Safety planning for teletherapy: What therapists need to know

Safety planning is a critical part of therapy in all settings.

Key Takeaways

• Teletherapy is becoming more common than ever before. But some therapists are hesitant to adopt this model of care due to concerns over client safety.
• As with in-person care, safety planning is a critical part of teletherapy. While all safety plans should contain some basic elements, designing effective safety plans for remote therapy involves a few extra steps.
• By proactively engaging your client in a collaborative, dynamic safety planning process, you will both be more prepared to address challenging situations if they arise.

Just a few years ago, teletherapy was not a service that many therapists offered to their clients. But since the coronavirus pandemic, connecting remotely via teletherapy (using a HIPAA-approved video or phone conferencing platform) has quickly become the norm for many therapists. This shift in the way we deliver care has made mental health support more accessible for many people. Yet some therapists have concerns over possible safety issues related to remote therapy. Because while safety planning is an important part of the therapeutic process no matter the setting, it becomes even more critical when you aren’t able to meet with a client face-to-face.

What are safety plans?

• Triggers: What are the signs that there could be an increase in risk?
• Coping strategies: What are the client’s existing, effective coping strategies? Who can the client rely on for support in difficult situations?
• Provider responses: What steps will the therapist take to keep the client (or someone else) safe? What does the client need to know about the limits of confidentiality in these situations?
• Emergency protocols: Who is on the client’s emergency contact list? What other emergency numbers (crisis hotlines, etc.) or resources might be helpful to include?

Best practices for teletherapy safety planning

• Crisis response protocols appropriate for a teletherapy context. During intake, collect your client’s emergency contact information and their exact location during their session. Without this information you won’t be able to direct emergency services to your client should the need arise. Be sure your client understands the importance of letting you know whenever they are accessing their session from a new location.
• A clear plan of action in case your internet connection is weak or interrupted. This might include directions for switching platforms or contacting you by phone if you lose access to your video conferencing platform. It’s also a good idea to check that your client has the numbers for local emergency services in their area. In addition, make time to ensure that your clients are familiar with how to use your teletherapy platform before they begin remote sessions.
• Information on how to ensure confidentiality during remote therapy and a discussion of thebenefits and risks of teletherapy. Be transparent about the privacy challenges associated with teletherapy and discuss ways your client can let you know if there’s a person nearby so that you can pause the session. This might mean using the chat feature or simply having a hand signal that means “Let’s pause, someone is listening.”

What to do when a safety plan doesn’t go according to plan

• Use your professional judgment. Consult with a peer if needed and take immediate action to reassure your client and address the concern. Your response might range from rescheduling a missed appointment to contacting emergency services. It all depends on your client’s situation.
• Remind your client. As you work to support your client, remind them of their coping strategies, and connect them with whatever resources they might need, communicate with them as you are able and keep them updated on recommended next steps.
• Adapt. Learn what you can from this experience and update the client’s safety plan accordingly. Be sure to follow up with your client after the incident to ensure their safety and talk about whatever changes might need to be made to their plan for the future.

Final thoughts

Whether you’re running an in-person, hybrid, or fully remote teletherapy practice, safety planning is a critical part of providing quality mental health care. At Rula, we’re here to help therapists simplify this process and make it easier to collaborate with clients in making safety plans that can evolve with their unique needs. And if you have a safety planning concern, our supportive provider community can offer you the consultation you need to help keep your clients safe. Learn more about joining Rula

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