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Running a Therapy Office in Crisis

It was over four months ago when it seemed like the world collapsed. It was 6:30 am when I received the text from a therapist in my office, "I was exposed to Covid19". In an instant I knew what I was going to do but I always call in reinforcements to collaborate on big decisions. I texted my husband to tell him the news and his response was identical to my own, "Shut it down". Within 45 minutes half of my office was completely shut down. There was a whisper of pending problems in the news but my kids were getting ready for school much like a regular Wednesday morning. But this Wednesday didn't "feel" like a regular Wednesday morning. By 8 am the office was scheduled for a disinfectant cleaning and we were working on a social media announcement to change appointments to telehealth. At this time my reaction felt extreme. This was days before Governor Baker started making television appearances and schools were closed. As I moved forward with the plan to close my therapy office there was a voice in the back of my head that questioned if I was overreacting. What if this is the Y2K of the medical field and I am overreacting? I knew my decisions would be costing my therapist and myself money and our patients would be affected. We were going to be inconvenienced and there was going to be a hard learning curve. But, everyone would be safe. As safe as I could control. This was going to be a tough road, but I knew what I wanted to do.

With one building shut down I still had to make decisions about the other building. Our exposed therapist was not located in this building but there was still the smallest chance that people were in danger. Due to the code of ethics which all social workers commit to, I could not allow any of my clients or my therapists to be exposed to this potential threat. All offices needed to be shut down immediately. It seemed drastic but it also felt very safe. Safe was the only feeling that felt solid at that moment.

Therapists were resistant to exclusively providing telehealth services, which would limit some clients ability to connect. I understood that. Throughout that long Wednesday I reached out to all the therapists to hear their concerns and help solve their issues. We were in this together. Technology, finances, resources, and privacy were all factors we were trying to consider in those early days of Covid19. I searched for what other companies were doing to protect their clients and staff. Disinfecting stations, CDC protocols, limiting groups of people to less than 50 seemed to be the standards people were following. The term "social distancing" wasn't even introduced yet. As I researched office protocol our therapists were busy collaborating on information about telehealth protocol, insurance requirements, and best practices. The information was overwhelming and frequently changing. Within the next few days many of the therapists were using telehealth and keeping their regular schedules. Other therapists came to their offices but it was only to use the internet access. We were finding a new rhythm. I had a crash course in patience and being open about my fears with my team. When this fear and stress threaten my ability to lead, my therapists gently reminded me we could do this together. The therapists found creative ways to complete their work and feel good about doing so. I found ways to trust. Each of us struggled and we found support in our team.

Our office services over 200 clients a week and have a total of 12 therapists. We even brought in a new therapist during this shut down and we are preparing to bring in another! In two hours notice, we changed over to telehealth sessions. The collaborative teamwork was impressive. We continue to maintain our caseload from our makeshift offices. We continue our monthly supervision meetings and our group chats. We continue these acts as small reminders to remain connected. We rarely speak about the ache in our hearts for all that we miss. Our unspoken bond still connects us. We remind each other that someday, we will once again share a cup of tea together during unexpected canceled appointments. We hold on to the hope that we will once again meet and laugh during supervision, and we will see our clients beautiful faces, in person. We continue to work in the virtual world today because we know that there will be a day that we will be in the office again. It has always been our goal to provide excellent clinical care for our clients and now we have also proved that we support and care for our therapists as well.

The support we have for one another, whether it is in person or online, continues in our monthly Supervision Sessions. This is one of the many reasons I have created Supervision Circles. For some therapists, a private practice can be extremely rewarding but lonely. Even for others that are part of a group, they may still sometimes feel like they are on an island.

Supporting each other during a crisis, or just everyday makes us all better therapists.

We can bounce clinical, business, or any kind of questions we might be having off our group. The open hearts and minds of these group members lifts us all up, which in turn helps us heal and support our clients.

I invite you to join our Supervision Circles Community! Visit our website: for membership information or reach out to me: Karen Peabody

Karen Peabody, LICSW is a therapist and business consultant for social workers and therapists interested in starting their private practice. She founded Forgewell Solutions in East Bridgewater, MA and launched Supervision Circles in 2020. For information on joining Supervision Circles, join here or contact us:

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