Face to face counselling

[Granolaslice]

Does anyone who works in the field know when it might resume? I’m on the waiting list and really struggle with talking on the phone. I’m thinking surely it’ll be possible if we’re sat two meters apart?

Webcam counselling?

Almost all counsellors I know are not planning to do face to face work for a while and have switched to online or phone.

I have no idea when this will change, one mentioned the possibility of doing socially distanced walking and talking.

The worry is that even with the 2m rule you are still in contact with someone for an hour and people are also worried about being able to adequately disinfect between clients. Counsellors are not keen on the idea of masks because so much communication is through facial expression,

That's a very long winded way of saying I don't know!

Is the waiting list you are on an NHS or agency list?

I think it’s appalling, and youngsters are being let down.

If I can sit in a classroom with 15 children all day and shops, doctors etc can accommodate dealing with big numbers of the public so can counsellors.

Bleach spray like we have in school and all staff are using,tables and chairs wiped down, windows open. Not hard.

Many youngsters don’t like telephone conversations which is all we’re being offered so the face mask excuse doesn’t hold up.CAMHs is bad enough as it is. Children and teens are in desperate need of support. They need to sort it out asap.

My dc had a long awaited phone call appointment after ringing crisis cancelled due to “ technology difficulties”. It was only my tears of frustration that got it back on miraculously 20 minutes later with noises in the background and apologies re the counsellor’s puppy. And we’re supposed to make troubled teens relax and talk in these circumstances.

It’s ludicrous. Does Boris even know that children/ teens are struggling and the already shit support they were getting is even shittier and falling way below what is required?

I'm an NHS therapist. I think we will be working remotely for a while..until the autumn at least. I am seeing most of my patients by video..would that work any better for you?
There are a few issues getting going with face to face, obviously the main one is distancing (rooms are often small), we often use rooms in hospitals, GP surgeries and we are not allowed to be there currently as they need all of the space to allow for distancing and worried about additional clinicians and infection control, also therapists might be clinically vulnerable or trying to juggle childcare around appointments. I do realise it's not great for some people though, I have had a couple of appointments with a counsellor myself via video and it worked better for me as I have chronic health issues so it was fab to be able to do it from home but its hard for some people.

Absolutely not. Teens are very private when troubled and had it drilled into them re not sharing stuff online. My dc would be mortified to think there was a video of her somewhere spilling things she feels awful about.

Childcare issues are not an excuse. We all have those and are expected to deal with it. Some have been working and struggling with that throughout.

Doctors are managing it ( every gp office I have ever been in is tiny but bigger than 2 metres) and I’ve never been in any hospital room less than 2 metres square.

Children pose little risk which is why I’m spending every day with 15. Pretty sure counsellors could cope with 1

I think some are milking the situation and it’s just appalling. I do wonder if the government are aware re how bad the mental health provision is at a time when so many need it.

Childcare issues are not an excuse. We all have those and are expected to deal with it. Some have been working and struggling with that throughout.

It's all well and good saying this but if you insist that counselling is done face to face in the normal space before schools reopen all you'll achieve is even longer waiting lists because all the counsellors with children - which is a lot of them - will struggle to work at all.

What are the rest of us supposed to do then?

I’m in school and struggling with childcare as are many who have been working throughout. Shop workers are returning in their droves.

If everybody struggling with childcare refuses to return to work out of the home the country would grind to a halt.

And actually I’m not sure I want my teen talking about her very complex needs whilst her counsellor is looking after children.

I dont work with children so cant speak for what's happening there. Re space, we are not allowed back into GP practices, they are seeing very few patients face to face and dont want people sitting in the waiting room or extra clinicians (I had a face to face gp appointment myself last week, I was the only patient in the surgery and the gp was in full ppe) The room I use usually is less that 2m..its in a hospital. You can only fit 2 chairs in it. As for video we use specific nhs software which doesnt record sessions. It's clearly not ideal for lots of people for lots of reasons, hopefully we can get back to face to face asap, lots of workers are v keen to do so, but we are not necessarily the ones making the decisions!

2 metres is an adult with both arms stretched out. You work in rooms smaller than that usually?

There seem to be a lot of excuses and not a lot of sorting.

Most teens with low self esteem, trust etc would never open up on zoom, video or telephone.

It needs to be sorted ASAP. I really don’t think they’re aware how bad it is and how much youngsters are being let down. If they are, it’s a national disgrace.

Nobody is caring for the kids whilst having sessions with patients. I dont have kids myself but think colleagues are doing say 3 hour chunks of work on rotation with a partner throughout day if they are both working from home. I'm shielding so wouldn't be able to physically see patients currently, although am happy to when I can although a lot of my patients are shielding or older too so I think it will be a mix of remote appointments and face to face for a while.

And that is appalling.

I’d really love to know the privacy and data regulations on this.

It’s very difficult to say.

Membership bodies are saying to check with insurance companies, insurance companies say to follow government guidelines or ask membership bodies for advice. It just goes round in circles with no answers, but if something went wrong the counsellor could be held liable. Some insurance companies are currently refusing to cover face to face work.

Most are doing video call or telephone work at the moment because that’s the only thing that seems to be covered. For many counsellors, building/office setup means government guidelines on social distancing just can’t be followed. Two metres is the same as an adult with both arms stretched out only if they are 6’7”. Counsellors are often put in forgotten rooms little better than cupboards!

@F1n1gans Absolutely not. Teens are very private when troubled and had it drilled into them re not sharing stuff online. My dc would be mortified to think there was a video of her somewhere spilling things she feels awful about.

There wouldn’t be a “video of her somewhere”, the videocall wouldn’t be recorded.

@f1n1gans You dont need to convince me that mental health services are a mess. Am sorry that your teen is really struggling, its shit for them and you.

The DPA 2018 has to be followed as normal.

Why aren’t the gov sorting this with insurance companies?

Because insurance companies are private entities and cannot be forced to cover something they believe isn’t safe.

I work for the nhs and we are seeing people but to even try to refer someone for therapy's t the moment is a challenge and they now have a huge backlog of work. The waiting lists were awful before corona and now they are even worse. People that are accepted are just placed on a waiting list for years in some cases!!

I dont know what happens in other services, I know in my service data protection and privacy are taken very seriously. We have to be alone in a room obviously with a headset on, using a ridiculously complex and longwinded multi identification process to logon to view even a patients phone number. It's fine to be angry about the situation but there are a lot of mental health workers working really hard in a really difficult situation to make sure that they are supporting their patients the best they can given the limitations.

The long awaited phone appointment we had the counsellor didn’t have her all notes due to “technology difficulties.” Background noise.

We’re now waiting 2 weeks until she is discussed and however long after. Previous paperwork lost too.

A teen who wants to die.

It’s mainly video. For face-to-face both parties would have to be wearing masks etc. so probably less comfortable/therapeutic than doing it remotely.

I’m a therapist. Our service has no base to work in, We have always been peripatetic to make the service accessible. Pre lockdown we were in and out of schools and hospitals, now we are not allowed. Which isn’t our decision. I did have a discussion with my supervisor about outdoor sessions, walk & talk maybe? We’re also in regular contact with our settings to try and go back in safely as soon as we can. I wouldn’t try doing phone or online therapy from home without childcare for my own kids, ethical and confidentiality issues are as important as ever. Everyone is frustrated.