Bulletin

32 | Bulletin vol. 34 no. 1 Check your own anxiety and prioritize self-care. It is important for providers to be aware of their own levels of stress and anxiety regarding the pandemic and to consider the effect it may have on patients and other individuals. Practitioners should also remember to prioritize their own self-care. There may be times when a provider needs to take a step back and focus on their own mental and physical wellbeing. APA offers a wealth of self-care resources on its website. Consider virtual visits when possible. Clearly, the most effective way to minimize exposure to the Covid-19 virus is to conduct virtual visits whenever feasible. Clinical interviews, feedback, and therapy sessions often lend themselves rather well to virtual visits. In many cases, neuropsychological testing can also be conducted virtually. Discussion of teleneuropsychology and telehealth services in general is beyond the scope of this tip sheet for resuming in-person neuropsychological evaluation visits; however, extensive information and numerous training opportunities are available from various national, state, and local professional organizations. Prior to conducting neuropsychological services virtually, practitioners are strongly encouraged to seek out training opportunities and to familiarize themselves with practice guidelines, state licensing laws and board rules, HIPAA compliant technology, billing and reimbursement issues, and ethical guidelines of telehealth and teleneuropsychology. Open the lines of communication proactively. Living and working during a global pandemic is a confusing time for both neuropsychologists and those we treat. Many problems that could potentially arise when resuming in-person visits can be prevented with clear information provided in advance of the appointment. Consider the following proactive communication strategies: • Contact patients and care providers prior to their visit and inform them of new clinic policies set in place to minimize virus transmission, such as enhanced screening tools, temperature checks, and visitor restrictions. Clearly inform them that they will be expected to abide by safety precautions during their visit, including CDC recommendations of physical distancing and infection control, including frequent handwashing and consistent use of face coverings. Contrary to some policies and popular belief, young children (who are in fact able to carry and transmit Covid-19) are quite capable of wearing a face covering. Although there may be an adjustment period, a child can learn to wear a mask appropriately and consistently and should be prepared to do so for their appointment. These tips may be helpful for children and families, which can be provided in advance of their visit. • Encourage patients and care providers to stay home if they are experiencing any symptoms or have been in close contact with another person who is sick. Given that many may have waited for quite some time to have their clinical neuropsychological evaluation appointments, it can be helpful to reassure them that you will make every effort to reschedule their appointment in a timely manner if they must cancel due to suspected illness or increased risk. • Reassure patients and care providers that although there have been some changes, you are ready to provide the same level of excellence in your clinical care as you always have. Consider informing them of practice changes in an introductory email, letter, phone call, or even short video. Providers at St. Charles Medical Group in Oregon have created this short video, which they send to families scheduled for evaluations in their pediatric clinic. Additional Tips for Providers Who Supervise: Academic institutions and training sites have both been directly affected by the pandemic, thus existing arrangements between "approved" institutions and sites need to be re-evaluated to ensure that the needs and requirements are met for all parties involved. Supervisors and supervisees should ensure full understanding and agreement of polices at both the academic institution and training site before the start of the training rotation. Familiarize yourself with the policies of your supervisee's academic institution and determine if you can meet their needs. Academic institutions have likely put into place policies and guidelines regarding the supervision of students during the Covid-19 pandemic. It is important to determine if there are any rules that may limit a student's full participation in your training program. Similarly, it is important to determine if there are any limitations with respect to how a supervisee acquires hours. For instance, will hours earned in the provision of telehealth services be counted toward their degree plan? What will happen if the training site is temporarily required to close or if patient volume is unexpectedly low? Consider consulting with your supervisee's course instructor and/or program director regarding these issues and encourage your supervisee to do the same. Also, consider modifying existing written site agreements to reflect these issues and to address various possible scenarios which may arise during the training period. Adhere to the policies of your institution and its clinical training program. Consult with your institution's credentialing office prior to the start of your supervisee's rotation to determine what additional training related to Covid-19 and the provision of telehealth services might be required of them and ensure your institution can provide it. If your program is APA accredited, seek guidance regarding compliance issues from the Office of Program Consultation and Accreditation. If your program is a member of the Association of Postdoctoral Programs in Clinical, review the Training Counsel's guidelines and recommendations. Encourage your supervisee to contact their licensing board and seek guidance through student divisions of professional organizations. State laws and board rules will vary with regard to supervision and training requirements, particularly as they relate to the provision of telehealth services and telesupervision, and particularly if psychological services and/or supervision cross state lines. Some states have issued emergency orders which may ease

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