for many, especially during the early weeks of quarantine. Compartmentalization also cannot happen in a telehealth appointment. You have no literal distance between an emotional catharsis in your therapist’s office and your daily life. What a challenge it has to be to spend 50 minutes discussing how quarantine has put a stress on your marriage only to take ten steps from where you were having your virtual session to join your spouse in the living room. Like most adaptations we’ve had to make in the past couple of months, telehealth is effective, but it’s not perfect.
As we soldiered on with remote sessions, we were surprised at how many of our clients began to ask if we knew when we would go back to in-office appointments. Technically we are considered essential. We could have opened the office at any time, but there were new parameters to consider and client exposure to take into account. We decided to continue with remote sessions until we all felt confident that we could see our clients in the office with maximum safety and minimum risk. When the time came to begin discussions on re-opening the office, there was one thing that we did not need to question, and that was whether or not we would continue to offer telehealth as a treatment option. Warts and all, there is an added accessibility that telehealth allows that will be necessary for clients going forward. Distance, schedules, and life, in general, can become obstacles in attempting to stay consistent with therapy. If the addition of a telehealth option can help our clients in their journey, we are more than happy to oblige. Our world changed seemingly overnight, but it will take a much longer amount of time for anyone to find their footing in a post-coronavirus world. Quality psychological support will be imperative. There will always be clients who prefer in-office visits, just as there will be clients who opt for a telehealth session even after we receive the ‘all clear.’ We took that into account as we began the process of returning to our normal operating procedures. Life in our practice before March 16 did not have a dedicated space for telehealth. In two months, we were able to successfully incorporate it as an additional part of our therapy model. As the world adapts, we too will adapt and evolve, and we view telehealth as an exciting part of that evolution.