As Demand Surges, Counseling Clinics Learn How to Adjust to Telehealth

The coronavirus pandemic forced many counseling centers to transition quickly to telehealth this past year. Some have had an easier time than others in adjusting, but nearly all have learned invaluable lessons in how to deliver virtual care.

“It’s been challenging at times,” says Nikki Fangman, LPCC, executive director of MEBS Counseling, whose Kentucky-based practice went all-virtual in about a week. “We had to shut down our face-to-face services very quickly. A lot of people had to adjust. The first two to four weeks were difficult.”

This affected people on both sides of the platform.

“For me, it was the human connection, that synergy you feel when you’re in the same room with the other person,” she says. “I worried that going online … would lose that.”

More than nine months later, with the pandemic still very much evident and the nation struggling with high rates of depression and anxiety, healthcare providers like MEBS – which stands for Meaningful Emotional Behavioral Services – are finding that synergy via connected health. And they’re developing their own workflows to manage those connections.

“Some people like it and some people don’t,” says Fangman, whose clinic partnered with Azalea Health to launch its telehealth service. “I’ve worked with some clients who are more comfortable with telehealth. They’re familiar with the technology. We’ve been able to find a very, very therapeutic component to the platform.”

“We have a very steady flow of folks calling for our services,” she adds. “There’s a lot of isolation and anxiety right now, affecting kids, parents, grandparents, everyone.”

That level of comfort is different from patient to patient – and, truth be told, from provider to provider. And it speaks to the value of a telehealth program that can be molded to fit the individual wants and needs of both patient and provider.

The old adage that seniors aren’t comfortable with technology isn’t always correct – nor is the idea that everyone born after the ‘70s is comfortable online. Fangman says she’s worked with adults who prefer making a virtual connection from the comfort of their home, while there are certainly kids who want or need someone to be in the same room with them to make a connection.

“It’s challenging to keep someone engaged through telehealth, especially over a long period of time,” she says. “You have to find out what works.”

Fangman says MEBS had telehealth on its agenda, but had been planning to gradually introduce the concept to providers and patients over time. COVID-19 changed all that, and quickly. So while it has taken the clinic time to help patients adjust to the new format, it’s also taken that much time to figure out what they can do with the technology.

Now, the clinic is conducting video visits in both individual and family therapy programs, and using the platform for “virtual walks” in programs like Big Brothers/Big Sisters. And they’re looking at programs for rural communities, businesses and schools – even the front porch, if that’s the one place that a patient feels comfortable talking to a counselor.

“We see this as an opportunity for us to be able to reach more people,” Fangman says, addressing not only barriers to accessing care but the phobia of seeking help with a mental health issue.

“With telehealth, we’re more accessible than we’ve ever been before,” she says. That means being able to connect with patient at the time and place of their choosing, rather than shoehorning everyone into an office schedule. This, in turn, has drastically cut back missed appointments and no-shows.

That also means setting boundaries for online access and behavior, and sometimes convincing people that telehealth isn’t just a video game, but a very real means of delivering healthcare.

At the same time, Fangman says, MEPS Counseling is bringing back in-person treatment for those who just aren’t comfortable with online care.

“Undoubtedly we will be going back to that when we can,” she says. “But that will be different, too. We might have a smaller office.”

Many counseling clinics are adopting that plan, part of a hybrid approach that mixes in-person care with telehealth. Some are establishing new workloads so that providers can mix office time and working from home, or they’re hiring new staff to handle online services.

That’s the lesson learned from COVID-19, Fangman says.

“It’s simply going to be just another service that we are able to offer,” she says. “We have to do this. We can adapt and we can change and we can still be helpful and supportive no matter what comes our way.”