A note to psychotherapy clients about COVID-19

By March 31, 2020June 30th, 2020News

March 31, 2020

During the COVID-19 pandemic, most health care providers are finding ways to provide care remotely, helping clients access care in different ways, or are even no longer providing services that are not essential. If your psychotherapist is registered with CRPO (you’ll know that if their title is Registered Psychotherapist), they have received information from us to help them respond to the pandemic. You can see some of it here.

The following questions and answers are to help you understand some of the changes you might be seeing in how your psychotherapist provides care.

My psychotherapist has told me that they can’t see me in person, but that we can continue therapy by phone or over the internet.  Why is that?

Because of the COVID-19 pandemic, the Chief Medical Officer of Health issued a directive for health care providers instructing them to stop providing non-essential and elective services in order to limit the spread of the virus. The Ontario government also ordered the closure of all but essential services;  “health services, including mental health and addictions and counselling supports” were included in the list of essential services that could continue to operate if required.

In response to this, CRPO has strongly encouraged RPs to stop seeing clients in person and to offer therapy by phone or over the internet. This is called “electronic practice.” Switching from in-person to electronic practice both allows clients and therapists to continue working together while practicing physical social distancing.

What does electronic practice mean?

Electronic practice is a way for psychotherapists to provide care using telecommunication technologies. Telecommunication technologies can include telephone, interactive videoconferencing, email, chat or text.

During the COVID-19 pandemic, your psychotherapist may use these communication technologies exclusively in order to provide therapy at a safe, physical distance.

I want to continue to see my psychotherapist using telecommunication technologies, but they have not offered this to me. Why is that?

Your psychotherapist might not be willing or able to continue to provide therapy to you using electronic practice. For example, they may feel they don’t have the competence to do so, or they may be prioritizing client care needs in light of all the clients they see, given that health providers across Ontario have been asked to provide essential care.

Psychotherapists are also expected to assess if using telecommunication technology is a good option for each client, taking into consideration:

  • the possible risk of harm
  • whether the client is able to access technology safely
  • if a client would be safe if they had an adverse reaction (for example, a panic attack) during a session that was not taking place in person

If your psychotherapist cannot provide care to you using telecommunications technology, they should speak to you about putting a plan in place until they can see you. They might recommend other ways to receive care in the community or online. And they should discuss what you should do in an emergency.

Does my therapist need my consent to provide care electronically?

Yes.

Your psychotherapist should take the time to explain how they will practice while using telecommunications technologies and should get your informed consent. This means they need to explain how the care will be provided, if there are any risks to providing care in this way and any other information you need to be able to decide that you want to receive psychotherapy electronically.

What do I need to know about technology to receive therapy this way?

Your psychotherapist should choose a system that they know how to use and can guide you in using so that your sessions run smoothly. If you can, you might want to practice with the technology before your appointment with your RP if it is unfamiliar to you.

How will I know that my privacy is being protected?

Registered Psychotherapists are required to take steps to protect your privacy, whether they provide services face-to-face or using telecommunications technologies. Before provide therapy using any technology, they are expected to explain any privacy risks that the technology might present. If you have questions about the steps your psychotherapist takes to protect your privacy, or you’re worried about your privacy we encourage you to discuss this with them.

If a therapist uses an internet-based solution, they should be choosing technology that has security features that meet the requirements of the Personal Health Information Protection Act such as having a certain level of encryption and secure ways for handling data. Some psychotherapists may choose to provide care by phone, a method that does not carry the same security issues as other solutions.

Your psychotherapist will do the best they can in the circumstances to help protect your privacy, but it’s important to remember that there are steps you can (and should) take to help protect your information, too. Keeping in mind your own personal circumstances and privacy needs, here are some steps to consider:

  • Ensure you are in a private place when you have your sessions
  • Ensure your computer has passwords so that nobody else can access any information you might have stored related to your psychotherapy
  • If you are using a shared computer, you may delete any information related to your psychotherapy (including internet browser history)

There are a number of resources available to help guide you in protecting your privacy – in particular your digital privacy – that you can look at:

Your health privacy rights in Ontario
Protecting your privacy online
How can domestic violence survivors protect their privacy?

Are there other resources I can access other than my psychotherapist?

The Ministry of Health has published a list of Resources for Ontarians Experiencing Mental Health and Addictions Issues During the Pandemic.

Jack.org has published a Youth Mental Resource Hub as well, specifically around coronavirus.

If you are looking for trusted information about the pandemic, you can find it here:

Public Health Ontario: Coronavirus Disease 2019 (COVID-19)
Government of Canada: Coronavirus disease
World Health Organization: Coronavirus disease (COVID-19) Pandemic