Getting back to work series — 4 of 7: Session Flow and Client Management

What seems like ages ago, this video was making the rounds: how we were making it through self-quarantine. Day 22 remains my favorite — and might reflect your mood at this point!

A New Routine for Our Sessions and Our Clients

Given these new protocols, safety equipment and pared down environment, it’s likely that our sessions won’t feel like they used to. At least at first.

Even with the few sessions I’ve done in the last several weeks, I can say that a new routine is easier to establish than I feared. Once the client is in and we’re doing our work, the treatment itself takes center stage. All that is gratifying in the work resurfaces: relating to the complexity of the human body, the presence of health, helping someone feel better, the learning, the quiet. That is not lost, not at all.

Here’s a bit of a checklist to make sure we’ve covered the bases:

• Leave 30 minutes between sessions to allow for hygiene turn over and more self care. Better to have more time to center ourselves than too little at this stage (ever?).

• I’m also telling clients that I’ll work on them until I feel that useful changes have been made (rather than for a pre-set # of minutes). So far, most sessions are running about 2/3 of the time that they would in the past. I like the added focus this time is bringing.

• I’m scheduling fewer people in a day, so that I can be flexible about rescheduling as needed and I can learn as I go.

• Fewer clients also means less risk of transmission should one of us be exposed to COVID-19. We and our clients can do everything “right” and still there’s a small risk of infection. I’m expecting to keep a light schedule at least until contract tracing is up and running in my community.

• We’re trying to cluster our clients onto the same day(s) to allow the possibility that the room could go unused for 48-72 hours at a stretch. It’s relieving to come into the space knowing that the risk of active virus is extremely low to nil.

Before the session via email, voicemail:
• Remind your client about wearing their own mask, leaving extraneous items in the car/at home, and if possible, coming at the start of their time outside the home.

• Encourage your client to stay home if they or someone in their household has any new (or unexplained) symptoms on the day.

• If needed, shift your practice policies to allow for late cancelations without penalty. (As ever, if a clients habitually no-shows or cancels late in the day, you’re not required to reschedule with them.) The goal is to empower clients to be as honest as possible with you about their status.

• I have ‘fired’ two clients because they were non-responsive or resistant to the new protocols we’ve implemented. I simply let them know that this is how we need to run our practice right now, so I won’t be able to see them for the time being.

Greeting the client outside the treatment room:
• I’ve been leaving my door open so I can see them arrive (they don’t have to knock/touch the door).

• Ask them to leave their shoes outside.

• I put my mask/goggles in place before I step out of the room. I give them a cloth mask if they’ve forgotten their own.

• Wiping down my thermometer/blood ox monitor in their presence gives them peace of mind. I take their signs and relay the findings.

• Stepping aside to let them pass, I welcome them in and close the door behind us.

•• See an earlier post for health screening strategies. ••

Intake/Health History:
Before the session or in person, it’s important to ask them how they have been managing this stay-at-home time. Have they been using appropriate protocols or has their behavior been more risky? Do I trust that they’re being candid about this?

• Some clients do this on line; some bring it with them. For those that forget, I’ve been conducting a verbal intake.

• They sign it with a newly-wiped pen while I hold the clipboard. I receive the pen and wipe it down again.

Between sessions:
• First thing is to open the window and door to air the room out. This  helps to disperse possible contagion and the fumes from the disinfectants.

• Alongside changing over the linens, I’m wiping down the chair where the client sits, the floor between that chair and the table, my computer and phone, door knob/surfaces — anywhere we have touched during the session.

• Remove my mask/goggles and place them, carefully, in a paper bag specifically for this use.

• Wash my hands. Put lotion on them so they don’t get too dry.

• DRINK WATER! Wearing masks means we’re not taking in water during sessions. Actually this has been one of the biggest changes!

• Stretch, breathe, eat good food that makes me happy, whatever else is resourcing. In the past, with clients more closely scheduled, I would be task oriented between sessions: emails, paperwork, errands. These days, I let myself rest in between. It’s lovely.
Some things feel very different during COVID-19 precautions. Once the client is there and we start working, most of that fades into the background. The connection with their body, a focus on health and helping someone feel better: all of these are at the heart of our work and remain unchanged. It’s such a gift, for them and for us, to be able to share this healing time again.


By far, my favorite show that has an element of on-going negotiation about physical contact is Pushing Daisies. If film noir and musical theater had a baby, it would be this show. Private detectives, requited and unrequited love, campy design, pies, a musical number or two and great big heart at its center. How did it get canceled after only 2 seasons?! Why is it no longer available streaming?? For your birthday, ask for the DVDs. Try the library. Come to my house.

So in lieu of that, still in a light-hearted, comedy of errors meets detective story vein: watch Pink Panther. The original with Peter Sellers — fabulous. The remake with Steve Martin — wonderful.