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Part three: How to deal with patient contact in-between therapy delivery

Part three: How to deal with patient contact in-between therapy delivery

As Ieso's Chief Clinical Officer and chair of the BABCP IT Special Interest Group, Sarah Bateup provides advice and guidance to clinicians on how to adapt working practices and deliver therapy effectively during the current coronavirus outbreak.

In this regular blog series, Sarah will cover many topics including:

  • The best preparation for seeing patients using digital therapy methods during COVID-19
  • Housekeeping and consent when moving to digital therapy methods
  • How to deal with patient contact in-between therapy delivery
  • The common phenomena when moving to non-face to face therapy delivery
  • …and much more.

As we navigate through the coming weeks and months and adjust to this changing world, we will continue to provide guidance on digital therapy methods, and what to think about and look out for during this challenging time.

Part three: How to deal with patient contact in-between therapy delivery

Communication between digital therapy sessions is mainly for practical reasons, for example, to change or cancel an appointment. However, if you want to amplify the effect of your therapy to your patients using between session contact, what is the best way to get it to work for you and your patient without your patient overstepping the boundaries? Hopefully, we can answer some of this for you here.

During three studies that we conducted last year, we taught groups of therapists to use in-between session messages with their patients. What we found on all three occasions is that:

  1. The number of sessions that the patient required was reduced and the overall recovery rate improved
  2. Not only do therapists find it helpful to communicate in-between sessions, but patients find it enormously beneficial too. A win-win for everyone

If you can work with your patient in between sessions, this doesn't necessarily mean you, as the therapist is working harder. Actually, the patient is working more, which stands to reason that this is probably going to have a very positive effect and amplify the impact of therapy. So how and what do you communicate and ensure your patient is happy for you to do so?

When we asked our therapists to think about communicating between sessions what we noticed is that they tend to ask check-in questions, such as 'how are you?' or 'how are things?'. But what we found is that doesn't really work very well because patients tend to say, 'I'm fine, thanks' or they don't really respond at all – which adds no value.

At Ieso, we are advocates of therapists using in-between messaging to bridge sessions, so asking questions around:

  • Preparing for the next session
  • Setting the agenda for next sessions
  • Focusing on the change mechanism that you are working on together

We found that when a therapist does any of those three things, magic happens. Patients really focus very closely on the work that you're doing together, and their mind is a lot more motivated. This also means the scheduled hour you have for your formal session, is much more productive and valuable. Again, this probably isn't rocket science, but it's good to point out.

Now this doesn't mean you are working harder; it just means you are thinking very carefully about a chosen sentence or two that you might ask your patient in between sessions. So, for instance, if you are doing a behavioural experiment, and you know the patient is doing the experiment that day, you may send a very simple message to ask how the experiment went. When the patient responds, you might just simply say, 'Well, that's interesting. What do you make of that?'. Just by using a very gentle Socratic method with a Socratic question, you begin to tease some learning from your patient and encourage them to consolidate any learning that they have. All this makes progress a little bit quicker.

This is just a taster of how you can get more from in-between messaging and questions, and one you, as a therapist, can do more within your sessions to get more from your patients – helping their recovery.

In the next blog in this series, we will cover the common phenomena when moving to non-face to face therapy delivery. Please take the time to read our other blogs by clicking the links below:

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