Talking therapies on adapting to lockdown

Second Step was commissioned to run one-to-one talking therapy support sessions in the homes of older people who otherwise would not have been able to access therapy support. This could be because of chronic pain or lack of mobility as well as a lack of confidence. Sessions with a therapist would last up to one and a half hours, involved an initial assessment and up to five weekly follow up visits. Talking therapy sessions used a Cognitive Behavioural (CBT) approach to supporting clients in finding solutions to subjects such as: anxiety, depression, lack of motivation and overcoming barriers.

Since the pandemic, the project has had to adapt its services in line with social distancing guidelines. We spoke to Jenny from Second Step about what the project has learnt during this time.

“The main change to the project was that we went from face to face interaction with clients, to over the phone, and at the same time we also had to adapt to working from home rather than in an office environment.

Prior to lockdown a part of our job was taking referrals from different services, and if space was available we would call the client to check if they were interested in receiving support. This is where I would explain our way of working and discuss the service and the client’s expectations of the service. We would then run an initial face-to-face assessment of the clients’ needs, and also take the opportunity to complete evaluation questionnaires.

However, doing an assessment over the phone takes longer than it would take in a face-to-face appointment. You need to ensure that both you and your client have all the relevant information in front of you, and that the client has this information in a format that they can read, e.g. large font. It also takes longer because you can’t read subtle body language ques you would normally see in a face to face appointment, you don’t know for example if the client is still considering a question, or if they haven’t heard you. Sometimes if there is a long pause I’ll say, ‘I’m still here,’ so they feel listened to.

In my experience, clients have adapted to a different way of working. I have received ongoing positive feedback from being able to provide a therapy service even via telephone, clients have commented on the vial service and how its supported manage there distress, being able to receive therapy via telephone has prevented long waiting times and enable people to receive support when they most need this.    

Working from home is a completely different way of working. I’ve found you have to be mindful that you are at home and be conscious of the space and its limitations, e.g. you need to be in a room where you can ensure privacy and confidentiality of the client you are speaking to, but also be aware that your work could be interrupted by the postman knocking on the door.

As a team, we had to adapt the way we work and consider how best we could stay connected. We have weekly Zoom sessions which has helped keep contact and I’m very lucky to have weekly supervision phone calls which helped a lot particularly during lockdown. Usually if I’m having difficulty with a client I’m able to discuss the case with colleagues and use reflective practice methods to bounce ideas off each other. We’ve still been able to do this, but it has to take place over Zoom instead.

We had some technical issues at the start of lockdown, so being more prepared for remote working would benefit us in the future, e.g. at the beginning I didn’t have access to headsets which made it quite difficult to speak over the phone.

In an ideal scenario we would continue face to face client work. We believe the client group benefit from face to face, especially when you consider how isolated some of our clients are.”


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