Post Pandemic Practice
Curt and Katie chat about what our practices can look like post pandemic. We explore the creativity that the pandemic has inspired and what the clinical and business implications might be for continuing in flexible modalities. We talk about logistics, clinical evaluation, and ethics related to the options available for the clients. We also talk about how to take care of yourself while taking care of clients.
It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.
Click here to scroll to the podcast transcript.Transcript
In this episode we talk about your practice post pandemic:
- How creativity can be used in practice
- Different options for therapy (telehealth, outdoor/walk and talk, in-person, concierge)
- The logistical challenges of having different options for your clients (different locations, different modalities, etc.)
- The flexibility required during the pandemic and how to adjust schedules after returning
“This is one of the major principles of things like recovery oriented principles of care: Of meeting clients where they’re at and how they think that they’re gonna benefit from it.” – Curt Widhalm, LMFT
- The benefits of having so many options
- Boundaries and flexibility needed to manage a multimodal practice
“The biggest piece [with a multimodal practice] is making sure that I am not so tightly scheduled that I don’t have flexibility. For someone who can’t make it to the park, for example, I may have to shift their time forward or back in order to do a virtual session…Clients [need to be] aware of that….having a consistent communication with them…so that you can know where are you meeting. It’s actually created almost this kind of teamwork around how do we best work together to get…you the therapy session that you need this week.” – Katie Vernoy, LMFT
- The importance of communication and teamwork
- The benefits of this flexibility to clinicians
- The considerations of cost and charging different fees, and rationale for how you set fees
- The clinical benefits and challenges for different modalities
- The necessary documentation of rationale
- Clinical considerations for in-person sessions
- Some CYA advice
“Take some deliberate, slow-thinking time to craft the practice that you want, given the opportunities that you have.” — Curt Widhalm, LMFT
- The importance of taking this time to deliberately design the practice you want
Our Generous Sponsors for this episode of the Modern Therapist’s Survival Guide:
Productive Therapist
You should be able to change the world and love your life. Productive Therapist can help you save time, make more money and feel a sense of relief. They provide mental health virtual assistants, business coaching, and unique training & support programs. Delegation can be the key to your freedom, but it is tough and comes with a learning curve. The Delegation Pro course will speed up that process by walking you through the important things you need to learn to start delegating like a pro (or a master)! You will get guidance on figuring out what tasks you should delegate, how to find the right person for the job and recommendations for the technology to make it a smooth process. As a listener of the Modern Therapist’s Survival Guide, you can get this course free by using the coupon code MODERN. Visit https://productivetherapist.teachable.com/p/delegation-pro to learn more.
Mulberry Web Design
Mulberry is a creative studio known for building fabulous custom websites, reasonable rates, and an obsessive dedication to customer service. The friendly team at Mulberry can take your private practice website to the next level with a complete redesign or help with your current website. Mulberry is a perfect fit for modern therapists ready to improve their online business presence. As a special welcome to listeners of this podcast, Mulberry is offering a 10% discount (up to $250!) on any service they provide. Mention the Modern Therapist’s Survival Guide podcast to receive your welcome discount.
Visit Mulberry at MulberryWebDesign.com today.
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below might be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
APA Article – COVID-19: When is it OK to provide more in-person services?
Outdoor therapy: Jennifer Deacon, MBACP
Leadership article – Checklist for Post Pandemic Reentry
Relevant Episodes of MTSG Podcast:
Interview with Anita Avedian, LMFT: Open to Opportunity
Interview with Megan Costello, LMFT: Field-Based Private Practice
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
—
Get Notified About Therapy Reimagined Conferences
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
… 0:00
(Opening Advertsiement)
Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.
Curt Widhalm 0:15
Welcome back modern therapists, this is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy. And this is the podcast about all things about therapists, the things that we do, the ways that we practice, the things that affect us. And in case you haven’t been around Coronavirus has effected of us a lot. Like…
Katie Vernoy 0:38
There’s just this pandemic thing that’s really impacted us.
Curt Widhalm 0:43
So a lot of us are wading back into practices of seeing people in person and we had an episode earlier this year about returning to the office. A lot of positive movement has happened as far as vaccinations, case rates going down, that kind of stuff. Here in America, the CDC guidelines have updated accordingly. And depending on where you’re located, your state’s guidelines, and even down to county guidelines may be very different depending on where you are. Well, this is an episode about reentry back into practice. We’ve covered a lot of material back in or going back into the office episode before…
Katie Vernoy 1:27
Or our shot at vaccines, I think is another one.
Curt Widhalm 1:30
Sure. So we’ll link to those in our show notes over to mtsgpodcast.com if you want to go back and listen to those. But we wanted to talk about just kind of some of the options of ways that therapists can consider transforming their practices with a lot of the lessons that we’ve learned here, during the pandemic. That being in kind of this new stage where we can make some decisions about the ways that we go forward, some of the flexible options that we have that don’t confine us just into the old ways of needing people just to show up to our office. So I know you’ve started some of these things already. And, you know, this might be a place of where have you grown in the last, you know, couple of months around this kind of stuff? And what considerations are you looking at going forward?
Katie Vernoy 2:22
I think the biggest thing and even just nodding back to these previous episodes, there’s a lot of information that has been updated and we’ll link to an updated article as well from the APA that talks about how to attend in person sessions and the rules there. But the first and foremost thing that I want to say is that each person, each clinician and an each relationship with your client needs to be honored in the decisions that you make, whether it’s in person, I’ve been doing outdoor walk and talk therapy. There’s also ongoing telehealth. I’ve got colleagues that are doing kind of concierge therapy going to folks backyards or homes. And I think there’s a lot of creativity that’s been happening. And disclaimer, Curt and I are not attorneys, we don’t even play them on TV. And so we’re not going to talk about whether or not you should have masks in your office or you know whether or not you should meet in an office, that kind of stuff. Because that stuff is so complex. I’ve personally decided to have some in person in my office availability that’ll expand a bit as vaccination continues. I am also doing walk and talk therapy in the park. And then I’m also doing a lot of virtual still. And that sometimes is flexibly kind of interchanging between the three. And so for me, what really was exciting is when I first became fully vaccinated as a frontline person, and most of my clients were not vaccinated, I tiptoed into this outdoor walk and talk therapy because there were clients that I saw that were not actively making good use of telehealth. Whether or not they could do video things in there the rest of their life, it felt like they weren’t able to get privacy, they were not able to get either good WiFi connections, or to really be able to engage with me over the over the screen, so to speak. I also had some clients where it felt like they felt very contained, staring very still at a screen and I was feeling the same way. And so for me, the excitement really became how do I meet these clients in a safe way? And what could that look like? And so I consulted with a colleague and I’ll link to her information on the show notes around what does walk and talk or outdoor therapy look like? How do we, how do we put that together? What does that mean? And I realized I’ve done a lot of it in working in public mental health because so much of that is meeting a client where they are, or I would be in a school and I’d go out and play basketball with a client or that kind of stuff. And so, and not well, I’m not a good basketball player, of note. But there’s a lot of different things that folks, I think get really concerned about with walk and talk, and we can go into that later. But what I uncovered is, there were some clients who absolutely adored it; moving and kind of the rhythmic nature sitting outside, having the bird noises, or the people playing in the park, or that kind of stuff and having some of those things. And some that I think they’re still trying to get used to it, especially walking with a mask on and what does that mean, and whether or not they’re going to be seen publicly? And are they crying in public. So there’s, there’s folks who really took to it, folks who are I think, still deciding, but for me, greatly improved my quality of life. I’m more active, I’m getting outside, I’m not just me sitting in the same chair for hours on end, very still, interacting with a screen. And so long way around to I think the conversation I want to have today is about the creative ways that we can clinically treat our clients, but also keeping in mind the ways that we either weren’t taking care of ourselves or were taking care of ourselves during the pandemic, when we were actually able to kind of start fresh with almost a blank slate on what our practice looked like.
Curt Widhalm 2:59
Dare you use blank slates in a positive way on this podcast?
Katie Vernoy 6:27
I know, I know, it’s crazy.
Curt Widhalm 6:30
I have not yet stepped into the foray of doing things not virtually. And that’s based on some individual and personal decisions that are affecting me and my life at the time of this recording, but it is on the horizon. And I am kind of dreading some of the logistical challenges I’m going to have to face. Now part of this is I have two different physical office locations that are geographically very different in the Los Angeles area. And at no point over the last year or so of doing things virtually and taking on new clients, did I ever keep anything of, oh, you need to see me on this day, because geographically, one day, you’re probably going to see me in this one physical office. So everything is just kind of a smattering of people all over. Some of those people are not going to be candidates to return back to my office sometimes, because they’re benefiting very much from online therapy. Nor do I think that they want to sit through Los Angeles traffic when they can see me from the ease of their home or wherever they are. But I think it is something where, because my practice has always kind of had a large focus on working with kids and teens, I have been able to have some of these things before you bringing up basketball, much to my suitemates hatred of the basketball hoop that I had in my office before where we were crashing into the doorway playing basketball, and it’s disrupting somebody else’s session. These are things that especially a lot of child and adolescent therapists have had to use before as far as creative ways to get people engaged. And I think where part of this is really beneficial to a number of older clients or people who might not have had the courage to practice in this way before, is our clients are now a lot more attuned to things that they need to do. And hopefully, this is where as part of that therapeutic alliance building, especially with these new options open, we can lead those conversations with these clients to help them feel more of a say in their overall mental health treatment. Surprisingly enough, this has been a recommendation for a long time. This is one of the major principles of things like recovery oriented principles of care. Of meeting clients where they’re at and how they think that they’re gonna benefit from it.
Katie Vernoy 9:14
Yes. And I think they’re, like you mentioned, there are some real logistical issues that we have to keep in mind. Because I think what I look at specific clients and obviously no client information will be shared. But when I look at specific clients, and what their treatment plan may look like, they may be virtual one week, meeting at the at the park for walk and talk another week, and potentially meeting in my office a third week and all of those things have logistical challenges. Partly is where am I do I have an internet connection to interact with them, and just physically getting to whatever location that I’m conducting therapy, I think it’s something where there is a, there has to be both a clinical collaboration on what’s best. And I’ve had clients decide like, I don’t want to go to the park this week, because I think I’m going to be crying the whole time. And also, I can’t get to the park because my work has sent me over to another place and I can’t do it, you know, those types of things. I think it’s, clinically there’s a collaboration. And then logistically, there has to be collaboration and a flexibility that I think with our back to back 50 minute sessions just isn’t possible. And even until things really shift a lot, having back to back 50 minute sessions in your office, probably isn’t wise, because then you’ve got people overlapping in the waiting room and stuff like that. And so then there’s the the exposure issues, which, you know, obviously, those are things that people want to study and consider on their own. But I think, to me, some of the freedom that was provided by the pandemic was that negotiation that started happening about when are we meeting. You know, your work schedule is completely different now that you’re home, or you’re not working, or you’re, you’ve got a different job, or your job changes every week, and being able to have some of that flexibility I think has lended itself well to the conversations we’re having around what’s most beneficial to you clinically, and interpersonally. But also, what can we actually do like what’s practical to do?
… 11:30
(Advertisement Break)
Curt Widhalm 11:31
Creating kind of a shortlist and much like that APA article that Katie mentioned, I’m really looking at a case by case basis of the reintroduction of people back to being seen in person. And, you know, there’s just a bunch of considerations that we all have to make on this. Part of this is being able to help benefit clients in the way that’s best for them. And for example, you know, some of our clients were facing some, especially some anxiety related stuff here of really being able to do exposure and response prevention type work, has to clients have a lot less chance to escape, doing those kinds of activities that they’ve been able to do online, even if they’re working hard at it. I know, I have a couple of people on my caseload where it’s just easy to stay at a certain level of work that being faced with the reality of now having to practice that stuff in therapy sessions is part of the example, whether it’s fear about, you know, the getting sick with Coronavirus, or a couple of people on my caseload who have other specific things related to their presentation, that are added logistical things here. You know, I can imagine, you know, a lot more parents right now, on my caseload, who are like, you know, traffic’s really bad, can we just do a video session today. That is, hopefully, going to continue to not have no shows, late cancellations and type, that type of stuff that does provide more of these options here. But I like what you were saying in leading up to the show about the way that you’re kind of already handling these kinds of scheduling issues.
Katie Vernoy 13:21
Yeah, I mean, I think for me, the biggest piece is making sure that I am not so tightly scheduled that I don’t have flexibility. And that’s hard for me, because I do have my practice. But I also have all the other things that we do with our stuff. And I also have my consulting business, which is almost 100% virtual. But for someone who can’t make it to the park, for example, I may have to shift their time forward or back in order to do a virtual session. So I can be in my office to do the virtual session, and then get back over to the park for another person. And so even shifting at 15 minutes, one direction or another and clients being aware of that and having a consistent communication with them, whether it’s text or messenger, or some of, whatever the ways that you’re appropriately communicating with your clients. But that you can actually reach them in real time so that you can know where are you meeting, what is at and, and also the criteria for completely rescheduling versus being able to just switch over to video. So I think for me being completely transparent with my clients about okay, well, yeah, we can move that but I do have to get over to the park, so I need you to come earlier. You know, I’ve got a hard stop. You know, we need to stop right at the 50 minute mark. There’s no no doorknob confessions, you know, clients, I cannot handle that because I need to get over to the park right now. It’s actually created almost this kind of teamwork around how do we best work together to get what you need from your treatment in a way that’s consistent because all of our lives are kind of a jumble of being at home, being virtual, getting out into the world in different ways, especially as more and more folks are getting vaccinated or workplaces are deciding it’s time you got to come back. I think we all feel like it’s, I feel like that we’re all in it together and trying to get, you know, how do we best get you the therapy session that you need this week.
Curt Widhalm 15:24
But I, I have noticed, you know, in some of these conversations with my clients, as we’ve started to talk about what working in person would be is, there’s also a lot more client acknowledgement of other clients. Of, you know, being aware of that these kinds of impacts are happening. And if your clients aren’t thinking about that kind of stuff already, that might be a conversation that you start having with them. And just to talk about some of the logistical changes that might happen. You know, for I brought up that, you know, some of my clients are gonna end up having to shift days in order to best accommodate being able to see things and the impact that that’s going to have on other clients, and I’m going to do my best to keep everybody where they’re at. But, you know, part of this is not just about the client work, but about the options that it affords us as therapists. That, you know, I have, in the past spent five days in, in my offices, a couple of days, in one, a few days in the other. I’m still gonna try and minimize the number of days that I’m going to work. I mean, I will still have work most days, but being able to not have to sit in traffic myself every single day. Being able to have some of the things that allow for my systems of care to end up really taking advantage of the options that I’m going to be able to afford myself as a practice owner.
Katie Vernoy 16:59
I think the way that I’ve done that, and I had started doing that, but well before the pandemic because I because I had so much of my work that was virtual with consulting and the other businesses that I have versus my in my in office therapy practice, is I really, and I think you kind of nod to this with, you know, this is when I’m in this office, you can come to that office on that day. I think for me, I’ve I’ve really started defining these are the these are the spots. And so you know, if you fit into this time spot, you can you can meet me at the park, if you fit in this time spot, I’ll you can either see me virtually or come to my office, I’ll be in my office, if you need a session outside of that time, it’s virtual. And so I’ve kind of designed my day based on what I want to be doing, at what time not completely oblivious to client needs, obviously. But it’s something where you have to kind of set some boundaries. Like this is where I’m going to be this is what’s possible at the time that you’re available. And it allows for a lot of flexibility in scheduling. It’s just if someone doesn’t want to be virtual, they have to kind of comply with my availability. And so I try to work with folks and that kind of stuff. But there are some folks that just probably will never be able to see me in person because their schedule doesn’t align for when I’m at my office or doing outdoor sessions.
Curt Widhalm 18:22
Have you thought about charging different fees based on this? I know some people that are going to be looking at whether or not that they’re going to be, you know, they might have been able to get out of an office lease and might be looking at some of the business costs of I need to go get a new lease or I need to refurnish an office or, you know, in some of the lost time that might be done in between sessions. Is that a consideration that you’ve had it all here?
Katie Vernoy 18:47
I kept my office because it was a good rent. It was an expensive mailbox for most of the pandemic. But I did like my office and so I kept it. So that wasn’t a change for me like there wasn’t an overhead cost. But I have thought about it because I’ve I’ve interacted with some folks who do more of a concierge style therapy where they actually go to people. And you know, whether it’s I think a Anita Avedian talked about it on her interview. And Megan Costello talked about field based therapy in her interview. So we’ll link to those shows in the show notes as well. But for me, I think if there is a above the overhead cost, I think it makes sense to have that be addressed in your fee. And I have thought about you know, kind of finding a day that I’m like, I’m going to fly up to San Francisco and I’m going to do in person sessions in San Francisco with clients I have there or whatever, right? And so obviously those sessions would cost more if I’m coming to your home, if I’m coming to your workplace. Like if there’s some of these more concierge costs. I think those need to be played in for that. The opposite, I think feels wrong to charge less for telehealth and so so I I don’t know that I would say like, well, if you come into the office, it’s going to be more expensive for me because I want to both empower folks to do telehealth. But I also don’t want to be in front of a screen all day. Like, personally, I was having eyestrain and migraines and stuff like that. So for me, I value being able to see folks in person and having some moving around and getting out of my house and stuff like that. So I think there’s the the actual costs and making sure those are covered in your fee structure. And I think it’s like, well, what are you incentivizing? If you charge more for in person session, some people will pay it with no problem. And some will say like, Okay, well, I’ll stay virtual. And you can decide. If that’s what you want, I would, I would incentivize it. But I think, for me, the way I looked at it is I kind of look at an overall overhead cost and make sure that’s covered within my overall structure, versus charging more for those two different types of services. But that’s just kind of my off the top of the head thought, if I’m going to travel to someone or do a longer session, or those types of things, I think that makes, that lends itself very easily to a different fee structure.
Curt Widhalm 21:09
On this note, I will encourage everyone to be aware of their states and local laws, especially when it comes to round fees like this. Is that states like California where Katie and I both practice, our laws are that we have to have our fees and the basis upon which they’re based advertised to clients at the commencement of therapy. And so if you are looking at changing fee structures, on something like this, make sure that you’re very clear, and that you have this as something that clients acknowledge generally through writing. So that way, you are able to make sure that you’re staying in compliance with all of those laws there. And one of the things that I want to bring up on crafting these things that are best for us. And some of this really does tie back to the level of functioning of our clients here, is I know, many people are considering just remaining entirely virtual. And during the lockdown of the pandemic, many of our clients, it was very easy to convince them like Hey, I just don’t have a physical office, I’m not seeing anybody in person, I’m not vaccinated, any of these principles, but as the world moves on, we end up being in this position where we still have a clinical responsibility. And along with that a legal responsibility of ensuring that our clients are suited for the type of treatment that we’re able to provide. And I’m looking at at roughly a third of my caseload right now, that as soon as a couple of logistical things fall into place, for me, are really strong candidates of needing to be seen in person. That certain things about their environment just are not allowing them to get the greatest benefit out of mental health treatment. And it is something where those of you who are really considering remaining in a virtual space that you’ve got good referral networks for those clients who do need to see, be seen in person in order for them to get the best out of their treatment.
Katie Vernoy 23:21
When we’re looking at the clinical criteria, and I’m sure there’s many different trainings and things that we can guide people to as far as the appropriateness of telehealth. But in reading the APA article about coming back into the office, there’s kind of the reverse, which is kind of the clinical requirements for having someone come into the office. Like what’s what’s worth the risk, so to speak. And you said, you’ve got a third of your caseload, I, mine were more logistical and practical, just folks that weren’t able to really get as much. It wasn’t unsafe, it wasn’t a disservice to them. It was just, we were not able to have the depth of sessions that they really would best benefit from. So it was it was kind of they were having okay therapy instead of good therapy. What are some of the things that clinical considerations that you’re seeing that you would suggest, either see your client in person or refer to someone who is seeing clients in person?
… 23:52
(Advertisement Break)
Curt Widhalm 24:27
Your documentation, especially about your clients progress is what should guide you almost more than anything else. That the clients desires to be seen in person may be one of many factors that you use in evaluating this, but it’s the overall client benefit that, or the client’s ability to access mental health treatment consistently. I’ve worked with a number of people who’ve experienced in, you know, depressive episodes during this pandemic, where they have nothing else to go out of their house or their apartment for. And so it’s very easy for them to just kind of stay stuck where they’re at, and just kind of roll over in bed to do a session. And that way…
Katie Vernoy 25:21
I laughed because I’ve totally been there. I’ve seen that too.
Curt Widhalm 25:26
So some clients, especially in, in evaluating that, like, they’re not benefiting by not getting out of the house. We looked at things like behavioral activation of just the need to get out of the house and go have to be accountable somewhere else, is something that will benefit them.
Katie Vernoy 25:46
So you’re saying that clients, if they put on pants and leave their house they might start getting better. Just…
Curt Widhalm 25:51
They might actually…
Katie Vernoy 25:53
…not even therapy is better? Just the fact that they got up, got dressed, got out of the house.
Curt Widhalm 25:57
Right, and you know, so some of the evaluative decisions that I’m making with them is, these are the same recommendations that I’ve been making for months, put on pants, go for a walk around your neighborhood, and they’re not doing it.
Katie Vernoy 26:10
Yeah.
Curt Widhalm 26:10
Is some of the considerations. Another example is a couple of the teens that I work with, have major privacy concerns that they’re being overheard. And sometimes I’ll hear caretakers yelling at them in the background for things that they’re saying in our session. Those are not the best environments for these kinds of clients. And so those are some of those clinical considerations of most people aren’t getting as much benefit as they would. And that should be very obvious in your documentation about these kinds of sessions. That should inform you, either, I need to see this person in session, or I need to make a referral for this person to be seen in person by somebody who is providing in person sessions.
Katie Vernoy 26:54
You’ve mentioned documentation a lot. And I think this is a really good place to dig in for just a couple of minutes. Because to me, I think having documentation about modality of treatment, so in person, outside, virtual, phone, you know, whatever it is, and then also making sure that you’re just documenting that you’ve had a conversation, but also making sure that you have a rationale. So you’re saying those things, how important is a rationale for I need to see this person in the office right now? Because that was the standard before. And so to say like, okay, now I have to have a rationale about why I’m actually going to see them in person feels a little weird.
Curt Widhalm 27:47
Everything about documentation comes down to a minimizing your risk. I mean, these are the standards of care. But let’s say, you know, a walk and talk client who is facing a depressive episode, you’re going to want to document why you’re choosing this particular client. And let’s say super worst case scenario, is you get in trouble in some way, and that your whole practice has to be evaluated, that it might not be just particular, a singular client where some of this decision making process is, but it might be looking at your overall client caseload that says, Oh, you are using sound judgment, because you are providing rationales for this specific client who needs it versus some of these other ones who don’t, you know. And so, I mean, I have clients who are in the greater Los Angeles area, but would never come to me in person because they’re not going to drive two hours to get to my office on a weekday at five o’clock and sit through five o’clock traffic to get there. Those people who are making progress, the rationale is going to be in the continuing to document at the beginning of sessions. Saw a client virtually from their house, and, and so you’re right in pointing out that this is a juxtaposition of where we’ve been to where we’re going. But I think in this meantime, that’s going to be the acknowledgement of the real world factors on where clients are. We can’t pretend that this is just happening in a vacuum.
Katie Vernoy 29:26
I’m just thinking that if I were, for some of my clients, the rationale for walk and talk is they thought it was cool. Is that sufficient? That they thought it was a cool idea? They would rather walk than sit and stare at a screen with me and they wanted to get outside. Like, is that sufficient?
Curt Widhalm 29:46
You’re going to definitely want to identify in those kinds of case notes, what your evaluative process is for doing it, and it’s fairly weak.
Katie Vernoy 29:58
They thought it was cool, not sufficient?
Curt Widhalm 30:01
Not sufficient there that you’re gonna want to look at the overall number of factors. Because, you know, let’s say that that walk in clients, you know, slips and falls, or they aren’t wearing a mask, you’re not wearing a mask, they somehow end up, you know, getting Coronavirus. That these are all overall factors that your, as a professional, expected to be able to use as far as your evaluative process and informed consents about some of those risks might be your ultimate legal defense if they decide to sue you. But that doesn’t prevent them from suing you in the first place. And so and so, just because I have a client who’s like, Yeah, I think it would be cool to see a person because I’ve been locked in my house for the last 15 months. Okay, go see another person, that doesn’t have to be me because you are benefiting from therapy in the way that we’ve been doing it already.
Katie Vernoy 31:02
Okay, I think that I’ve mitigated risk with the consent form and the ability to opt out and all that stuff. But I think I will, I will go back and look at my rationale documentation to make sure I wasn’t just like, and we both thought it would be cool to meet outside. I can’t imagine myself actually writing that. But anyway, so there’s a lot to consider. I think, as we’re getting ready to close up, I think the biggest pieces and I’ll link an article, it’s a leadership article. But I think it has some good questions. As we’re getting ready to go back into the world, the reentry, so to speak, I think there’s some questions that we may want to ask ourselves, both kind of what we talked about here, which is the what are you know, what, what are the different options we have? How can we craft our practice to really support all the creative options that we have, as well as create a life that we want to keep living here? And then with a with a profession that we want to keep doing? And then also take some time to think about what you learned during the pandemic. Because I think for me, that’s been what I’ve been really focusing in on personally, is, how do I create all of the pieces based on what I learned from the pandemic? And in this episode, it’s been how do I have a creative practice that serves my clients best and is sustainable and exciting for me? And so, my goal.
Curt Widhalm 32:31
I think the overall takeaway is a lot of this is putting into good practice things that we’ve been talking about all along. It’s just, you know, now as case numbers drop, as vaccination numbers rise, that it affords us the freedom to actually start thinking about it. And our takeaway here is, think about it. That, you know, think about what the practical steps are for you. Apply all of these things that make you have modern therapists in the first place about what makes the practice a balance for the benefit of our clients, as well as for ourselves. It’s just that a lot of us are getting an opportunity for the first time maybe since we started setting up our practice, to really have an opportunity to reset and do things in the way that we want to, rather than just feeling constantly pulled in every single direction based on you know, the way that things always have been. And so that’s really the takeaway here is: take some deliberate, slow thinking time to craft the practice that you want, given the opportunities that you have, because some of these decisions that you have now may paint you into a corner that 2, 3, 4 years from now, you’re like, Oh, I just wish that I had given myself that creative opportunity when I first started going back to seeing clients in person.
Katie Vernoy 33:55
Excellent.
Curt Widhalm 33:56
Our show notes can be found at mtsgpodcast.com. You can let us know how you’re moving forward in the world over in our Facebook group the Modern Therapists group or let us know on our social media. And until next time, I’m Curt Widhalm with Katie Vernoy.
… 34:11
(Advertisement Break)
Announcer 34:11
Thank you for listening to the modern therapists Survival Guide. Learn more about who we are and what we do at mtsgpodcast.com. You can also join us on Facebook and Twitter. And please don’t forget to subscribe so you don’t miss any of our episodes.
SPEAK YOUR MIND