As more and more Americans are asked to stay home, mental health care is just one industry that has had to quickly adapt.
David Baumrucker, a licensed professional clinical counselor at Momentum Life Counseling in Cottage Grove, said about 20% of his clients have switched over to teletherapy since he began offering the option in mid-March. Other clients are still coming into the office but may eventually transition to virtual sessions. Still others, he said, are "unphased by it all."
For those who still show up to the office for appointments, providers say they are taking special care to disinfect surfaces they or clients may touch. Baumrucker said he keeps a checklist of objects to wipe down and that he often opens the door for client to further reduce contact.
Though mental health professionals and their clients often meet one-on-one, that isn't always the case. Substance abuse counseling, for example, is often done in a group setting, said Heather Mundis, a licensed psychologist who manages Canvas Health's Forest Lake location (Canvas Health also has a location in Cottage Grove). Mundis said these clients are still getting care, but it's now one-on-one.
"This is a very high-risk time for anyone with substance use issues, so we want to make sure that we’re meeting their needs," she said.
Mundis said only "about 5%" of clients are still attending sessions in person at any of Canvas Health's locations.
For Dr. Shalene Kennedy, a psychiatrist at Aris Clinic in Woodbury, and the rest of the clinic's care team, developing new curriculums and treatment plans for their K-12 patients was "stressful." On March 16, staff closed the clinic's two locations and broke into small groups to not only figure out how to adapt their outpatient therapy sessions, but also their Intensive Outpatient Program 6-8 week program that, during the school year, combines three hours of daily therapeutic programming each day with schooling from teachers at Northeast Metro Intermediate School District 916.
"We’ve had to get super creative," Kennedy said. "It is not an option to leave these families without services, so how are we gonna do it?"
By March 20, all of Aris Clinic's operations had gone virtual, including its day program, Kennedy said.
Mental health care providers said that, in light of the ongoing pandemic, certain treatment has taken a backseat to discussions about day-to-day concerns, like health, safety and other anxieties that have arisen as people face uncertain and extraordinary circumstances.
“You can’t get away from it — it’s where we are as a society," said Michelle Rowlison, a licensed marriage and family therapist and the owner and clinical director of Clearwater Counseling, which has locations in Woodbury, St. Paul, Shoreview and Maple Grove.
What's lost, and what's gained
Providers that were used to sitting face-to-face with a client, often only feet apart, now must grapple with what is lost when they meet virtually.
“I think every therapist would tell you they’d rather be sitting across from somebody than on teletherapy, and because we’ve had to make that switch, it’s kind of a big identity switch for most therapists," Baumrucker said.
Some clients struggle to find a place to conduct a session privately within their own home, along with what Baumrucker called "a sense of closeness" when a provider and client meet in a room together, and a therapist's diminished ability to see and read body language.
“You really have to rely on the client really being honest with you because you don’t get that insight," Baumrucker said.
The transition is also complicated by some insurance companies that still don't allow providers to bill for telehealth services, Mundis said.
But there are advantages, providers said. For example, some people seem to feel more comfortable expressing themselves or speaking their mind when separated from their provider by a screen.
“You get to see a little bit more of their personality," Baumrucker said. "You can just see a little bit more of their character because they’re in their own element, they’re in their world, they have that security of having that distance.”
Rowlison echoed these comments, adding that the increased openness may also come from clients feeling more at ease in their own home than they might in a therapist's office. She's seen growth in clients, as well, as the separation forces clients to learn to sit by themselves with hard-to-deal-with thoughts or emotions.
Kennedy said virtual sessions have come with some adjustments for her child and adolescent patients, including slightly shortening sessions and adding in 10-minute movement breaks. Though at first she expected virtual sessions to be a barrier to providing good care, at least three of her patients "have really come out of their shell," she said.
Kennedy described how the switch to virtual sessions reveals that treatment could be easier for patients who struggle with inconsistent transportation, as well as the potential to reach patients in more rural areas in the future.
"To have it work so well just feels like, wow, we have an opportunity, and maybe a duty, to reach out to those kids that have difficulty getting access to care," she said.