Private Practice Startup Podcast

Episode 177b: Coronavirus – How to Prepare Your Practice

Date: March 16, 2020
Hosts: Dr. Kate Campbell & Katie Lemieux
Guest: Camilla Gamba (Psychotherapist, Milan, Italy)

Episode Overview

This special episode delivers a real-time, international perspective on how psychotherapists can prepare their practices for the challenges posed by the COVID-19 pandemic. Featuring guest Camilla Gamba, podcasting live from Milan—one of the first European epicenters—the conversation explores practical, clinical, and emotional strategies for transitioning private practices online, maintaining client relationships, and coping with uncertainty. Camilla shares her firsthand experience navigating rapid change, uncertainty, and the psychological and logistical ripple effects on practitioners and clients.

Key Discussion Points & Insights

1. The Rapid Escalation in Italy: Learning from the Future

• Timeline of Events ([03:34] – [11:15])
  • First local case appeared near Milan.
  • Within three weeks, total lockdown.
  • Progression from in-person, to optional online, to full virtual sessions.
  • Government/law boards recommended but did not enforce online-only sessions; Camilla made the shift following guidance.

“Three weeks ago we had the first case near Milan and in three weeks now here we are, total lockdown.” – Camilla [01:20]

• Key Takeaway:
  Act quickly—what happened in Italy may occur in other countries within weeks.

2. Client Communication and Proactivity

• Early and Frequent Contact ([04:54] – [07:25])
  • Camilla sent a series of proactive emails to clients, first about hygiene, then about shifting online.
  • Therapists who did not communicate saw more cancellations.
  • Transparency—even with uncertainty—builds trust and keeps clients engaged.

“Even if it's just ‘we don't know what we're doing, but we'll let you know’, that was one of the discriminating factors between getting a lot of cancellations and not getting cancellations.” – Camilla [06:24]

3. Deciding When to Move Online

• Balancing Caution & Panic ([08:18] – [09:38])
  • Some clients and clinicians hesitated to go online; fear of “creating panic” vs. acting on best information available.
  • Lesson learned: switch to telehealth sooner rather than later to avoid unnecessary risk to all parties.

“If I can really share something that we learned for everyone who’s listening, switch to online—now’s the time to do it.” – Camilla [08:27]

• Practical Concerns:
  • Risk of client exposure; necessity of contacting all clients if a COVID case is traced to your office.
  • Online therapy can be logistically challenging, especially with couples and certain populations ([10:11]).

4. The Realities and Logistics of Quarantine Life as a Therapist

• Quarantined Practice Management ([16:29])
  • Have all clinical files, consents, and devices at home.
  • Update platforms: shift to HIPAA-compliant video (US regulations); notify clients about payment changes.
  • Create new routines and boundaries when working from home.

“If you have the time to prepare, do that—have your files at home, everything you need, just bring it at home and be ready.” – Camilla [15:19]

5. Self-Care for Clinicians

• Personal Impact and Adaptation ([18:38]-[20:31])
  • Regular routines disrupted; find new self-care methods.
  • Online socializing, creative community support (balcony music, online dinners & workouts).
  • Limit news intake to trusted sources to avoid anxiety overload.

“Every message that you always give about self care, having time for yourself and having a routine… I'm very happy it's been embedded in my mind.” – Camilla [18:38]

6. Content in Sessions: Addressing Client Anxiety and Broader Impacts

• Main Concerns are Economic and Social, not Medical ([23:35])
  • Most clients focus on working from home, children, job security, not just health.
  • “We're all happy that these measures have been taken, but we just have to cope with making them happen.” – Camilla [24:50]
  • For some, therapy session serves as “coronavirus-free zone”; for others, pandemic-linked anxiety is front and center ([21:54]).

7. Practical Business Considerations

• Policies, Procedures, and Financial Preparedness ([16:29] – [33:40])
  • Emphasize need for clear telehealth processes and consent forms.
  • Importance of emergency funds and business continuity plans (profit first method, cash reserves).
  • Use downtime for neglected business tasks: blogging, marketing, policy upgrades.

“I had my [Profit First] Excel sheet ... how many cancellations I could get before I have to worry and what the break-even point is for my practice. I had all these numbers.” – Camilla [32:23]

8. Social Responsibility and Community Spirit

• Collective Action Saves Lives ([14:54], [27:01])
  • Adopt mindset: “Act accordingly as if you may have it, to protect others.”
  • Strong social campaigns: hashtags like #iorestoacasa (“I am staying home”) & #andratuttobene (“everything will be fine”).

“There's nothing wrong with starting today just not going out, not socializing with friends ... you don’t know that friend may have… had coffee with another friend who then tested positive.” – Camilla [25:22]

“Andratuttobene ... means ‘everything’s gonna be fine.’ And we are a community… your group of therapists ... Now I think we're realizing that we're a global community.” – Camilla [35:39]

Notable Quotes & Memorable Moments

• On Taking Early Action:
  “If I could go back in time, I wouldn't have [kept seeing clients in-person] ... Switch to online, now's the time to do it.” — Camilla [08:27]

• On the Therapist's Dilemma:
  “You're going through the same thing that your clients are going through… and yet, at the same time, there's that expectation that you have to have it together.” – Kate [18:06]

• On Community and Hope:
  “There's another trending hashtag in Italy... andratuttobene ... people are hanging this outside their windows… it means everything's gonna be fine.” — Camilla [35:39]

• On Self-Care:
  “There was no doubt that I needed to take time out ... Quickly go into a new routine to make sure you’ve got that personal space to stay balanced.” – Camilla [18:38]

Key Takeaways & Action Steps

1. Act Fast: If you haven’t already, set up your practice for telehealth. Be proactive in communications, secure platforms, and paperwork. [08:27]
2. Streamline Logistics: Gather files and necessary materials so you can operate fully from home. Update clients about payment and session processes. [16:29]
3. Prioritize Self-Care: Form new routines for your own well-being. Limit media exposure to reduce anxiety. [18:38]
4. Support Your Clients, Support Yourself: Remember you and your clients are experiencing the crisis together. Create boundaries, and allow therapy to supply moments of normalcy. [21:54]
5. Financial Stability: Have emergency business funds set aside (e.g., Profit First model). Reflect on your finances now and plan for future disruptions. [32:23]
6. Stay Connected: Foster community—support groups, online meetups, creative ways to keep interpersonal connections strong. [29:29]
7. Embrace Flexibility: Accept the unknown, adapt routines and policies, and keep your practice moving forward—there is no need to panic. [35:39]

Important Timestamps

• 00:30 – Introduction to Camilla and the episode’s urgency
• 03:34 – Camilla shares the Milan escalation story
• 06:24 – The importance of therapist communication
• 08:27 – Why and when to move fully online
• 16:29 – Logistics: preparing files and home setup
• 18:38 – Therapist self-care during quarantine
• 21:54 – Sessions as space apart from coronavirus
• 23:35 – Key anxieties in therapy: social & economic impact
• 25:22 – Healthy community mindset & responsible behavior
• 32:23 – Financial preparedness and business survival
• 35:39 – Final takeaways: seriousness without panic, hope, and collective support

Final Words

“Take what's happening very seriously, but there's no need to have anxiety over it... We're definitely all in this together.” — Camilla [35:39]

Resource Highlight:
The Private Practice Startup hosts are offering a $20 discount on their attorney-approved technology-assisted counseling (telehealth) consent form—use code “BE WELL”.

For more information and resources, visit: PrivatePracticeStartup.com