COVID-19 counselling preparation

A guide for clients and therapists.

Life in the era of COVID-19 has thrown up many challenges for clients and therapists alike.
The practice of and engagement with therapy has in most cases moved from the physical to virtual.
The safety and neutrality of the counselling room is absent for the client, while the first principal of relationship intimacy is one step removed for the therapist.
For both lie the potential challenges of space and technology.
It also offers new opportunities for both parties in the relationship:
For the client this could be reducing the time and effort committed to travel and being present in an unhurried state.
For the therapist perhaps greater autonomy to develop their practice.
It also presents the unusual circumstance of an important and uniquely shared context: pandemic and lockdown, uncertainty and anxiety that affect both client and therapist simultaneously.
The following are some thoughts on maximising the professional and ethical delivery of therapy virtually to give the client the best authentic and safest experience within current limitations.

For the therapist:

Work from a consistent and designated space decluttered and de personalised.
Delineate you’re workspace from your living space for you to focus and allow you to de-role.
Be aware online focus takes a different energy. Leave longer gaps between clients.
It is important that initiating your call should not be premature but punctual.
Be clear on time and contact boundaries depending on what flexibility you consider appropriate.
Be clear on your work schedule, when your day starts and finishes to avoid burnout and maintain a work life balance.
Be mindful that distress and risk issues could be rooted in the environment the client is in.
Be mindful of the shared context of COVID and it’s possible resonance for you.

For the client:

Explore similar options with your client re: delineation of time, space, focus and risk. Additionally explore self care options after sessions.
Encourage the client to prepare as they would a face to face session ie dressed, not eating or smoking.
If possible discuss with the client how to deal with possible interruptions (deliveries, family, pets etc).
Assess with the client that they are safe in engaging with you in confidence and in privacy. To imbed the importance of safety, explore how any challenges to the therapy session can be communicated discretely if the need arises.
Explore with the client how they might self-care and manage through their potential distress after the counselling session. This can be particularly important if they are communicating directly from their home environment.
If home doesn’t feel safe for the client, explore other possible mutually acceptable environments. For example, a car, a garden or park.
For both parties, boundaries, clarity and safety are paramount. It is likely that many clients will chose to meet again face to face when risk recedes, but online working brings its own benefits. It is likely that many clients will continue to choose online therapy as the model and practice develop.
Both options should continue to be routinely offered and therapists should see these as an equal rather than online as a less effective choice.

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