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Excerpt from Clinical Practice Today (June 2014)
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Vicissitudes of Summer Practice

Edited by Bet MacArthur, LICSW


Dear CPT: I see that I could protect myself from the inevitable summer decline in client hours by providing vacation coverage for nearby private practice colleagues. But this seems like a potentially tricky role to play. What are best practices for ‘brief interim’ therapists?

—AG, LICSW, Malden

Dear CPT: What can I do to minimize the impact on my practice each summer when my clients, most of whom are college students, leave town for two or three months? How do I ‘hold’ their spaces for fall? And what’s an appropriate framing of that sort of ‘hiatus’ in the therapy?

—AC, LICSW, Boston

Summertime is so precious to us in New England, since it is all too brief. People are dedicated to making the most of it, with leisure time and travel, but these two questions highlight some of the complications of summer practice for those who stay at work.

Certainly, staying ‘in town’ during the summer brings some therapists a boom in intakes, since so many other providers are away. Some even regard the summer months as the time to build their caseloads for the rest of the year.

The other special role for therapists in the summer is coverage for vacationing colleagues. Question #1 was correct in stating this role calls for some specialized skills.

First of all, most therapies are simply suspended over the therapist’s vacation, so the interim provider’s role is “just in case” of need. In other cases, a client may need to be seen regularly while the main therapist is away. (This is more common for more extended therapist absences, typically due to travel or illness, not vacation.) Either way, signed releases must be obtained from all clients being covered, whether or not there is a likelihood of need. This permits the vacationing therapist and the interim one to talk openly about each case in advance and during the break, as needed. Certainly they ought to meet live or by phone, to review every case being covered, even if only “in case.”

What about payment for interim services? In the past, in some circumstances the main provider could bill insurance for sessions conducted by the covering one. With a few exceptions, this is no longer true in private practice settings. Therapists who need summer coverage try to find seasoned colleagues whose differences in style or approach will not be too jarring to the client, and who are on the same insurance panels as the vacationing provider. This is usually not an easy task...


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