Corona Virus and Therapy: Virtual sessions update

3-18-2020

IMPACT OF CORONA VIRUS ON THERAPY SESSIONS

As of this writing, all work with my private practice clients has gone to the virtual setting. In these stressful time, change and exceptions are afoot. For one thing, restrictions on insurance coverage for therapy sessions has been lifted. You may even count phone calls I believe for insurance-covered sessions.

Here is info on this from the US Dept of Health and Human Services for therapists for example on being able to use virtual services / solutions that are not usually approved of for telehealth (please check your individual situations to be sure of getting paid / being covered). That means providers should check which insurance companies are covering virtual sessions, and whether specific video solutions need to be used. Clients should call your insurance company to make sure they are covering video or phone sessions, and again, if it’s OK to use any system, or if it must be certain ones.

Many are not quite concerned with limiting contacts and following “social isolation” precautions. But as we see the inevitable progression of Covid19 cases (and the US follows about two weeks behind Italy’s situation), it’s become more critical in my mind, to be cautious. This is having a huge impact on many businesses and many support services. The impact of corona virus on therapy sessions does not have to be negative though, if you can work with the virtual arena.

HOW VIRTUAL SUPPORT WORKS

As usual, therapists will want to check with your billing manager or insurance companies, and clients will want to check with their insurance plans on how the coverage works.

Logistically, a session can use any number of virtual solutions – you probably have used Facetime or Skype for example. Many professionals use Gotomeeting, or Zoom for business or group meetings. For HIPAA compliant (privacy protected/secure) meetings, there are free solutions by doxy.me or vsee.com for example. My therapy group has set up their own system which is working well, and I also have tried some of the free solutions for my non-insurance funded clients.

I worked in a telephone counseling position for 19 years. Although initially everyone said they preferred face to face sessions, after one ten month program, the clients I worked with changed their view. In the end they preferred the phone setting for it’s convenience, it’s easy intimacy and depth over time, and the way the lack of distractions helped get to the heart of the matter.

Today’s virtual solutions provide video capacity, so you can also see each other. You can also choose to block your video from your end if you’d just like audio. Right now in a national emergency, it’s clear that adding this format helps our safety and well being. It can be more convenient, and even more supportive of intimate sharing / feeling expression, than face to face can be. (more coming on this)

So check with your providers and arrange to have the support you need in such a crisis/opportunity time. It’s important not to lose ALL of our support systems right now as many of our usual support systems are needing to close doors. Massage therapy anyone? : (

STRESS and COPING challenges

As you might see, the Corona virus is testing everyone’s stress and coping practices. Quick notes: coping with what we can’t control? Very very different than coping with challenges where we have control. If we need to get toilet paper for example ; ) we may have to get there when the stores opens these days. That’s taking control. If we’re more anxious and distracted, having a good supply of TP won’t quite be enough to calm our nerves or help us stay grounded. That’s where we need practices that regularly help us lower stress levels and release the tension that builds up. This tames the ever present fight or flight instinct, and keep chronic stress, the real health- derailer-side of stress, at bay.

I’ll be offering more on this – for now I’ll suggest a few steps based on the Transactional Model of Stress and Coping.

Get a piece of paper and write these steps out – it helps the brain.

  1. Define what about the virus most stresses you out
  2. Make two columns under that –
    What’s in your control – and – What is not in your control
    about the situation / problem side of corona virus in your world.

Although it may seem like everything’s out of control, that’s never true. After the first glance, you can start to come up with other things you can control. For example, diet, exercise, stress management, communication – all huge areas you usually control. Coping here is pretty straightforward and tends to follow a type of problem solving approach. You feel empowered when you take actions, even small steps. However, not taking care of steps that are in your control that are waiting for attention can also drain you.

Now, that stuff on the side we can’t control is often the most nerve wracking. Here you just need to do things that reduce your stress level – anything helps. But obsessing here can mess you up. You can catastrophize, and today, you can watch too much news for example. Unchecked, anxiety, frustration and depression can spiral and grow without regular stress reduction (meditation, pets, creativity, play).

Instead, you might list 5 things that – though they won’t change the situation – tend to comfort you, lower your stress, inspire you. For me that’s walking in the woods for example, and for many exercise is a key stress reducer and perspective booster. Small self care steps, like baths, or foot care, are often cited. Reading, movies – netflix now has a way for people to stream together and share comments/chat. (Note: binge-watching may work for a time, but then doesn’t help anxiety lessen when you’re procrastinating about what needs doing.) Staying in touch with friends via facetime, phone, email, letters, is another good technique to use to help the stress of what you’ve no power to change.

Another thing to mention is the boost that helping others can provide. We all know people who are more vulnerable right now, whether physically or mentally. Random acts of kindness can boost both your health hormones, and theirs. Don’t be shy if  you need help or support – your helpers get helped by helping you too – if  you follow me.

I’ll attach the 4 Steps for Stress – see step 4 on the first page, for a list of things that can help with the stuff we can’t control. Make your list of 5 things that would most help you in this area.

“SOCIAL DISTANCING” reframing

I heard this rephrased as Physical distancing. Much better. More to come on how to stay connected with your social circles.

On a webinar I heard today from ProductiveFlourishing.com, Charlie Gilkey and Angela Wheeler had some great suggestions. The above rephrase, for example, that the isolation now is only in the physical realm. The suggestion to name 2-5 of your key support people is another good one they names – and to actually figure out what you might need, what they need, and how you’ll do it together. I knew I’d be needing to schedule phone time with friends – and set that up. Maybe a regular time.

If you have a work setting to stay in touch with, say if working from home, you can stay in touch through daily check ins, text messaging, team and project mgmt software, etc. There is some good info on the webinar below about how to stay productive together, how to minimize distracting each other.

RESOURCES

4 steps for stress 

Good article from my colleague and Reiki master Meg Sullivan on Dealing with Fear: Being Practical

CO-VID 19 Resources from Productive Flourishing

Mid March Energy Update from Lee Harris
Good to get the energetic / broader perspective on what’s going on. I had some of these senses about things myself, and like Lee’s work a lot. See what you think, and you can email me any questions of some terms are unfamiliar. I like how in the end, he looks up and asks his guides, Help! what did this mean?

What parts of this pandemic are the most stressful in your world? What is helping you most with these stressful times? Share your experience below in the comments.