Reflecting on what I want to change before going back into the field
Hello, all you beautiful essential workers out there. Without going into too much detail, I’m sure we can all agree that March/April of 2020 was more disappointing than the end of Game of Thrones with even worse plot holes. With the spread of COVID-19 many of us are making the shift to teletherapy or continuing to see clients to continue to offer literally life-saving services. We’ve all dealt with some form of grief and loss recently, whether it’s the loss of our daily structure, the loss of our jobs, or the loss of a friend, family member, or client. During this time of reflection, I have noticed several areas in my job as a home-based mental health professional that could benefit from the lessons we’ve learned while navigating this new “normal”. This week, I’m trying to focus on the positive by imagining what changes I’ll make in my practice once this pandemic is over so that it at least implies that there is an end to this. Below are five specific changes that I want to explore in light of the COVID-19 pandemic because even when I’m home with nowhere to go, I’d still rather be doing anything but notes.
- I will review phones and communication with my older clients/clients with disabilities
As many of you will understand, the initial jump into teletherapy for many agency providers was a shaky transition to say the least. Medicaid providers in my own state of Louisiana were especially hesitant to begin reimbursing for services such as CPST, PSR, FFT, Homebuilders, etc, through teletherapy. When Medicaid finally made the decision to reimburse us for virtual services, we received the email on Friday and made the switch on Monday. I had essentially zero time to meet with my older clients face to face to explain the change in these services so I had to walk many of them through the technology over the phone. When coronavirus is over, or at least the threat is lessened, I will begin the practice of reviewing the most basics of using a phone with my clients who are elderly or my clients who have a disability that limits their ability to use a phone.
- I will see clients earlier in the day
Since starting teletherapy, I have actually started “seeing” clients earlier in the day since I don’t have a commute at this point. This has allowed me more time to catch up on administrative tasks such as finishing authorizations for insurance or scheduling reassessments. I have possibly more freedom in my schedule to either go home early or fit in extra clients when one (or two) no shows. Once this pandemic is over, I will start seeing clients at 8:00am or earlier to allow more time for administrative tasks which otherwise give me a lot of anxiety.
- I will start keeping a list of virtual resources and delivery resources
I learned the hard way in the first week of teletherapy/stay-at-home order that my once treasured resource binder was wholly unprepared for this type of event. Specifically, there was an immense pressure as that spread of the virus increased to find alternatives to physically going to the pharamacy or grocery store for my elderly clients. I worked up a quick guide for how to order groceries online or do pickup at these stores which I will now be offering to all of my clients. My next plan is to write up a guide for clients to having your prescriptions delivered through Walgreens or CVS. Even outside of COVID-19, clients without access to transportation or who are home bound can benefit from these types of resources.
- I will review safety measures with my clients for crises besides natural disasters or self-harm
In New Orleans, we understand that everyone has some sort of a hurricane safety plan. What category storm is too strong to “ride out” at home? How soon should we stock up on water and batteries? Who is boarding up the windows and mowing the grass before the storm hits (don’t ask, it’s a cultural phenomenon of the south). I review a hurricane plan and crisis with each of my clients and some accrediting bodies like CARF require these types of plans for each client. One lesson I’m taking away from 2020 is to have a plan for each client, or at least discuss a plan, of what to do should our entire society collapse. All jokes aside, I want to make sure I at least have a model for treatment should one of my clients become home-bound. For example, I will review with clients who they will call should they feel unsafe to leave their homes. I will also review financial and virtual resources with them such as unemployment benefits and telemedicine options.
- I will use my commute time wisely
Remember when we used to ride around in cars or public transportation? Can’t wait to tell my kids about those times. Anyway, I have been trying to think about how I will use my 80+ minute commute to the full advantage in the future since I can’t finish paperwork until I have access to a self-driving car. I plan to now use this time to contact clients with more purpose, such as having a schedule of who I want to contact on the way home instead of just randomly calling clients who previously no-showed or who have lost contact. I also hope to use this time to catch up on educational podcasts that have been on my list. My favorite way to spend my commute is decompressing by making calls to people who are important to me. This is where I might call a coworker or a counselor friend to reflect on the good parts and bad parts of the day and just to talk to someone who “gets it”. I also use this time to call my brother as we are both commuting back from work or school. I see these calls as being a built-in part to my self care routine because it brings immense value to my personal life and to my practice.