In-person counselling: Protocols for returning to operation
These protocols are for those providing in-person counselling services, including psychiatrists, psychologists, social workers, and counsellors. These employers may also benefit from reviewing protocols related to office space and health professions. Employers must also ensure they are abiding by any orders, notices, or guidance issued by the provincial health officer, and the appropriate health authority, that are relevant to their workplace.
Developing a COVID-19 safety plan
Employers are required to develop a COVID-19 Safety Plan that outlines the policies, guidelines, and procedures they have put in place to reduce the risk of COVID-19 transmission. This plan follows the six steps outlined on COVID-19 and returning to safe operation. Employers must involve frontline workers, joint health and safety committees, and supervisors in identifying protocols for their workplace. You do not need a formal plan in place to begin operation, but are expected to develop it while protecting the safety of your workers.
Employers are not required to submit plans to WorkSafeBC for approval, but in accordance with the order of the provincial health officer, this plan must be posted at the worksite. During a WorkSafeBC inspection, we will ask employers about the steps they have taken to protect their workers or to see the plan if it has been developed.
One part of developing your COVID-19 Safety Plan is identifying protocols that everyone at the workplace must follow to keep workers safe. We’ve provided industry-specific protocols below to consider as you develop the plan for your workplace.
These protocols are not a list of requirements; however, they should be considered and implemented to the extent that they address the risks your workplace. You may need to identify and implement additional protocols if the protocols suggested here do not sufficiently address the risk to your workers.
Understanding the risk
The virus that causes COVID-19 spreads in several ways, including through droplets when a person coughs or sneezes, and from touching a contaminated surface before touching the face. Higher risk situations require adequate protocols to address the risk.
- The risk of person-to-person transmission is increased the closer you come to other people, the amount of time you spend near them, and the number of people you come near. Physical distancing measures help mitigate this risk.
- The risk of surface transmission is increased when many people contact same surface, and when those contacts happen in short intervals of time. Effective cleaning and hygiene practices help mitigate this risk.
Selecting protocols for your workplace
Note that different protocols offer different protection. Wherever possible, use the protocols that offer the highest level of protection and add additional protocols as required.
First level protection (elimination): Limit the number of people in your workplace where possible by implementing work-from-home arrangements, establishing occupancy limits, rescheduling work tasks, or other means. Rearrange work spaces to ensure that workers are at least 2 m (6 ft) from co-workers, customers, and members of the public.
Second level protection (engineering controls): If you can’t always maintain physical distancing, install barriers such as plexiglass to separate people.
Third level protection (administrative controls): Establish rules and guidelines, such as cleaning protocols, telling workers to not share tools, or implementing one-way doors or walkways.
Fourth level protection (PPE): If the first three levels of protection aren’t enough to control the risk, consider the use of non-medical masks. Be aware of the limitation of non-medical masks to protect the wearer from respiratory droplets. Ensure workers are using masks appropriately.
Protocols for in-person counselling
- Where possible, provide virtual services for clients and offer in-person services only if necessary.
- Use alternate work practices to reduce the number of workplace visitors (clients, delivery persons, etc.).
- Consider a plan or policy that speaks to COVID-19 related issues; this can be communicated to clients and help to standardize practices among counsellors.
- Communicate illness policy and safety protocols with clients through email or website before entry into the workplace. Consider recording a video or voice message to educate and inform clients about service delivery changes.
- Consider adjusting cancellation policy to allow for clients to cancel or reschedule in-person appointments without penalty if they develop symptoms.
- Refrain from home visits and transportation of clients to minimize physical contact.
- Consider whether an informed consent for in-person services during COVID-19 is appropriate (see the APA Services website for an example); this should be communicated to clients prior to in-person services.
- Consider maintaining virtual services, if in-person informed consent is not agreed upon by client.
- Establish policies and procedures around when clients can access the workplace. Ask clients when booking whether they have symptoms of COVID-19. Ask them to cancel or reschedule their appointment if they develop symptoms or have a family member who has confirmed or suspected COVID-19. Remind clients of this policy when they arrive for their appointment.
- Ensure that all in-person appointments are scheduled and staggered to allow time to sanitize surfaces between appointments (e.g., schedule a break or virtual session following an in-person appointment) and to minimize contact with others.
- Identify any risks that arise from the reduction of people at the worksite; for example, counsellors working alone and/or with high-risk populations. Address these risks as required.
- Post COVID-19 protocols using signage for both workers and clients throughout the workplace. Consider posting signage in other majority languages or provide pictograms. This may be posted at entrance and/or exit locations, if practicable. WorkSafeBC has signage available for this purpose.
- Consider asking clients to wait in their vehicles, or outside the office if possible, until just before their appointment or when they are called or texted to come in.
- Plan the work and anticipate areas where physical distancing cannot be maintained (e.g., corridors, small offices, etc.). Consider single-person access if entry into constricted area is required.
- Determine occupancy limits for each workplace area to maintain the physical distancing requirement and ensure total number of people do not exceed this limit.
- Consider creating cohorts of workers who work together and who do not interact with other cohorts. This will assist in reducing transmission throughout the workplace in the event that a staff member becomes ill.
- Waiting areas should be arranged to maintain the physical distancing requirement. Install barriers (e.g., plexiglass) between receptionists and visitors. Place markings on the floor directing visitors where to stand to communicate with front desk staff.
- Provide clients with a direct and accessible route to sit in the waiting area and during the therapy session to ensure physical contact is not required to access the seating area(s).
- Remove non-essential items from the reception area and treatment areas, such as candy, magazines, booklets, pamphlets, and complimentary phone chargers.
- Where elevator use is required to access the office, ensure clients maintain physical distancing and use of the elevator is staggered. WorkSafeBC has occupancy limit signage for employers to post.
- Restrict access to clients only where possible (i.e., no children, friends, or family accompaniment allowed). Include consideration for disabled individuals and those who require accompaniment (e.g., a parent or guardian).
- Provide handwashing facilities or hand sanitizer for clients to use upon entry to the workplace.
- Use alternative forms of greetings and avoid hand shaking or close contact.
- Consider implementing alternative forms of treatment that do not require physical contact.
- For couples or family counselling, ensure that clients who attend are from the same household or “social pod.” Where appropriate, consider outdoor sessions for couples or family counselling to ensure the physical distancing requirement. Confidentiality considerations should be made when providing sessions outdoors or in public settings.
- Try to limit the use of cash and limit the handling of credit cards whenever possible, by allowing clients to scan or tap their cards and handle the card readers themselves. Encourage tap payment over pin pad use.
- Limit the use of communal pens and refrain from exchanging items before and after the appointment (e.g., send receipts, documents, and reports electronically).
- If it is not possible to maintain physical distancing with clients, consider the use of masks. Masks can reduce the spread of droplets from the wearer, but may not prevent the wearer from inhaling the droplets of others. It is therefore important to ensure that clients as well as the counsellor are wearing masks to ensure protection for both parties. Refer to WorkSafeBC’s guidance on the selection and use of masks.
- Implementing hand hygiene practices and avoiding face touching with unwashed hands can prevent infection transmission. This is particularly effective before and after breaks or meeting clients, even in the absence of physical contact. Refer to WorkSafeBC’s cleaning and hygiene protocols.
- If masks will be used at the workplace, post signage about the correct use of masks.
- Ensure good respiratory etiquette by covering the mouth and nose with the crease of the elbow or with a disposable tissue when coughing or sneezing. Encourage clients to do the same.
- Where practicable, use of touchless hand sanitizer dispensers, garbage bins, etc. can be helpful to minimize the transmission of infection through physical contact.
- Ensure used tissues, disinfectant wipes, and safety equipment are properly disposed of in a lined waste receptacle that is emptied at least daily. Waste receptacles should not require physical contact (e.g., removal of lid) to discard items.
- Minimize sharing office space or work stations. Ensure counsellors use their own equipment (e.g., pens, staplers, computers). If required, clean and disinfect frequently touched surfaces before leaving the space, such as the computer keyboard and mouse, desk surface, and telephone.
- Refrain from providing and consuming communal food. Consider providing bottled water instead of community water coolers or fountains.
- In office spaces that allow pets, request that they do not come or are restricted to another area of the workplace.
- Counsellors should ensure that they are sanitizing all high touch services (e.g., door handles, light switches) before and after a client attends an in-person appointment.
- Establish hygiene practices that address the needs of the workplace and that includes the requirement to wash or sanitize hands after coming into contact with public items.
- Request contactless delivery to maintain physical distancing requirement (e.g., delivery person leaves packages in a pre-arranged location) where possible.
The following links may have additional information, guidance, or resources that may assist you in the development of your plan.
A PDF version of the industry protocols is available for printing.
For more information
The information on this page is based on current recommendations and may change. For the latest guidance, please see the health information from the British Columbia Centre for Disease Control and the latest news from the government of British Columbia.
If you have a question or concern
Workers and employers with questions or concerns about workplace exposure to COVID-19 can call WorkSafeBC’s Prevention Information Line at 604.276.3100 in the Lower Mainland (toll-free within B.C. at 1.888.621.SAFE). You’ll be able to speak to a prevention officer to get answers to your questions, and if required, a prevention officer will be assigned to assess the health and safety risk at your workplace.