When, Can, or Do You Go Back To In-Person Practice? Part 1

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When, Can, or Do You Go Back To In-Person Practice? Part 1 | Articles | Practice of the Practice | Mental Health Clinicians | Virtual Practice vs. In-Person Practice

Going Back to In-Person Practice – My Current Predicament

I don’t know about you, but I had no choice but to fully transition my practice to virtual during the pandemic. If nothing else, my office was too small to accommodate 6-feet of social distance between me and my patients. Yet, it seems with each passing day, more patients are asking when I’m going back to in-person practice. I keep telling them the truth: “I simply don’t know.”

However, the increasing frequency with which I keep getting asked this has also increased the amount of time I’ve been thinking about this. I realize that the reason I answer them with “I don’t know” isn’t actually because of the pandemic. It’s because I truly don’t know if I personally ever want to go back to providing therapy in-person. Which, quite honestly, is even a shock for me to hear myself saying.

Initially, I didn’t like the transition to virtual therapy all that much. On the few occasions that I’d done a phone or video session prior to the pandemic, I seemed to always have some technical issues. I found it so frustrating on occasions when there was a delay or someone “froze” in the middle of a session.

Furthermore, I was so used to seeing the whole person that I worried about missing something important that could help inform my assessment or interventions. For instance, in person, I’d be able to see if someone’s leg shook incessantly while bringing up a certain topic. In person, I could smell if a patient was coming in with excessive body odour. There are just certain things I still wonder if I’m missing while I am on a phone session, or only limited to seeing someone from the chest up on a video call.

What’s Stopping Me From Going Back to In-Person Practice:

Perhaps it’s just me, but I’m sure that you can relate to the following perks of virtual therapy:

Distance Is No Longer An Issue

That being said, however, now that it has been close to a year, I find myself really preferring virtual therapy for many reasons. For one, I can see patients who I would otherwise not be able to see. Someone in my state who lives 50 or more miles away would most likely never be able to see me. Whereas now, distance is not an issue. Likewise, because traffic where I live is oftentimes so variable, many of my patients would find themselves very stressed out just trying to get to their appointment on time.  Now, they are much more relaxed, as they can fit in their session without that stress at times convenient to them; even during a lunch break at work.

The Convenience of Virtual Therapy

Selfishly perhaps, I also do quite like the convenience that offering virtual therapy offers me, too. I’ve become rather fond of being able to work from home. For one, I have more freedom with my schedule. I can essentially decide to see patients whenever I want to because I am home.  When I went into my office, I set certain hours to see patients based on when I would drop off my kids and pick them up from school. I would hope patients would be able to see me in those hours. If they couldn’t, then I was simply unable to see them.

Now, however, I can book someone at 9 AM, 11 AM and then again at 6 PM. I could never have imagined that type of schedule before, as not only would that be a ridiculous amount of driving back and forth to my office, but it would not be realistic because my kids would be home alone if I left the house after they got home from school.

I can now be home and schedule a session anytime without worrying about all the driving or leaving my kids home alone. They’re now teenagers, so they don’t need me constantly like they did when they were babies or toddlers. So scheduling in an hour here and there while they’re home is seriously convenient and has helped with my work-life balance. I’m also able to see patients I might not have been able to see before, as my hours are more flexible.

The Flexibility of Virtual Therapy For Clients

I’m fine fitting in a patient at a later time than I’d have scheduled in the past because I’m no longer seeing patient after patient, hour after hour to leave the office at a certain time. As such, I have more time in between sessions. And, because I’m home, I can spend those hours doing those things I always felt I had so little time to do: laundry, dishes, etc…

I also do consider how all of this affects my patients. Things like, being able to accommodate patients’ schedules more now than I have been in the past benefits them. I also think that having more work-life balance and feeling less stressed helps me to be a more effective therapist for them.

Going Back to In-Person Practice vs. Staying Virtual

So, now when I think about the return to in-person therapy, I struggle.

Can I go back to practicing the way I have my entire career when I’ve found that providing virtual therapy is not only effective for my patients but has allowed me more work-life balance?

In all reality, my life is now structured around a virtual practice. I don’t even know if I could return to having the scheduling constraints of an in-person practice. The lingering question in the back of my mind, however, is if the demand for in-person practice will be such that if I don’t return to it, my practice will suffer.

I know that the pandemic has brought about many changes in the past year. I do wonder if it has forever changed the way in which we, as therapists, will provide therapy going forward.

Is virtual therapy going to be the norm vs traditional, in-person therapy? Will patients demand in-person therapy? Or will they continue to have virtual sessions going forward? What about for you?

If you’re also a therapist in practice who is undecided about fully returning back to an in-person practice, I think it’s worth taking some time to really consider how the transition to virtual therapy has impacted your life overall.

While I focused here on the personal reasons to consider about your decision to return to an in-person private practice, there are other, more practical things to consider.

In Part 2, I’ll discuss all the day-to-day, procedural changes you may need to consider about running a practice in a world where COVID still exists.

Here Are A Few Other Articles To Consider:

The Toll Covid Is Taking On Therapists: 5 Self Care Tips

Deciding on Solo or Group Private Practice 

About Cristina Castagnini, Ph.D., CEDS

Cristina Castagnini, Ph.D., CEDS, is a licensed psychologist and is recognized as a Certified Eating Disorder Specialist by the International Association of Eating Disorder Professionals (IAEDP). She graduated with honors, earning her bachelor’s degree in psychology from The University of California, Santa Cruz, her Master’s Degree in clinical psychology (with an emphasis in Marriage and Family Therapy) from Pepperdine University, and her doctoral degree in counseling psychology at the University of Southern California. Find out more here. Listen to Cristina’s Behind the Bite Podcast Series here.