banner image

Practice in the Time of COVID-19

An Open Letter to My Client

  As we’ve come to expect over the last few years, the news moves fast. The letter I sent three days ago to you about moving to online therapy if desired seems to be quite outdated. But because of how quickly things are moving, I am forced to write this quickly. So it might seem rambling. As of Monday, March 16th, I am going to be working entirely online, in the fullest spirit of “flattening the curve” (please read if you can: I believe that we not think of just ourselves in this time, and whether we are going to get through “a mild flu because I am young and healthy,” but rather whether we can wittingly or unwittingly contribute to the “community spread” that seems so much easier in cities like New York. After just last night I now believe my home of Jersey City and the broader NYC area should impose a shutdown of some sort (take-out establishments only, perhaps?), as it is clear at this time that not enough of us are taking this seriously ( Even if they do not do what seems appropriate, my urging to you would be to comply with some sort of personal shutdown. The impact that a large-scale outbreak can have on our healthcare system and its workers could be so catastrophic that it seems almost imperative for us to overreact. But, actual panic is not advisable. So, this might sound counterintuitive to some (though if you’ve been listening to me it probably shouldn’t): it’s OK to be anxious. These are trying times, and there is a threat to our community and the larger society. In order to get through this relatively unscathed, we need to adopt behaviors that just a week ago were foreign to most of us. The idea of “social distancing” wasn’t something I had ever read about until this past week. Some amount of anxiety is actually needed so that we continue to practice safe behaviors. Try to explain this to the inner critic when you sense it judging your anxiety! It’s when this healthy anxiety isn’t attuned to, it can then bleed into panic, when our self-care routine breaks down and it feels like a battle to just move. I will be doing my best over the next few days to figure out ways to communicate so that even though we might feel isolated and only able to meet weekly (or bi-weekly for some), you can still feel like I’m here. I will probably be blogging a bit more. In the meantime, I am available by text or email to figure out how to meet your needs. Because I will be exclusively online, this might be tricky for some (if there is not exclusive space in the apartment, for example.) I feel incredibly fortunate that I have been practicing online for almost 4 years and feel quite comfortable with the interface (there are some therapists who have never done a single session and have to start from scratch and I feel for them right now as their job just got even more challenging.) Many clients who have worked with me online found it awkward going into the first session, and then afterwards commented that it wasn’t what they thought it was going to be, in a good way. If you have feelings about working with me online at this time, please reach out and we can process them. I have also worked with couples online, so I am not deterred from maintaining my therapeutic relationship with all of my clients. My schedule is now going to be Monday through Friday. I am happy to reschedule sessions with clients so long as I have space in my schedule. For the sake of a “policy,” I would like a 2-hour notice, but will not require one. I know that so many of you are working from home (thankfully), and understand that your companies are likely going to be scrambling around. I won’t enforce any sort of cancelation policy other than charging for a no-show, but for mental health purposes (and to prevent a negative butterfly effect of sorts), my strong suggestion is that we maintain session cadence, or even increase in certain circumstances. If you are not working from home but technically could if your agency would let you, I’d be happy to help draft a letter on you and your colleague’s behalves to advocate for this need. Lastly, this is not easy financially on anyone. Economics should be the last thing we think about (which is why I brought it up last) when it comes to our health, and especially now. Our mental health is going to be tested through this. I can empathize if you feel like your financial situation prohibits you from maintaining sessions with me, and PLEASE bring this to my attention to process how we can handle it. There is no shame as this will affect all of us economically in some way. I will do what I can do. We are all in this together, and the stronger we can all be, the better we will all be. There is nothing I’d rather be doing during this time than helping all of you. Because if I can give you what you need, that can get passed along into the community. A positive butterfly effect of sorts. David Addendum: What about those who might be sick? I can't believe how in my own not-sick world I am. Please contact me and we take it from there. I'm still here to help you in whatever way I can.