In light of the current COVID-19 situation, and having carefully considered the latest Government guidelines (Close contact services dates 14th July 2020), Choosing Change is issuing the following information:
Please note: For information on how to protect yourself from the Coronavirus you should always follow the government advice: www.gov.uk
During lockdown and since I have been offering counselling/coaching/supervision remotely via telephone and Zoom/Skype and this will continue as a preferred way of working. As lockdown measures have eased and with people returning to the workplace I have reviewed my practice to see if I can work safely in-person for those clients for whom working remotely is not a feasible form of support for them. Whilst Covid-19 threatens physical health there is also the toll it is taking on peoples mental health to be considered and have given returning to a limited in-person services considerable thought. Please see below for details of the risk assessment carried out
Ethics, Protection and Provision of In-Person Service
I recognise that there is a potential tension between wanting to offer clients continuity of service as well as appropriate protection.
As such I am considering the ethical principles of the BACP Ethical Framework for the Counselling Professions
Being trust worthy: honouring the trust placed in the practitioner
Autonomy: respect for the client’s right to be self-governing
Beneficence: a commitment to promoting the client’s wellbeing
Non-maleficence: a commitment to avoiding harm to the client
Justice: the fair and impartial treatment of all clients and the provision of adequate services
Self-respect: fostering the practitioner’s self-knowledge, integrity and care for self
Above all I want to protect my clients and supervisees, but also to offer commitment in relationship and not sever these relationships carelessly or unnecessarily or refuse support for people who for different reasons cant work remotely. Thus I am holding the tension between maintaining appropriate service levels but being responsible and protective – within government guidelines.
As of 3rd August, Choosing Change is open to clients who have considered remote working and still feel they need an in-person service. Therapy, coaching and supervision will continue as normal for those who wish to have online/telephone appointments. Those attending in-person appointments must follow the guidance on entry and exit outlined in the risk assessment and informed consent form available on this website. I will also make this information available in electronic form via email and the hardcopy in session. Clients must not attend if they are showing signs of illness – ie temperature, cold symptoms or a persistent and new cough or any other Covid-19 symptoms.
Should or when the government advises greater isolation levels again, then sessions will be offered using telephone or online methods.
As therapist/coach/supervisor, I am committed to following appropriate government advice regarding working and living safely during the pandemic.
The decision to Meet Face-to-Face
If there is a resurgence of the pandemic , however, I may require that we meet remotely (telephone, Zoom or Skype). If you have concerns about meeting remotely, we will talk about it first and try to address any issues.
If you decide at any time that you would feel safer staying with, or returning to working remotely, I will respect that decision.
Risks of Opting for In-Person Services
You understand that by coming to the therapy room, you are assuming the risk of exposure to the coronavirus (or other public health risks). This risk may increase if you travel by public transportation.
Our Responsibility to Minimise Exposure
To obtain services in person, we agree to take certain precautions which will help keep everyone you, me, and our families as safe as possible. These actions are outlines below :
- We will only keep your in-person appointment if you are symptom-free
- You will not attend a session if you have a high temperature or any other Covid-19 symptoms
- You will wait in your car or outside until our appointment time
- You will wash your hands or use alcohol-based hand sanitiser when you enter the building
- We will adhere to the safe distancing precautions
- You are advised to wear a mask in the entrance hall. Please wear your face mask until you are sitting and settled.
- I will open and close all doors for you in order to reduce as much cross contamination as possible. Please touch as little as possible during your visit; also try not to touch your face
- If you have to sneeze or cough please cover your mouth and nose with a tissue provided, but please take this away with you
- Please use the toilet only if really necessary, wash your hands for at least 20 seconds with soap and dry your hands with your own towel provided
- We will both take steps between appointments to minimise our exposure to COVID
- If we are exposed to other people who are infected, we will inform each other
- If a member of your household or mine tests positive for the infection, we will inform each other
If you or I are unwell
You understand that I am committed to keeping you, me, and all of our families safe from the spread of this virus. If you show up for an appointment and I believe that you have a fever or other symptoms, or believe you have been exposed, I will have to require you to leave the venue immediately. We can follow up with remote services. If I test positive for the coronavirus, I will notify you so that you can take appropriate precautions.
Your Confidentiality in the Case of Infection
If you have tested positive for the coronavirus, I may be required to notify local health authorities that you have been in the office. If I have to report this, I will only provide the minimum information necessary for their data collection and will not go into any details about the reason(s) for our visits. In attending face to face sessions you are agreeing that I may do so without an additional signed release.
Review Process:
The above procedure will be reviewed on a regular basis and may change at short notice based on government guidelines. I will continue to keep you updated on any further actions regarding this matt
Choosing Change COVID 19 Risk Assessment
Risk Assessment Overview
In order to ensure that the risk of infection between therapist and client is reduced, it is important that certain procedures are assessed, and measures put in place to reduce infection risk. The matters to consider for each individual client are the same, but there are also some general procedures that are to be adopted. However, the outcome of that risk assessment may be very different and it may be that it is not appropriate for some clients to resume face to face sessions at this time due to vulnerabilities that increase risk of harm.
It is important that I am transparent about my risk assessment process because you, as a client, have a part of play in the risk process. As a result, I must trust you and your ability to be equally as transparent.
I am acutely aware of obligations with regard to duty of care toward all clients, and in the current pandemic the interpretation of that duty becomes less obvious. For example, whilst the therapist’s duty of care towards your mental health remains the same, their duty towards your physical health and safety has now changed.
The pandemic and risk of infection requires that I consider the risk of infection and, in addition, your mental health as a result of the risks and restrictions that the pandemic brings. It may not be reasonable or appropriate to offer a face to face session to some clients even after all possible precautions have been taken to reduce infection. The therapist reserves the right to make this decision based on the facts at their disposal.
Physical safety and risk of infection
| 1. Reducing risk of contamination and spread before/during/after a session. |
| ACTION: The therapy room will be cleaned before appointments. The therapy chairs, table, doorbell, door handles and other surfaces will be wiped down with antibacterial wipes. Clients are able to use the on-site toilets (as indicated by the therapist) and antibacterial wipes are available to clean down the door handle, toilet seat, flush area, taps and sink after use. A wipe should be used to open the toilet door after using the facilities. Paper towels will be available for the washing (at least 20 seconds) & drying of hands in the toilet facilities Each client will wait outside in their car until their actual appointment time. Only the therapist will open and close any doors. The therapist and client sit at least 2m apart. If clients have to sneeze or cough please they have been asked to cover their mouth and nose with a tissue provided and to take used tissues away with them. After each client leaves, windows and doors left open for at least 15 minutes to air the room. Clients should bring their own drinking water (or alternative) as none can safely be provided at present Hand sanitiser and tissues are available throughout the session for clients to use at will. Clients are requested to take their tissues away with them please. Other factors: To maintain confidentiality, it is not possible to leave the door open during sessions – whilst the risk of a confidentiality breach is a low, many clients are likely to feel vulnerable to being overheard which could inhibit free expression. All of the above measure have been outlines in a Client informed consent document that they will sign to say they agree to |
| 2. PPE of therapist and client |
| ACTION: Hand sanitiser and tissues will be available throughout the session |
| 3. Social distancing in relation to entering/leaving and seating arrangements |
| ACTION: The client will notify the therapist via text (or alternative method) that they have arrived at the venue and wait until the therapist asks them to enter. Clients should wait in their cars until their appointment time. The therapist will open the door fully and step back to allow the client to cross the threshold safely Hand sanitiser will be available for the client to use on arrival. Clients are advised to wear a mask in the entrance hall and to keep that in place until they are sitting and settled Doors to the therapy room will be open so there is no need for a client to touch any surfaces on route to their seat in the therapy room. The therapist will wait for the client to be seated and will then enter the room. The chairs will be 2 metres or more apart. On leaving, the therapist will open doors and be followed by the client – maintaining social distance wherever possible. |
| 4. Session length – impact of time spent in therapy room |
| ACTION: In order to allow sufficient time to properly prepare the room before the next client, from this point on, all face to face session times will keep strictly to 50 minutes with a minimum of 15 minutes between clients. |
| 5. Payment |
| Wherever possible payment should be made using BACS transfer. If clients do not do internet banking, they must bring the exact amount in cash as no change can be given |
| 6. Ongoing Review |
| ACTION: Each party holds an obligation to be aware of and report to the other, any factors which may occur which could increase the risk of infection during the time face to face sessions. |