Private practice and Coronavirus

We’ve gathered all of the current advice we could find as of 15th March about best-practice during the pandemic, so that you can access it in one easy place. 

As well as general advice, we’ve collated information about preparing to work online with clients, from training you can take to choosing video, email and messaging applications, and the privacy implications of this way of working.

As you know, this is a period of rapid change, and the sources cited throughout this article may be updated frequently to reflect the latest information – please check the links provided to make sure the details are still relevant. At the very least, we encourage you to keep up to date with the latest from the Government, NHS and Public Health England sites, as these will be informing most other reputable sources.

We hope you find this useful during this period of change! If you would like us to include any additional information, please let us know

In this article:

  • working with clients during the pandemic
  • face to face sessions
  • providing online, telephone and text-based counselling
  • providing online supervision
  • preparing to work with clients online
  • training to work online
  • software applications for online therapists
  • privacy and Data Protection
  • financial support for small businesses
  • looking after yourself during the pandemic
  • relevant reading

Working with clients during the pandemic

Several professional bodies have recently posted member updates about working safely during the pandemic: 

  • BACP have issued a FAQ about coronavirus, offering guidance based on therapist questions. As well as signposting members to the NHS and Government guidance on coronavirus, they provide practical tips on running a private practice during the pandemic. In it, they stress the importance of weighing up your ethical duty to put clients first with the potential risks against your own well-being and health.
  • UKCP have issued a similar statement, stating:

“We recognise that there may be times over the coming weeks when therapists and clients are unable to meet for therapy in person because either is in isolation and/or unwell. We suggest that, if possible, the therapist and client explore this situation before it happens to discuss what psychotherapeutic support is likely to be needed and how it can be delivered safely.”

They encourage you to think about what emergency support and help could be made available to your clients if they’re unable to see their usual therapist.

“Communicate with all clients and inform them that their sessions could be liable to postponement or disruption on a temporary basis. Where possible, offer clients the option of continuing sessions by phone or video conferencing.”

For the sake of brevity, we’ve only listed three professional bodies here; generally speaking, the advice appears to be fairly consistent, but you may wish to check your own professional body’s site for specific details if it’s not listed here. 

Like us, all professional bodies are consistently encouraging their members to keep an eye on Government, NHS and Public Health England sites for further updates as these events unfold.

Some key things to consider are:

  • What steps can you take to minimise risk for your clients and yourself? These may be as simple as increasing hygiene measures, to suspending face-to-face contact temporarily.
  • Are you capable of providing therapy remotely, e.g. online or via telephone, during the pandemic? Would these methods be suitable for your clients?
  • How will you communicate any updates to your clients – for instance, if you become unwell and are unable to take sessions? 
  • Do you have a process in place for clients to let you know if they are unwell, or have been in contact with a confirmed case of COVID-19 and has this been communicated to them? Do you need to review your cancellation procedures in light of recent news? 
  • If you contract COVID-19, do you need to let your clients know that you may be asked to provide their details to the relevant authorities for contact tracing, and is this covered by your contracts and insurance?
  • How might your fees be affected? For instance, if you normally charge a cancellation fee, will this still be the case in light of the pandemic? Might this cause a client to feel compelled to break self-isolation to come to a session?
  • How will you take care of your own health during this time?

Face to Face Sessions

Read Managing Coronavirus: A Psychotherapist’s Perspective on Happiful.

There are many simple steps you can take based on existing advice, such as:

  • Practise social distancing. Keep at least one metre away from clients (ideally two metres for extended periods, i.e. over 10 minutes). Avoid hand-shaking or other physical contact.
  • Wash your hands thoroughly before and after each client.
  • Regularly disinfect door handles, hand-rests of chairs, computers, laptops, phones, writing implements etc. between clients.
  • Make sure tissues are available to clients (if they weren’t already) so they can practice the mantra “catch it, bin it, kill it”. Pre-divide tissues into batches so that you can provide clients with their own portion – don’t have one central box of tissues that could become contaminated.
  • If you provide a bin for tissues, make sure it is emptied between clients and use appropriate measures to prevent yourself from coming in contact with the contents – or ask clients to take their tissues home and dispose of them themselves.
  • Air out the consulting room where possible by opening windows etc.
  • Use your judgement: if you have any doubts about your own health or that or your client, take the appropriate steps. This may include self-isolation, sign-posting clients to resources such as NHS111 or PHE, and notifying other individuals who you may have been in contact with (or who may be affected).

These are just a few ideas that could make a difference; think about the way your practice currently operates, and what changes you could put in place that will have the greatest impact for you and your clients. You could even discuss ideas in our Member Notice Board, or in other online therapist groups that you’re a part of.

Providing online, telephone and text-based counselling

For ease, we will refer to all of these methods as “online counselling” throughout this article unless otherwise specified.

Online counselling may provide an excellent alternative to face to face sessions during the pandemic, and may enable you to keep working with clients who might be otherwise unable to attend.

Online counselling and psychotherapy is currently unregulated, and there are no specific qualifications required to conduct sessions online instead of face to face; however, you should be mindful of your professional body’s code of ethics and any specific competency frameworks in place. You can normally find this information on their website – for instance, you can see BACP’s Telephone and e-counselling competences and curricula here

Regardless of the method in which you deliver therapy, you will naturally still be expected to adhere to your professional body’s code of ethics, and to only offer therapeutic services that you’re competent to deliver.

If you currently offer online or telephone counselling, check that your Counselling Directory profile has been updated to reflect this. You can specify your methods of delivering therapy here

You may also want to update your main profile text to refer specifically to online or telephone counselling sessions and how these are conducted, as we anticipate that this option will be of particular interest to visitors over the coming months and it’s likely to be an approach that many aren’t familiar with.

For those new to online counselling: in the words of the Association for Counselling and Therapy Online (ACTO), “counselling online is different”, and you may need to adjust the way you’re used to working. You will also need to be able to competently assess your own ability to deliver therapy effectively online, and the client’s receptiveness to this approach. 

ACTO recommend that you take certain steps to make sure you’re prepared practically for the transition, such as:


Check that your insurance (and that of your employer, if applicable) covers you for online and other forms of remote therapy – you may need to amend your policy to make sure you’re covered when working in this way.

Client contracts

You may have already made provisions for your unexpected absence – such as in case of illness – in your existing client contracts: nevertheless, it’s a good idea to review your contracts, and re contract with clients if necessary. In particular, you may want to consider including clauses referring to online counselling and when it may be appropriate to suggest this to your clients; additional security or privacy considerations that might arise from working online, etc. This may need to be reflected in individual clients and your privacy policy.

Client payments

You may need to investigate electronic means of being paid, such as bank transfer, Paypal or other online invoicing. Many of these options are quick and easy to set up.

As a leading organisation for online counselling and psychotherapy, you can find a lot of useful information about working online on ACTO’s website, including advice on self-care when working online

Working remotely has the potential to be a challenging transition when you’re used to seeing human beings in person day to day, and it’s important to recognise that you may need to spend a bit more time looking after yourself while you’re at home. We’ll talk more about looking after yourself later in this article.

Providing online supervision

Like online therapy, supervision requires an adjustment to the way that you’re used to working face to face, and many of the same principles will apply.

If you haven’t done so already, this could be an excellent opportunity to consider offering supervision online or by telephone via your Counselling Directory profile. 

You can update your free Supervisor profile here.

Preparing to work with clients online

Training to work online

Because there are specific considerations that must be taken into account when you’re not in the same room as your client, many professional bodies recommend that you undertake a specific course in training to cover online, or e-counselling, telephone, email (“asynchronous therapy”) and text-based/life chat (“synchronous therapy”). 

These courses will typically require you to have already undertaken a traditional counselling or psychotherapy qualifying training, and have a level of relevant experience before you can enrol.

The following training organisations offer courses specifically tailored towards working online with clients and/or offering online supervision:

Online Training for Counsellors

OLT offers online training to counsellors, coaches and therapists, ensuring that they know how to work ethically online. Their Certificate and Diploma Courses (including their Diploma in Online Therapeutic Supervision) are validated by CPCAB, the Counselling and Psychotherapy Central Awarding Body, and delivered entirely online.

  • Online Counselling Training: Yes
  • Online Supervision Training: Yes 

Academy for Online Counselling & Psychotherapy

The Academy specialises in training for mental health professionals, especially for those working therapeutically online or wishing to work online. Their ACTO-approved courses cover general professional topics such as Online Counselling & Psychotherapy and Digital Supervision, plus specialised CPD in areas such as CORE-Net, ProReal Avatar therapy and more.

  • Online Counselling Training: Yes
  • Online Supervision Training: Yes

Online Counselling Services & Training (OCST)

OCST is an approved ACTO Training Provider and Successful completion of their OCST1, OCST2 and Online Supervision Diploma programmes will allow you to register for full Professional Membership of ACTO (as well as providing CPD hours).

  • Online Counselling Training: Yes
  • Online Supervision Training: Yes

Therapy Institute

Manchester’s Therapy Institute aims to provide the highest quality training for counsellors, psychotherapists and similar professionals in a safe and encouraging environment. They offer several courses, including a one-day introduction to online counselling and a 13-week Certificate in Online Counselling.

  • Online Counselling Training: Yes
  • Online Supervision Training: No

The Online Therapy Institute

Founded in 2008, the Online Therapy Institute offer training programmes on Online Therapy and Counselling, Online Coaching, Online Supervision, and Avatars and Virtual Reality.

  • Online Counselling Training: Yes
  • Online Supervision Training: Yes

Software applications for online therapists

Communicating with clients over the internet requires a platform that you can both use to speak to each other and, often, see each other too. 

It’s natural to feel a degree of trepidation when transitioning from the familiar world on face to face work to your first online client, particularly if you don’t consider yourself to be technically astute. 

The good news is that, as far as the technical aspects go, connecting with a client online is actually relatively straightforward, and opening communications can be as easy as sending a video link to them prior to their next session!

Video-calling and Instant Messaging

Here is a list of three popular video-calling and messaging services used by therapists: use the links to see which one fits the bill for your practice.

Trusted by household names such as Sonos, Delta Airlines and 21st Century Fox, Zoom offers a free Basic package with no limit on 1 to 1 meetings (meetings with 3+ participants have a 40-minute cut off).

VSee is the platform of choice for 1000+ telemedical companies, as well as NASA for the Space Station. It offers HIPAA-approved secure video communications, and their Free packages offer up to 25 video calls per month plus unlimited secure messaging.

Signal provides end-to-end encryption on calls and messages, and is available in desktop and mobile app form. As an open-source project, it is free to use.

While a popular option, some therapeutic organisations have expressed concerns about the security and overall suitability of Skype as a platform for therapy. Because it is an application most likely to already be used by many members of the public – and therefore adds a certain degree of familiarity and ease of use during periods of distress – you should assess the pros and cons of this platform yourself, and check that your client has familiarised themselves with the terms of this product. You may find ACTO’s guidance notes on Skype an interesting read.


If you’re planning to conduct therapy via email, consider the security of your email provider and the implications of transmitting more personal data via this platform than you would normally. Regardless of the platform you use, it’s important to be open and honest about the ways you process client data in your company privacy policy.

The following platforms offer enhanced privacy and may be of interest if you’re planning to conduct sessions in this way:

Designed for the healthcare industry, Hushmail provides encrypted email and secure webforms for clients to contact you. Fees start at $5.99 per month per user (a small business will typically only require one email address), and a one-off setup fee of $9.99. It has a 60 day cooling-off period, during which you can get a full refund.

Switzerland-based ProtonMail offers end-to-end email encryption, and is open-source – meaning it’s free to use.

Privacy and Data Protection

Your obligations to protect the data you process don’t change materially when you work online with clients; however, you will need to apply the same kinds of security measures while working in this way that you would have to normally. For instance:

  • Who has access to your computer/applications that you’re using to work online?
  • If you’re using third party applications to process your clients’ data, what are their security policies? How will they protect this data?
  • If you’re using applications based outside of the EEA, will you need to update your privacy notice or client contracts?

For general advice on privacy and your obligation to protect the data you process, The Information Commissioner’s Office (ICO) Guide to Data Protection is the place to go. If you still have questions after reviewing the information available, you can contact the ICO directly for clarification.

ICO have recently published a statement on Data protection and coronavirus, with specific information for Data controllers (organisations).

In it, they confirm that communicating updates to your clients about public health – e.g. if you keep them informed about measures your practice is taking – are not direct marketing, and so are not restricted by data protection laws. Ensure you have a way to communicate with your clients quickly and easily so that you can keep them informed of any factors that affect them.

In addition, public bodies may require “additional collection and sharing of personal data to protect against serious threats to public health”: as outlined above, you should keep clients informed about the possible implications contract tracing may have on your confidentiality clauses. You may be asked to provide information about individuals’ health to the authorities, though it is unlikely.

ICO have stated that they “recognise the unprecedented challenges we are all facing during the Coronavirus (COVID-19) pandemic”, and are happy to answer questions. You can contact them on 0303 123 1113.

Financial support for small businesses

The Government has issued information about financial support for employees, benefit claimants and businesses following the 2020 Budget, including measures to protect small businesses and self-employed people during the pandemic. 

This includes a dedicated helpline for businesses and self-employed individuals in financial difficulty, and how to access support.

If you have income protection included on your insurance policy, you may wish to familiarise yourself with any updates your insurer has provided in light of the pandemic.

Looking after yourself during the pandemic

Last – but by no means least – we want to take a moment to talk about you. You. The human being who bridges the gap between individuals needing help and support (particularly during this anxiety-inducing time) and their own rich personal life (and that of their family) which may be being affected by the current state of play.

First and foremost, we can’t stress enough that following official guidance on social distancing and hygiene is paramount to safeguarding your physical health. It goes without saying that you can’t realistically look after others without looking after yourself first.

When it comes to seeing clients, your own judgement is key, and this is apparent in professional body codes of conduct. In their Ethical Framework under Care of self as a practitioner, BACP write that their members should:

“Take responsibility for our own wellbeing as essential to sustaining good practice with our clients by:

  1. taking precautions to protect our own physical safety
  2. monitoring and maintaining our own psychological and physical health, particularly that we are sufficiently resilient and resourceful to undertake our work in ways that satisfy professional standards
  3. seeking professional support and services as the need arises
  4. keeping a healthy balance between our work and other aspects of life.”

Likewise, National Counselling Society’s Code of Ethics states:

“As well as abiding by the Code of Ethical Practice and following guidance from the Society, a practitioner must consider their own self-care and wellbeing in remaining fit to practice in accordance with the fifth fundamental principle, integrity and self-responsibility… a practitioner will only commit to a practice that they can offer being aware of own expertise, training, health and wellbeing and let the client know if anything changes”.

In short, you will need to weigh up the two sides of the scale:

  • your ethical duty to protect the welfare of clients
  • being responsible for your own health and wellbeing

Measures such as working online/via telephone or text-messaging with clients may strike an excellent balance between the two, and offer you a way to continue therapy while balancing risk – provided you are both mentally and physically (and ethically!) capable to do so.

If you find yourself unable to commit to sessions for the immediate future, the key thing is to make sure that your clients are informed, and to make provisions for their ongoing support in your absence. If you need help doing this, your professional body or supervisor will be able to signpost you to the relevant sources.

If you’re used to working from a building with other people, you may find the switch to home working takes some adjustment. You may even find that missing out on the change of environment that comes with travelling to a consulting room has an unexpected impact on you. The Guardian has prepared a list of helpful tips for home-workers which you may find useful, even if some of the information may not be directly relevant to the way you work.

Finally – even though we’re pretty sure we’re preaching to the choir (or even the pastor!) – we wanted to take a moment to share some of the self-help literature that we’ve produced for the public in the last few days. As you know, this is something that we truly believe in at Counselling Directory and Happiful, and sometimes the little things really do have a big impact.

Stay safe!

Relevant reading:

Please note: Counselling Directory and Happiful are not affiliated with any of the organisations referenced in this article, and this article has not been sponsored by any third parties. We strongly recommend that you carry out your own research to make sure that you can make an informed choice that best suits your business. While we hope that this information is useful, we cannot be held responsible for any business decisions you make based on this article, or for the information published on third party sites.

All information correct as of 15/03/2020.

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Written by Jo Ferguson
Written by Jo Ferguson
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