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Wed Mar 18, 2020, 10:39 AM

Across the street from my office, the lights are off in the dining area and playroom at McDonald's

I work in behavioral health, in a small practice. We are debating how to handle this pandemic, as there are some complications to doing psychotherapy work during a crisis such as this.

Some clinicians are attempting to get telehealth or teletherapy up and running, but that's typically not something you can do over a weekend. Also, there are all kinds of problems billing insurance for a telephone conversation. In addition, although I often see people pointing to research that shows that teletherapy can be effective, I myself am not trained to track people's affect and state of arousal purely by tone of voice. I use visual cues to inform me of what emotional or mental processes a client is going through. Looking at someone on a computer screen gives me a tiny range of their bodily affect, or embodied emotion.

Doing sessions by telephone or telehealth, you have to steer clear of triggering subjects or content that could cause a person to go into a downward spiral emotionally. In person, you can take someone into their affect and have them work through their feelings in a safe environment, but over a telephone, you're playing with fire if you do that.

On the other hand, my clients with intense depression, suicidal depression, intense anxiety, agoraphobia, social phobias, or germ phobias need our clinic to stay open. So we can't just shut down, and we can't just easily switch all of the appointments to telephone appointments for theoretical and administrative reasons.

These are my thoughts as I look across the street at the dark play area at the McDonald's across the street.

I was raised a Lutheran, although I'm basically an atheist now. Nonetheless, I pray for all of us.

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Reply Across the street from my office, the lights are off in the dining area and playroom at McDonald's (Original post)
bluedye33139 Mar 2020 OP
intrepidity Mar 2020 #1

Response to bluedye33139 (Original post)

Wed Mar 18, 2020, 10:43 AM

1. Good insights, thanks nt

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