COVID-19: Reopening Practices and Resuming In-Person Sessions

As states being to reopen and lift stay-at-home orders, it is important to strategically plan and implement policies before reopening. Therapists are to exercise their professional judgment in considering reopening their practices. The decision to reopen is unique to each therapist situation. As you begin to consider reopening your practice, please take these necessary steps before reopening your practice.

Comply with Federal, State, and Local Guidelines

As the on-going pandemic unfolds, federal and state governments continuously release updated guidelines for reopening and operating your practice. Therapist should review and comply with all relevant federal, state, and local guidelines. The federal government and the World Health Organization (WHO) have developed guidelines for reopening businesses and reducing the transmission of the coronavirus.

Most state government and cities have published guidelines for safely reopening operating businesses. These guidelines should be closely reviewed and monitored by your practice.

Below is a list of helpful resources:

CDC Guidance on Face to Face Interactions
White House and CDC Guidelines for Opening Up America Again
Getting Your Workplace Ready for COVID-19
OSHA Guidance on Preparing Workplaces for COVID-19

Assess Whether an In-Person Session is Necessary

Marriage and Family Therapists should consider continuing using telehealth to reduce the risk of transmission of the coronavirus. Many clients will insist on resuming in-person sessions after many weeks of self-isolation. However, you must consider the best interests of your clients and whether resuming in-person sessions outweighs the risk of transmission of the coronavirus for vulnerable clients (e.g. at-risk age groups and clients with health conditions).

Therapists should document reasons for why telehealth is a safer alternative and appropriate if a client persists on resuming in-person sessions and it is not safe to do so. Additionally, therapists should consider the potential risk to their own health and family members for resuming in-person sessions. Therapist should not needlessly risk their own health or the health of their family members, staff, or clients.

Please read AAMFT’s COVID-19 Telehealth Guidance and Resource page for guidance on conducting telehealth.

Liability and Legal Implications

As you contemplate reopening your practice, please consider the liability and legal implications that may arise from reopening your practice. You should consider developing concrete strategies and written policies that comply with government guidelines. Disregarding and violating public health guidelines could give rise to a potential legal claim. Therefore, it is important to implement written policies that demonstrate compliance with government guidelines.

If you decide to resume in-person sessions, it is suggested to have clients sign an informed consent form that addresses some of the following concerns below. Please note that this is not an exhaustive list of all precautions that should be taken and does not waive all liability for therapists. State and local health authorities may have published additional guidance.

  • Client consents to meet for in-person sessions during the COVID-19 pandemic. By agreeing and coming into the office, client assumes the risk for exposure to COVID-19 or other public health risk. Clients should consult with their physician on public and personal health risk.
  • Clients are under no obligation to attend in-person therapy sessions and the client may choose to return to telehealth sessions at any time. I reserve the right to terminate any in-person sessions if it becomes unsafe during the COVID-19 pandemic.
  • You agree to comply with public health orders and guidelines addressing protective masks and gloves.
  • You agree to wash your hands with soap or use an alcohol-based hand sanitizer prior to entering the building.
  • You agree to notify me if you or a member of your household has been exposed or infected to COVID-19.
  • You will notify me and my practice if you work in an environment that exposes you to individuals who may be infected to COVID-19.
  • In order to keep you, my employees, and myself safe from the transmission of COVID-19, I reserve the right to cancel our appointment and require you to leave the office immediately if you or another person in the office has a fever or any other symptoms. If I or a member of my staff are sick, I will notify you so you may take necessary precautions.
  • To begin or resume in-person session, you agree to take necessary precautions to protect yourself, me, my staff, and our families from exposure to COVID-19. If you do not adhere to these precautionary requirements, I reserve the right to terminate in-person sessions. Telehealth may remain as an alternative to any in-person sessions. Initial each provision to indicate that you understand and agree to each required safeguard:
    • You agree to wash your hands with soap or an alcohol-based sanitizer before entering and leaving the building.
    • You agree to take your temperature before each in-person session. If your temperature is higher than 100 degrees Fahrenheit or if you have any other symptoms, you agree to immediately notify me or my office and agree to cancel the in-person appointment. You will not be charged a cancellation fee. Telehealth will remain as an alternative option for therapy.
    • You agree to adhere to any safe distance measuring policy in the building, waiting room, and in my office.
    • You agree to maintain a safe distance of six feet from myself and from all staff.
    • You agree to avoid all physical contact e.g. handshakes.
    • You agree to not bring in any unannounced visitor before the session.
    • You agree to take precautionary steps to minimize your exposure to COVID-19 before and between appointments.
    • You agree to notify me if you or a member of your household was reasonably exposed to COVID-19.
    • You agree to notify me if you or a member of your household works in an environment that is frequently exposed to COVID-19.
    • You agree to notify me if you or a member of your household has tested positive for COVID-19.
  • I reserve the right to amend, add, or abrogate any of the foregoing precautions according to any published federal, state, or local health guidelines. I will notify you of any changes to the agreement.
  • In certain circumstance, I may be required to notify federal, state, or local health authorities that you have been in the office. This may occur if you have tested positive for COVID-19. If I am required to report this, I will only report the minimum information necessary to perform their health duties.
  • Disclaimer: The information at the time of publishing this article is believed to be current and accurate. However, our understanding of the COVID-19 virus frequently changes. Therapist must follow federal, state, and local officials for new and updated guidelines. The information provided in the article is not to be relied upon as legal advice. A signed informed consent form does not waive all liability for therapists. You are encouraged to contact an attorney licensed in your respective state to obtain guidance to your specific situation.