We advise all members to keep up to date with the latest advice about coronavirus from the Government and from the NHS.

Should we be continuing with face-to-face work with our clients?

Given the Government's guidance to stay at home unless absolutely necessary, we advise that, wherever possible, you do not continue to see clients face-to-face if other options are available.

There are many factors to consider, including:

  • the client's need and safety
  • your need and safety
  • the context of the service
  • whether other options are possible and the ethical and practical risks of any decision
  • the known risk factors of age and any pre-existing health conditions for both yourself and your client
  • clients with particular needs who may not be able to engage using online platforms

We'd encourage you to work through the ethical decision making process with your supervisor to make a personal decision on this.

We realise some members will want us to give a definitive answer to this question, but because of this range of factors we’re not able to give a single answer that will be applicable in every case.

Am I a key worker?

Our members work across a range of settings, with a wide range of clients and many of you have children of school age.

The Government has asked parents to keep their children at home, wherever possible. Children of those whose work is critical to the coronavirus response, or who work in one of the critical sectors, and who cannot keep children safe at home, will be prioritised for education provision.

Like many other healthcare professionals, counsellors and psychotherapists are not specifically listed in the guidance. However, if you think your work could be classified under the headings, we advise you to contact your individual employer, school or local authority for clarity on the approach they're taking locally. We're also engaging with all Governments across the UK to ensure there is recognition of the vital need to ensure appropriate access to counselling and psychotherapy throughout the crisis.

Can you clarify whether counselling is deemed essential or non-essential contact? Has there been any official clarification from the Government or the Department of Health?

We'd like to have more clarity on this from the Government or the Department of Health. We’ll keep you posted as and when we hear anything to help with any decision making.

At the moment, we believe this is a judgement that needs to be made with each individual client. For some clients counselling is an essential contact, and you could consider whether telephone or online therapy may be possible, while others may be able to manage or choose to take a break in therapy.  

We'd encourage you to work through the ethical decision making process with your supervisor to make a personal decision on this.

I don’t know whether to continue seeing clients face to face, move to online or take a break from practice?

This is an understandably difficult decision so look at the guidance provided on our website to help inform your decision making.

Some clients may be comfortable with taking a break, which makes the decision relatively straightforward. Or you may feel that you want a break for personal reasons, which may make the decision more challenging.

You need to weigh up the commitment to put clients first with the principle of self-care.

Good Practice point 91 in the Ethical Framework provides the following guidance on care of self as a practitioner:

1. We’ll take responsibility for our own wellbeing as essential to sustaining good practice with our clients by:
a. taking precautions to protect our own physical safety
b. 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
c. seeking professional support and services as the need arises
d. keeping a healthy balance between our work and other aspects of life

You may also find it helpful to look at our Good Practice in Action resources. Any decisions you make must be discussed with your supervisor.

Whether you've reached a decision or not, this might be a good time to recontract with your clients and include a contingency plan relating to the virus.

This could include:

  • what you’ll do if you or anyone in the setting where you practise is symptomatic
  • what you’d like your clients to do if they are symptomatic
  • an alternative method of contact - for example phone or online

Can I offer telephone or online counselling instead?

If you decide to suspend face-to-face contact, telephone or online counselling might be an acceptable alternative if you consider the following points:

  • that the reason for doing so is to prevent the spread of the virus. If either party is experiencing symptoms of coronavirus the best option may be to take a break from therapy until fully recovered (seek NHS guidance).
  • you are competent to deliver therapy via these two methods (see our competency framework for telephone and e-counselling)
  • delivering therapy via this method is suited to the needs of the client and the material being discussed. Telephone or online therapy may not be suitable for all clients or certain issues.
  • you can recontract with the client to take into consideration any differences in delivering therapy via this method
  • your supervisor is competent to supervise online practice

For older clients who do not have access to, or experience of, video-calling, continuing sessions by telephone may be the best alternative to face to face sessions.

We’ve already seen a significant increase in the number of BACP members advertising online and telephone counselling services on our Therapist directory.

If you’re able to offer telephone or online counselling and you currently advertise on our directory, we’d recommend updating your profile to reflect this. Simply log into your account and click on Personal details. You'll find your directory listings at the bottom of this page and you can edit them accordingly. It can take up to 48 working hours for changes to be reflected on your directory page.

Data protection

If you decide to offer telephone or online counselling, remember to consider your data protection and confidentiality obligations. Ensure the solution you're using is secure and make sure you can’t be overheard or overlooked during sessions.

What happens if I contract the virus and can’t see clients?

The Ethical Framework has a section that specifically looks at breaks and endings. In respect of unplanned endings, it states:

“Any unplanned breaks due to illness or other causes will be managed in ways to minimise inconveniencing clients and, for extended breaks, may include offering to put clients in touch with other practitioners.” (Good Practice, point 41)

The Ethical Framework also commits members to make plans for who will contact their clients if they are unable to because of serious illness. This is sometimes referred to as a making a clinical will.

Practitioners need to ensure that their “wellbeing is sufficient to sustain the quality of their work” (Commitment 2d) so you need to pay attention to self-care and take steps to ensure that, if you have to take breaks from practice, your clients are informed, supported and referred to other appropriate services if needed.

If you test positive for coronavirus, the NHS is undertaking contact tracing, which means you'll be interviewed about people you've been in contact with. The NHS will then contact them to  provide support and testing. What's your advice about identifying clients to the NHS if you're diagnosed with coronavirus?

As discussed above, you may want to revisit your contract with your clients.

Your existing contract may refer to the limits of confidentiality relating to the balance of public interest. Public interest is the general welfare and rights of the public that should be recognised, protected and advanced. Disclosures in the public interest, based on the common law, are made where this is essential to prevent a serious and imminent threat to public health, national security, the life of the individual or a third party, or to prevent or detect serious crime.

You could explain to your clients that this clause may become relevant if you contract the virus and are obliged to inform the NHS of people you've been in contact with. In this case, you may need to share their name and contact details but not the context in which you know them. However, they may be contacted by the NHS. 

If you want to separate this out to make it clearer to clients, you could add a coronavirus contingency clause, stating that confidentiality will be broken if necessary for reasons of public interest in the area of public health.

Is there any guidance for employers or employees?

We offer a free employment law advice line through the Ethics hub, provided by Law Express. You can email the ethics team to request a call-back. They also list employment law considerations relevant to coronavirus on their website. 

We've also published an FAQ page for members working in private practice or for small organisations, which provides some information for employers.