Covid-19 Frequently Asked Questions

Face coverings in the consulting room

On 8 August government advice about face covering in public and professional settings changed. Counselling and psychotherapy services are not explicitly mentioned in the government guidance on face coverings, and government continues to advise to work remotely whenever possible. However there will be instances where it is clinically appropriate to return to the consulting room.

We have been advised by the Department for Health and Social Care that face coverings should be used when delivering face to face psychotherapy unless clinicians and/or patients are exempt or the consulting space is Covid secure . A list of exemptions, such as ‘where putting on, wearing or removing a face covering will cause you severe distress’ or a mask cannot be used ‘because of a physical or mental illness or impairment’ is available in the face covering guidance link above.

If working in an institutional setting, government continues to advise that the employer’s guidance should be followed.

Can I resume face to face sessions? 

The easing of social distancing measures from 4th July offers the potential to return to face to face sessions, however government still advises that every reasonable effort should continue to enable working remotely as a first option and people who can work from home should continue to do so.   

Registrants who decide to open their consulting rooms are required to assess whether they can implement current government guidance to contain the spread of Covid-19. 

1. Assessing Risk  

Government has published guidelines for businesses and the self-employed returning to face to face work. There has been no specific guidance issued for psychotherapists and counsellors, however, the guidance for ‘close contact services’ can be useful when risk assessing premises and ensuring they are safe enough for registrants and patients. Further information is also available on the UK Government and HSE websites. The location of the consulting room, how it is accessed, whether it is shared with other practitioners, located in a private or public setting will also influence whether government guidance can be adhered to or not. Risk assessment includes whether: 

• Registrants and/or patients may be particularly vulnerable to Covid-19
• Increasing the frequency of handwashing/sanitising and surface cleaning is possible to implement
• Every reasonable effort to comply with the social distancing guidelines set out by the government (2m, or 1m with risk mitigation where 2m is not viable) has been put in place
• Every reasonable effort to clean and sanitize the consulting room, door handles, to protect/clean chairs/couch and to air the room during and/or in between sessions can be implemented. 
• Waiting areas are spacious enough to continue to be made available or the appointment system needs changing to avoid any unnecessary contact between patients. 
• A clear action plan is in place in case registrants or any of the patients they have been in contact with, test positive to Coronavirus (for example would they communicate this to each other and to other patients or would they solely rely on the Test and Trace system).  

2. Mitigating risk for both clinicians and patients 

Registrants should consider the needs of their patients and their own personal circumstances. If they are satisfied contracting and spreading Covid-19 can be mitigated according to guidance available and that there is mutual understanding of the risks and of the actions needed to mitigate such risks, they may consider implementing the following specific protective measures before, after and during sessions: 

• Telling patients they cannot arrive early. 
• Leaving enough time between sessions to ensure the room can be sanitised and aired. 
• Hand washing upon entering the premises and upon leaving. 
• Ensuring there are infection control measures in place at all times (wipes, alcohol had gel and disinfectant spray for furniture).  
• Considering using single use plastic covers for chairs and sofas/couch. 
• Opening doors for patients to minimise patients touching anything in the room or considering the use of disposable plastic gloves. 
• Keeping windows open if/when possible – but always ventilating between appointments. 
• Cleaning door handles, surfaces, taps, light switches, loo flush (if toilet facilities are provided) before and after every session.  
• Discouraging the use of toilets unless absolutely necessary. 
• Avoiding touching objects in the room. 
• Wearing masks or visors when the two metre distance cannot be maintained. 
• Regular and effective hand-washing/hand sanitising remains an essential and core principle. 

3. Covid-19 Test and Trace and disclosing patients’ details  

The wider approach to contain Covid-19 includes contact tracing to identify positive cases and to slow down the spread of the virus.  

People considered ‘close contacts’ are: 

• people you’ve spent 15 minutes or more with at a distance of less than 2m 
• Sexual partners, household members or people with whom you have had face-to-face conversations at a distance of less than 1m  

It is important that registrants are aware that if tested positive to Coronavirus, they will be required to inform the NHS of people they have been in close contact with this includes disclosing patients’ names and contact details. However, disclosing the nature of the relationship is not a current requirement.  

Registrant are expected to comply at all times with the BPC Code of Ethics. We recommend that all registrants explain their obligation in relation to Test and Trace to their patients and set out the steps they would take if they were to test positive.  If a written contract is provided, this will need to be amended to include the new disclosure requirements and shared with patients.  

If patients are uncomfortable with the possibility of their details being disclosed, they may choose to continue with online or telephone sessions.  

An explanation of how contact tracing works can be found on the BBC website. 

Can I safely and ethically work remotely? 

In order to assist registrants in making changes to their work practices as a result of Covid-19, in March we issued the following general guidelines, applicable to online or telephone psychotherapy sessions: 

• Registrants should make a plan about moving to remote therapy which is communicated to each patient. For registrants working in institutions, those guidelines and requirements will have to be followed first.
• Registrants should make themselves aware of the differences between providing online/telephone and face to face psychotherapy. They should consider the impact this may have on the relationship between the therapist and patient and whether this move is appropriate for the patient.
• Registrants should take appropriate software/hardware measures to ensure the safety and confidentiality of online therapy and they may want to check which software is most secure. There are many providers available and many people use Zoom although we cannot recommend a specific provider. 
• Registrants should discuss in advance with the patient what measures they are putting in place to protect their confidentiality whether the therapy is online or on the telephone and explore how the patient can ensure they have a safe and confidential physical space to participate in the session remotely.
• Registrants should continue to be aware of the obligations in relation to privacy and confidentiality as set out in the GDPR guidelines and the BPC GDPR briefing that can be found here.
• If in doubt, registrants should check with their insurance company in order to ensure that they are able to provide online/telephone therapy and have the relevant insurance cover. 

Furthermore, some of our registrants have shared their experience of working remotely during lockdown and their reflections can be read in the Covid Reflections section of our website.  

What about vulnerable clients and patients?  

There may be instances where stopping or moving therapeutic interventions to remote delivery when social distancing is required is not in the best interest of the patient. ‘Services relating to mental health’ may be an exception when it comes to government’s advice about social distancing – see UK Government advice for businesses and the self-employed.  

We advise that in all circumstances psychotherapists and counsellors must apply their professional judgement, seek professional/supervisory advice, refer to their insurers and, if applicable, to their employers. If they are unable to provide care to a vulnerable patient who needs face to face intervention, they must refer to alternative practitioners/institutions.   

Does my insurance cover Covid-19 claims? 

We have been in contact with the Association of British Insurers and the leading insurance companies that provide cover to counselling and psychotherapy professionals and although there are no plans to introduce changes to current policies due to Covid-19, Registrants are reminded to regularly check with their insurers they are in compliance with their policies. 

Can I continue my CPD online?   

We encourage Registrants to continue with their CPD whenever possible and to take advantage of online courses, events and information and resources available, such as:  

• How to manage the change of the therapeutic frame, such as the one offered by the Tavistock Relationships. 
• The Open University in collaboration with BACP has created an module on how to deliver on-line counselling 

• The American Psychoanalytic Association has made available significant and useful information for providers working during the pandemic as well as a free presentation on how to move from face to face to tele-treatment 

There are many more resources available that can be accessed online.  

Can I continue to see my training patients? 

We acknowledge that training and all clinical work needs to have the flexibility to adapt to the changes required to contain the spread of the coronavirus. Since the onset of ‘lockdown’, training organisations are delivering training remotely and the individual training organisations will decide if, when and how to resume face to face teaching.  

It was agreed that trainees own training therapy, and their existing training cases, can continue remotely and this will be accepted by BPC as part of their training requirement. As in every situation, if the trainers consider that the trainee has reached the required standard, they have the authority to qualify them even if they have not completed all the course requirements.   

It is also possible for trainees to begin their training cases remotely. Trainers, having taken into account the trainee’s individual situation, the assessment of the potential training case and the specific setting issues which may pertain to the particular situation, have the discretion to allow trainees to take new training cases.   

We advise our Registrants to keep up to date with the latest advice about Covid-19 from the Government and from the NHS. 

Where can I find further resources to help adapting my practice during the Covid-19 pandemic? 

The IPA has made available several resources to support clinicians during the Covid-19 pandemic, they include: 

• Advice on confidentiality and remote working  
• An extensive and very useful reading list on remote therapy 
• Remote session guidelines for patients 

Other external links: 

• ICO  Data protection and coronavirus  
• BACP FAQS on Coronavirus 
• BACP Guidance to Working Online 
• UKCP Guidance on Coronavirus 
• ACTO advice on Covid-19 

Can I receive any support to adapt my practice to Covid-19? 

The Coronavirus Mental Health Response Fund (CMHRF) is available for mental health charities that wish to expand their support services, however due to the successful take up it has currently been paused. To find out more about the Fund please click here.  

In May the Government announced the launch of the Local Authority Discretionary Grant in response to COVID-19. The £617 million funding is available for distribution by Local Authorities and it is aimed at small businesses with ongoing fixed property-related costs. Local Authorities are being asked to prioritise businesses in shared spaces, regular market traders, and small charity properties that would meet the criteria for Small Business Rates Relief. 

We have supported IPSE’s (Association of Independent Professionals and the Self Employed) campaign calling for government to provide support to the self-employed. Recognising these challenges, the Chancellor announced specific financial measures for the self-employed, they can be accessed here, under the heading ‘Government Support for the Self-Employed’.